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[[File:UNREST Film Still Whitney.png|250px|thumb|right|[[Whitney Dafoe]] is a [[Severe and very severe ME|very severely ill ME]] patient that must stay in a dimly lit room. Here, he protects his eyes due to light and [[visual dysfunction]]]] '''Photophobia''', also known as '''light sensitivity''', is a symptom of abnormal visual intolerance to light.<ref>{{Cite web | title = photophobia|url=http://medical-dictionary.thefreedictionary.com/photophobia|website=The Free Dictionary}}</ref> It can manifest as discomfort or pain. It occurs in [[ME/CFS]] as part of a range of sensitivities such as [[hyperacusis]] and [[misophonia]] (sound sensitivity), and [[allodynia]]. Photophobia also forms part of the wide range of [[:Category:Ocular signs and symptoms|ocular symptoms]] that occur in ME/CFS. ==Prevalence== [[File:Photophobia Brea.JPG|250px|thumb|right|[[Jen Brea]] is using an eye mask]] *In 1995, [[Katrina Berne]] reported a prevalence of 65-90% for 'photosensitivity'.<ref name="Berne">{{Cite book | last = Berne | first = Katrina | date = Dec 1, 1995 | title = Running on Empty: The Complete Guide to Chronic Fatigue Syndrome (CFIDS)|edition=2|url= https://www.amazon.co.uk/Running-Empty-Complete-Chronic-Syndrome/dp/0897931912/ |publisher= Hunter House | page = 59 |isbn= 978-0897931915}}</ref> *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 [[Chronic fatigue syndrome|CFS]] patients, reported photophobia.<ref name="DeBecker2001">{{Cite journal | last = De Becker | first = Pascale | authorlink = Pascale De Becker | last2 = McGregor | first2 = Neil | authorlink2 = Neil McGregor | last3 = De Meirleir | first3 = Kenny | author-link3 = Kenny De Meirleir| date = Dec 2001 | title = A definition‐based analysis of symptoms in a large cohort of patients with chronic fatigue syndrome|url=https://onlinelibrary.wiley.com/doi/full/10.1046/j.1365-2796.2001.00890.x?sid=nlm%3Apubmed|journal=Journal of Internal Medicine|volume=250|issue=3|pages=234–240|doi=10.1046/j.1365-2796.2001.00890.x|quote=|via=}}</ref> *A 2013 study by Hutchinson, et al, using a patient population of 59 answering questions on the [[DePaul Symptom Questionnaire]] (DSQ) found that the most common vision-related symptom was sensitivity to bright lights with a 92% prevalence.<ref name="Hutchinson, 2013" /> ==Symptom recognition== Photophobia is not a symptom required for diagnosis in any definition. In the [[Canadian Consensus Criteria]] (CCC), it appears under the section ''Neurological/Cognitive Manifestations'' and can be used to form a diagnosis.<ref>{{Cite web|url=http://sacfs.asn.au/download/consensus_overview_me_cfs.pdf | title = Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Clinical Case Definition and Guidelines for Medical Practitioners - An Overview of the Canadian Consensus Document | last = Carruthers | first = Bruce | date = |website=sacfs.asn.au|publisher=|format = PDF | archive-url=|archive-date=|url-status=|access-date=}}</ref> The [[International Consensus Criteria]] (ICC) also lists photophobia as a diagnostic criteria, under the section ''Neurosensory, perceptual and motor disturbances''.<ref name="ICC2011criteria" /> *In the [[Holmes criteria]], photophobia is an optional criteria for diagnosis, under the section ''Minor Symptom Criteria - Neuropsychologic Complaints''.<ref name="Holmes, 1988" /> No other definitions mention photophobia. [[File:Chronically_Hopeful_Char_Profile_Pic.jpg|250px|thumb|right|Char, author at [[Chronically Hopeful]], writes of light sensitivity which she suffers daily but becomes worse during a flare.