BLOG: Dry eye and photophobia: The outlook may be rosy
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Key takeaways:
- Photophobia is difficult to understand and treat.
- Consider using FL-41 tinted lenses when dry eye patients complain of light sensitivity.
How many times have you seen a dry eye disease patient with little or no remaining clinical signs, only to learn that they are so stricken with photophobia that they’ve become nocturnal?
You know, just in case you missed the diagnosis of “vampire.”
Seriously, photophobia is one of the tougher symptoms to understand and to treat. Not just to treat as part of the dry eye disease (DED) thing, but to treat in general. Patients with chronic migraines and photophobia are routinely referred to our practice for consultations. Unfortunately, if DED wasn’t an obvious driver of the photophobia, we weren’t all that helpful. To be honest, even if we were able to successfully treat everything DED, solving for all the usual signs and symptoms, the photophobia often remained an issue.
Even though SkyVision has a full-service optical shop and great relationships with several very high-quality optical labs, I admit that I forgot about how helpful tinted glasses can be in these cases. Coming to the rescue in last month’s American Journal of Ophthalmology is an article by Reyes et al (and by that I mean “et Anat Galor”) on the effects of FL-41 tinted lenses on photophobia in patients with dry eye pain. These rose-colored lenses block 480 nm wavelengths. In this study of 25 individuals, light-evoked discomfort was surveyed, and subjects underwent functional MRI (fMRI) scans to evaluate the effects on brain activation to light stimuli with and without the FL-41 lenses.
It’s fair to say that the results are impressive: 19 of 25 subjects reported decreased light-evoked discomfort. Multiple areas in the brain showed increased activity when the light stimulus was applied. When the same stimulus was applied through the FL-41 lenses, there was a significant decreased activation in cortical areas involving the processing of the affective and sensory-discriminative dimensions of pain. The fMRI findings suggest that minimizing 480 nm wavelength light causes a decrease in activity in those areas of the brain responsible for at least a part of the pain patients with photophobia experience.
FL-41 tinted lenses have a role in treating photophobia in general. We should add them to our quiver when our dry eye patients complain of light sensitivity.
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