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Photophobia, also known as light sensitivity, is a symptom of abnormal visual intolerance to light.[1] It can manifest as discomfort or pain. It occurs in ME/CFS as part of a range of sensitivities such as allodynia, hyperacusis and misophonia. Photophobia also forms part of the wide range of ocular symptoms that occur in ME/CFS.

Prevalence[edit | edit source]

  • A 2013 study by Hutchinson, et al, using a patient population of 59 answering questions on the DePaul Symptom Questionnaire found that the most common vision-related symptom was sensitivity to bright lights with a 92% prevalence.[2]
  • In a 2001 Belgian study, 70.7% of patients meeting the Fukuda criteria and 75.8% of patients meeting the Holmes criteria, in a cohort of 2073 CFS patients, reported photophobia.[3]
  • In 1995, Katrina Berne, PhD, reported a prevalence of 65-90% for 'photosensitivity'.[4]

Symptom recognition[edit | edit source]

Photophobia is not a symptom required for diagnosis in any definition. In the Canadian Consensus Criteria, it appears under the section Neurological/Cognitive Manifestations and can be used to form a diagnosis.[5] The International Consensus Criteria also lists photophobia as a diagnostic criteria, under the section Neurosensory, perceptual and motor disturbances.[6]

  • In the Holmes criteria, photophobia is an optional criteria for diagnosis, under the section Minor Symptom Criteria - Neuropsychologic Complaints.[7]

No other definitions mention photophobia.

Notable studies[edit | edit source]

There have been no studies done specifically on photophobia in ME/CFS.

Possible causes[edit | edit source]

Photophobia can be caused by the pupil dilating rather than contracting when exposed to a light source. Pupil dilation is controlled by the sympathetic nervous system, which is usually hyper-responsive in people with ME/CFS due to an excess of excitatory neurotransmitters.[8]

A magnesium deficiency can cause photophobia, and such deficiency is common in ME/CFS.[9] This can be resolved with appropriate magnesium supplementation.

Some medications have photophobia listed as a side effect, notably benzodiazepines.[10][11]

Photophobia is also often caused by illnesses that are common comorbidities of ME/CFS, such as Sjögren's syndrome,[12] TMJ,[13] migraines,[14] Ehlers-Danlos syndrome,[15] infectious mononucleosis,[16][17] chiari malformation,[18] dyslexia[19] and lyme disease.[20]

Potential treatments[edit | edit source]

There are no treatments that specifically target photophobia. It is usually resolved by treating the underlying cause. Treatable causes of photophobia include magnesium deficiency, and when photophobia occurs as a side-effect of medication. If the photophobia is caused by a comorbid illness, treatment may help alleviate the symptom.

In the absence of successful treatment, discomfort can be ameliorated by avoiding bright lights, keeping curtains drawn, and wearing an eye mask or dark glasses. When going outside, wearing dark glasses or other special glasses and hats can help.[8]

Learn more[edit | edit source]

See also[edit | edit source]

References[edit | edit source]

  2. Hutchinson, Claire V; Maltby, John; Badham, Stephen P; Jason, Leonard (2013), "Vision-related symptoms as a clinical feature of chronic fatigue syndrome/myalgic encephalomyelitis? Evidence from the DePaul Symptom Questionnaire", The British journal of ophthalmology, 98 (1), doi:10.1136/bjophthalmol-2013-304439 
  3. De Becker, P; McGregor, N; De Meirleir, K (Sep 2001), "A definition-based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome.", Journal of Internal Medicine, 250 (3): 234-240, PMID 11555128 
  4. Berne, Katrina (1 Dec 1995), Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS), 2nd ed., Hunter House, p. 59, ISBN 978-0897931915 
  6. Carruthers, BM; van de Sande, MI; De Meirleir, KL; Klimas, NG; Broderick, G; Mitchell, T; Staines, D; Powles, ACP; Speight, N; Vallings, R; Bateman, L; Baumgarten-Austrheim, B; Bell, DS; Carlo-Stella, N; Chia, J; Darragh, A; Jo, D; Lewis, DP; Light, AR; Marshall-Gradisnik, S; Mena, I; Mikovits, JA; Miwa, K; Murovska, M; Pall, ML; Stevens, SR (22 August 2011), "Myalgic encephalomyelitis: International Consensus Criteria", Journal of Internal Medicine, 270 (4): 327–338, doi:10.1111/j.1365-2796.2011.02428.x, PMID 21777306 
  7. Holmes, Gary P.; Writing Committee (1988), "Chronic Fatigue Syndrome: A Working Case Definition", Annals of Internal Medicine, 108 (3): 387-389, PMID 2829679 
  8. 8.0 8.1 Verrillo, Erica (14 September 2012), "Symptoms - Photophobia", Chronic Fatigue Syndrome: A Treatment Guide, 2nd Edition (Kindle eBook) 
  9. Durlach, Jean; Morii, Hirotoshi; Nishizawa, Yoshiki (March 6, 2007), "10: Clinical forms of Magnesium Depletion by Photosensitization and Treatment with Scototherapy", New Perspectives in Magnesium Research, Springer London, pp. 117–126, doi:10.1007/978-1-84628-483-0_10, ISBN 978-1-84628-388-8 
  10. Wakakura M, Tsubouchi T, Inouye J (March 2004), "Etizolam and benzodiazepine induced blepharospasm", J. Neurol. Neurosurg. Psychiatr., 75 (3): 506–7, doi:10.1136/jnnp.2003.019869, PMID 14966178 
  11. Pelissolo A; Bisserbe JC (Mar–Apr 1994), "[Dependence on benzodiazepines. Clinical and biological aspects]", Encephale, 20 (2): 147–57, PMID 7914165 
  12. Reference needed
  13. Reference needed
  14. Drummond PD (October 1986), "A quantitative assessment of photophobia in migraine and tension headache", Headache, 26 (9): 465–9, doi:10.1111/j.1526-4610.1986.hed2609465.x, PMID 3781834 
  15. Dr. Diana Driscoll, Ehlers-Danlos Eye Dr PDF
  16. A.D.A.M
  17. Gauthier-Smith, P.C. (December 22, 2004), "Neurological complications of glandular fever (infectious mononucleosis)", Brain, Oxford University Press, 88 (2): 323–334, doi:10.1093/brain/88.2.323, PMID 5828906 
  18. Reference needed
  19. Light sensitivity — photophobia, Royal National Institute of Blind People 
  20. Reference needed

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From MEpedia, a crowd-sourced encyclopedia of ME and CFS science and history