Photophobia

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Algorithm

Medical History

  • Trauma, injury?
  • Dry eye symptoms?
  • Pain, redness?
  • Vision worse in brightness or darkness?
  • Excessive (involuntary) blinking?
  • Migraine?
  • Neurological problems, deficits?

Work-up

  • Improvement after administration of Oxybuprocaine eye drops?
  • Further investigations depending on the suspected underlying condition

Treatment

  • Treat the underlying condition
  • Tinted glasses with FL-41 filter
  • Note: dark sunglasses should not be worn indoors – counterproductive!

Sources

  • Digre KB, Brennan KC. Shedding light on photophobia. J Neuroophthalmol. 2012;32(1):68-81. doi:10.1097/WNO.0b013e3182474548
  • Albilali, A., & Dilli, E. (2018). Photophobia: When Light Hurts, a Review. Current Neurology and Neuroscience Reports, 18(9). doi:10.1007/s11910-018-0864-0
  • Wilkins AJ, Haigh SM, Mahroo OA, Plant GT. Photophobia in migraine: A symptom cluster?. Cephalalgia. 2021;41(11-12):1240-1248. doi:10.1177/03331024211014633
  • Katz BJ, Digre KB. Diagnosis, pathophysiology, and treatment of photophobia. Surv Ophthalmol. 2016 Jul-Aug;61(4):466-77. doi: 10.1016/j.survophthal.2016.02.001. Epub 2016 Feb 12. PMID: 26875996.