Because many of the photophobia patients surveyed in this study reported feeling like their optometrist didn't clearly explain the condition, better clinician education is needed. Photo: Angela Leshchinskiy on Unsplash. Click image to enlarge.

Photophobia is associated with a number of different ocular and neurological conditions. However, the most common causes of abnormal sensitivity to light are still not well-understood. To better equip primary eyecare providers, researchers recently initiated a retrospective chart review involving 147 patient records.

The following data was collected: demographics, presenting symptoms, medical history, examination findings, assessment and plan. Of the 147 patients, photophobia was the chief complaint for 133 (90.5%). The researchers found that 10 men and three women linked their symptoms to a recent injury. Seven men and one woman attributed their photophobia to an injury that occurred in the workplace.

The researchers reported that the mean age of presentation was 37 years, with the most frequent cause of photophobia being migraine headache (53.7%). Other causes were dry eye syndrome (36.1%), ocular trauma (8.2%), progressive supranuclear palsy (6.8%) and traumatic brain injury (4.1%).

The researchers observed that a significant number of patients left the clinic without a documented cause for their photophobia (25.9%). This included 11.7% of adults and 69.4% of children. These findings indicate, according to the study authors, that eyecare providers—particularly those who care for children—may not understand the most common causes of photophobia. As a result, they may not know what history questions to ask and what examination techniques to use.

“Photophobia affects patients of all ages, and many patients are left without a specific diagnosis, indicating a significant knowledge gap among ophthalmologists and optometrists evaluating these patients,” the study authors wrote. They are currently studying vision-related quality of life in patients with photophobia and developing a curriculum to help clinicians diagnose and treat photophobia in adults and children.

“We hope that a better understanding of the most common causes of photophobia, the pathophysiology of photophobia and the impact of photophobia on vision-related quality of life will help us better address the knowledge gap identified in this study,” the study authors concluded.

Buchanan TM, Digre KB, Warner JEA, et al. The unmet challenge of diagnosing and treating photophobia. J Neuroophthalmol. March 25, 2022. [Epub ahead of print].