<ref name="ch">{{Cite news | url=http://chronicallyhopeful.com/mecfs-flares/ | title = ME/CFS flares: what do they feel like and how to cope | last = Char | first = | date = 2017-11-02|work=Chronically Hopeful|access-date=2018-10-11|archive-url=|archive-date=|url-status=|language=en-GB}}</ref> Patients will use sunglasses and some patients need to wear them indoors. [[Jessica Taylor-Bearman]] titled her memoir ''[[A Girl Behind Dark Glasses]]''<ref name="Girl-Behind">{{Cite book |url=https://www.amazon.com/Girl-Behind-Dark-Glasses/dp/1999805356 | title = A Girl Behind Dark Glasses | last = Taylor-Bearman | first = Jessica | date = 2017-07-01|publisher=Hashtag Press|isbn=9781999805357|language=English}}</ref>]] {{clear}} ==Notable studies == * 2000, Ocular manifestations in chronic fatigue syndrome<ref>{{Cite journal | last = Mastropasqua | first = Leonardo | author-link = | last2 = Ciancaglini | first2 = Marco | authorlink2 = | last3 = Carpineto | first3 = Paolo | authorlink3 = | last4 = Iezzi | first4 = Antonella | author-link4 = | last5 = Racciatti | first5 = Delia | authorlink5 = | last6 = Falconio | first6 = Gennaro | authorlink6 = | last7 = Zuppardi | first7 = Eduardo | last8 = Pizzigallo | first8 = Eligio| date = Sep 2000 | title = Ocular manifestations in chronic fatigue syndrome|url=http://link.springer.com/10.1007/s12009-000-0059-5|journal=Annals of Ophthalmology|language=en|volume=32|issue=3|pages=219–224|doi=10.1007/s12009-000-0059-5|issn=1530-4086|quote=|via=}}</ref> [http://link.springer.com/10.1007/s12009-000-0059-5 (Abstract)] * 2013, Vision-related symptoms as a clinical feature of chronic fatigue syndrome/myalgic encephalomyelitis? Evidence from the DePaul Symptom Questionnaire [https://dx.doi.org/10.1136/bjophthalmol-2013-304439 (Abstract)] ==Possible causes== 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]].<ref name="Verrillo1" /> A [[magnesium]] deficiency can cause photophobia, and such deficiency is common in ME/CFS.<ref name="durlach" /> This can be resolved with appropriate magnesium supplementation. Some medications have photophobia listed as a side effect, notably [[Benzodiazepine|benzodiazepines]].<ref>{{citation |vauthors=Wakakura M, Tsubouchi T, Inouye J |url=https://doi.org/10.1136%2Fjnnp.2003.019869 | title = Etizolam and benzodiazepine induced blepharospasm |journal=J. Neurol. Neurosurg. Psychiatr. |volume=75 |issue=3 | pages = 506–7 | date = March 2004 |pmid=14966178 |doi= 10.1136/jnnp.2003.019869}}</ref><ref>{{citation |journal=Encephale | date = Mar–Apr 1994 |volume=20 |issue=2 |pages=147–57 | title = [Dependence on benzodiazepines. Clinical and biological aspects] |url = https://pubmed.ncbi.nlm.nih.gov/7914165 | last = Pelissolo | first = A | last2 = Bisserbe | first2 = JC |pmid=7914165 }}</ref> Photophobia can also often caused by illnesses that are common comorbidities of ME/CFS, such as [[migraine]],<ref>{{citation | last = Drummond | first = PD | title = A quantitative assessment of photophobia in migraine and tension headache |journal=Headache |volume=26 |issue=9 | pages = 465–9 | date = October 1986 |pmid=3781834 |doi=10.1111/j.1526-4610.1986.hed2609465.x|url = https://doi.org/10.1111%2Fj.1526-4610.1986.hed2609465.x }}</ref> [[fibromyalgia]],<ref name="PMC3485070" /> [[dry eye syndrome|dry eyes]],<ref name="PMC3485070">{{Cite journal | title = Shedding Light on Photophobia | date = Mar 2012|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485070/|journal=Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society|volume=32|issue=1 | pages = 68–81 | last = Digre | first = Kathleen B. | author-link = | last2 = Brennan | first2 = K.C. | authorlink2 = |doi=10.1097/WNO.0b013e3182474548|pmc=3485070|pmid=22330853|access-date=|issn=1070-8022|quote=|via=}}</ref> idiopathic [[intracranial hypertension]] which can occur in [[Ehlers-Danlos syndrome]]<ref name="IIH">{{Cite journal | title = Neurological and spinal manifestations of the Ehlers–Danlos syndromes | date = 2017 | url=https://onlinelibrary.wiley.com/doi/abs/10.1002/ajmg.c.31549|journal=American Journal of Medical