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Photophobia and Anterior Uveitis
Published in Amy-lee Shirodkar, Gwyn Samuel Williams, Bushra Thajudeen, Practical Emergency Ophthalmology Handbook, 2019
Photophobia implies a painful sensitivity to light, nothing more, nothing less. Some health professionals seem to automatically link photophobia with iritis, more properly termed anterior uveitis, but there are in fact several other important causes that need to be excluded before such a diagnosis can be made. Patients with sudden onset acute light sensitivity, particularly if this is the first ever episode, may present to accident and emergency. This is usually not so convenient as after a 4-hour wait the harried casualty officer usually has not much more ophthalmic experience than their week's worth of training in medical school. After using a broken down slit lamp to ascertain that, yes, the patient is photophobic will then call the on call ophthalmologist without a visual acuity test and without having performed a useful examination.
Ophthalmologic Side Effects
Published in Ayse Serap Karadag, Berna Aksoy, Lawrence Charles Parish, Retinoids in Dermatology, 2019
Photophobia (ocular discomfort or pain associated with light exposure) is a symptom that is associated with a wide spectrum of ocular or extraocular pathologies, such as migraine headaches. Photophobia is commonly seen in association with various ocular inflammatory conditions such as uveitis, keratitis, allergic conjunctivitis, and dry eye disease. UVA exposure of isotretinoin results with its photoisomerization to other retinoic acid products and photolysis to other degradation products which is a possible mechanism for explaining the photosensitivity (26). Development of dry eye disease is obviously an important contributing factor for the development of photophobia associated with this treatment; however, it is unclear whether the photosensitizing property of the isotretinoin molecule under UVA exposure is linked with photophobia in the eyes, as well. Management of this disturbing finding includes treatment of the underlying pathology (such as dry eye disease) and the use of sunglasses.
Meningitis
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Bacterial meningitis has a rapid onset, within days. The classical triad of fever, neck stiffness and altered mental status are only present in less than half of the cases. Other symptoms may include photophobia, vomiting and headache. Almost all adults present with at least two of the four signs and symptoms of headache, fever, neck stiffness, and altered mental status. One-third of adults may present with focal neurological deficits. In contrast, in children and elderly populations the clinical symptoms often can be ambiguous.
A Stereotyped Syndrome with Retro-Ocular Pain, Photophobia, and Visual Disturbance Masquerading as Optic Neuritis: Case Series
Published in Neuro-Ophthalmology, 2018
Joanna M. Jefferis, Revelle Littlewood, Irene M. Pepper, Simon J. Hickman
Photophobia is defined as pain (in the eye or head) secondary to light exposure.1 It is a common feature of migraine, reported in up to 80% of migraineurs,2 and is a feature of both classical migraine and migraine without aura.3 The neural pathways accounting for photophobia have been proposed to include non-image-forming photosensitive retinal ganglion cells containing melanopsin4–6; and even light responsive pathways independent of the retina and optic nerve.7,8 These light responsive pathways enable light to modulate the trigemonovascular pathway such that bright light increases sensitivity to trigeminal stimuli.9,10 Migraineurs seem to have a particular susceptibility to photophobia and this heightened susceptibility persists following a migraine attack and results in a drop in pain perception thresholds following light stimulation.10,11 Photophobia forms part of the diagnostic criteria for migraine headache in the international headache classification3 and is increasingly being recognised to have a complex, multi-factorial neural circuitry.1,9
A primary care physician’s approach to a child with meningitis
Published in Southern African Journal of Infectious Diseases, 2018
I Govender, C Steyn, G Maricowitz, CC Clark, MC Tjale
Symptoms include headache and photophobia.3 Cryptococcal meningitis can present with acute or chronic headache in the older HIV-infected child. TB meningitis can have a gradual onset with vague complaints of drowsiness, fatigue, and headache. In new-born infants, symptoms such as poor suckling, vomiting, recurrent apnoea, temperature instability and seizures should raise suspicions. Infants (children below 1 year) frequently present with fever, irritability, vomiting, seizures, hypothermia, lethargy, respiratory distress, jaundice, poor feeding, diarrhoea, restlessness, excessive crying and/or a bulging fontanelle.4,5 Infants often do not present with meningism, thus it is imperative to always have a high index of suspicion with any of the mentioned signs. Toddlers or children present with the triad of headache, fever and vomiting.4 Meningitis should furthermore be suspected with unexplained crying.6
Observer‐perceived light aversion behaviour in photophobic subjects with traumatic brain injury
Published in Clinical and Experimental Optometry, 2019
Phillip T Yuhas, Patrick D Shorter, Catherine E Mcdaniel, Michael J Earley, Andrew Te Hartwick
Photophobia is a pathological state in which innocuous light induces or exacerbates pain within the eye or head.1951 Behavioural aversions, such as squinting,1951 tearing,1951 blinking2007 and excessive eye movements,2015 accompany the perceived discomfort. Anterior segment diseases that incur ocular inflammation, such as herpes simplex keratitis1985 and iridocyclitis,1989 are often associated with photophobia; however, pathology anywhere along the visual pathways can elicit a painful response to light. Thus, photophobia has been reported in a variety of ocular and neurological conditions that do not induce ocular inflammation, including achromatopsia2017 and migraine.1986