Genetics Part C: Seminars in Medical Genetics|volume=175|issue=1|pages=195–211 | last = Henderson | first = Fraser C. | last2 = Austin | first2 = Claudiu | last3 = Benzel | first3 = Edward | last4 = Bolognese | first4 = Paolo | last5 = Ellenbogen | first5 = Richard | last6 = Francomano | first6 = Clair A. | last7 = Ireton | first7 = Candace | last8 = Klinge | first8 = Petra | last9 = Koby | first9 = Myles | last10 = Long | first10 = Donlin | last11 = Patel | first11 = Sunil|language=en|doi=10.1002/ajmg.c.31549|issn=1552-4876}}</ref>, [[infectious mononucleosis]] (although this not common),<ref>{{Cite web|url=http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001617/ | title = Mononucleosis | last = A.D.A.M. Medical Encyclopedia | date = May 15, 2012 | website = PubMed Health|language=en|access-date=2018-08-07|archive-url=https://web.archive.org/web/20130118161429/http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001617/|archive-date=2013-01-18|url-status=dead}}</ref><ref>{{citation |doi=10.1093/brain/88.2.323 | last1 = Gauthier-Smith | first1 = P.C. | date = Dec 22, 2004 |url = https://doi.org/10.1093%2Fbrain%2F88.2.323 | title = Neurological complications of glandular fever (infectious mononucleosis) |journal=Brain |volume=88 |issue=2 |pages=323–334 |publisher=Oxford University Press |pmid=5828906}}</ref> [[chiari malformation]],<ref name="NHS-chiari">{{Cite web|url=https://www.nhs.uk/conditions/chiari-malformation/ | title = Chiari malformation | last = | first = | authorlink = | date = 2017-10-18 | website = National Health Service|language=en|archive-url=|archive-date=|access-date=2021-12-27}}</ref> [[dyslexia]]<ref>{{Cite web |url=http://www.rnib.org.uk/EYEHEALTH/EYECONDITIONS/EYECONDITIONSDN/Pages/photophobia.aspx | title = Light sensitivity — photophobia |publisher=Royal National Institute of Blind People }}</ref>, and [[lyme disease]].{{citation needed}} ==Potential treatments== 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.<ref name="Verrillo1" /> ==See also== * [[Hypersensitivity]] * [[Visual dysfunction]] * [[Dry eye syndrome]] * [[Eye pain]] ==Learn more== * [https://www.amazon.com/Girl-Behind-Dark-Glasses/dp/1999805356 A Girl Behind Dark Glasses] {{Cite book |url=https://www.amazon.com/Girl-Behind-Dark-Glasses/dp/1999805356 | title = A Girl Behind Dark Glasses | last = Taylor-Bearman | first = Jessica | date = 2017-07-01|publisher=Hashtag Press|isbn=9781999805357|language=English}} * [http://chronicallyhopeful.com/mecfs-flares/ ME/CFS flares: what do they feel like and how to cope] *[https://www.prohealth.com/me-cfs/library/prize-winning-animation-released-severe-day-84638?utm_campaign=Social%20Media%20-%20ME-CFS Prize-winning Animation Released for Severe ME Day]<ref>{{Cite news | url=https://www.prohealth.com/me-cfs/library/prize-winning-animation-released-severe-day-84638 | title = Prize-winning Animation Released for Severe ME Day - Prohealth| date = 2018-08-11|work=Prohealth|access-date=2018-08-16|language=en-US}}</ref> *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485070/ Shedding Light on Photophobia]<ref>{{Cite journal | last = Digre | first = Kathleen B. | last2 = Brennan | first2 = K.C.| date = 2012 | title = Shedding Light on Photophobia|url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3485070/|journal=Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society|volume=32|issue=1 | pages = 68–81|doi=10.1097/WNO.0b013e3182474548|issn=1070-8022|pmid=22330853|via=}}</ref> *[https://en.wikipedia.org/wiki/Photophobia Wikipedia - Photophobia] ==References== <references> <ref name="ICC2011criteria">{{citation | last1 = Carruthers | first1 = BM | authorlink1 = Bruce Carruthers | last2 = van de Sande | first2 = MI | authorlink2 = Marjorie van de Sande | last3 = De Meirleir | first3 = KL | authorlink3 = Kenny de Meirleir | last4 = Klimas | first4 = NG | authorlink4 = Nancy Klimas | last5 = Broderick | first5 = G | authorlink5 = Gordon Broderick | last6 = Mitchell | first6 = T | authorlink6 = Terry Mitchell | last7 = Staines | first7 = D | authorlink7 = Donald Staines | last8 = Powles | first8 = ACP | authorlink8 = A C Peter Powles | last9 =Speight | first9 = N | authorlink9 = Nigel Speight | last10 = Vallings | first10 = R | authorlink10 = Rosamund Vallings | last11 = Bateman | first11 = L | authorlink11 = Lucinda Bateman | last12 = Baumgarten-Austrheim | first12 = B | authorlink12 = Barbara Baumgarten-Austrheim | last13 = Bell | first13 = DS | authorlink13 = David Bell | last14 = Carlo-Stella | first14 = N | authorlink14 = Nicoletta Carlo-Stella | last15 = Chia | first15 = J | authorlink15 = John Chia | last16 = Darragh | first16 = A | authorlink16 = Austin Darragh | last17 = Jo | first17 = D | authorlink17 = Daehyun Jo | last18 = Lewis | first18= DP | authorlink18 = Donald P Lewis | last19 = Light | first19 = AR | authorlink19 = Alan Light | last20 = Marshall-Gradisnik | first20 = S | authorlink20 = Sonya Marshall-Gradisnik | last21 = Mena | first21 = I | authorlink21 = Ismael Mena | last22 = Mikovits | first22 = JA | authorlink22 = Judy Mikovits | last23 = Miwa | first23 = K | authorlink23 = Kunihisa Miwa | last24 = Murovska | first24 = M | authorlink24 = Modra Murovska | last25 = Pall | first25 = ML | authorlink25= Martin Pall | last26 = Stevens | first26 = SR | authorlink26 = Staci Stevens | title = Myalgic encephalomyelitis: International Consensus Criteria | journal = Journal of Internal Medicine | volume = 270 | issue = 4 | pages = 327–338 | date = Aug 22, 2011 | pmid = 21777306 | doi = 10.1111/j.1365-2796.2011.02428.x | url = http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2011.02428.x/full }}</ref> <ref name="durlach">{{Cite book | title = New Perspectives in Magnesium Research | last1 = Durlach | first1 = Jean | last2 = Morii | first2 = Hirotoshi | last3 = Nishizawa | first3 = Yoshiki|url=https://doi.org/10.1007%2F978-1-84628-483-0_10|chapter=10: Clinical forms of Magnesium Depletion by Photosensitization and Treatment with Scototherapy | date = Mar 6, 2007 |publisher=Springer London|doi=10.1007/978-1-84628-483-0_10 |isbn=978-1-84628-388-8 |pages=117–126}}</ref> <ref name="Verrillo1">{{cite book | last = Verrillo | first = Erica | authorlink = Erica Verrillo | title = Chronic Fatigue Syndrome: A Treatment Guide |edition = 2 | title-link = Chronic Fatigue Syndrome: A Treatment Guide - 2nd Edition | chapter = Symptoms - Photophobia | type = Kindle eBook | date = Sep 14, 2012}}</ref> <ref name="Holmes, 1988">{{Citation | last1 = Holmes | first1 = Gary P. | authorlink1 = Gary Holmes | last2 = Writing Committee | title = Chronic Fatigue Syndrome: A Working Case Definition | journal = Annals of Internal Medicine | volume = 108 | issue = 3 | page = 387-389 | date = 1988 | pmid = 2829679 | url = https://pubmed.ncbi.nlm.nih.gov/2829679 | doi = }}</ref> <ref name="Hutchinson, 2013">{{Cite journal | last1 = Hutchinson | first1 = Claire V | authorlink1 = | last2 = Maltby | first2 = John | authorlink2 = | last3 = Badham | first3 = Stephen P | authorlink3 = | last4 = Jason | first4 = Leonard | authorlink4 = Leonard Jason | title = Vision-related symptoms as a clinical feature of chronic fatigue syndrome/myalgic encephalomyelitis? Evidence from the DePaul Symptom Questionnaire | url = https://doi.org/10.1136%2Fbjophthalmol-2013-304439 | journal = The British journal of ophthalmology | volume = 98 | issue = 1 | page = | date = 2013 | pmid = | doi = 10.1136/bjophthalmol-2013-304439}}</ref> </references> [[Category:Signs and symptoms]] [[Category:Ocular signs and symptoms]] [[Category:Neurological signs and symptoms]] [[Category:Sensitivity signs and symptoms]]
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