Photophobia Associated with Traumatic Brain Injury: A Systematic Review and Meta-analysis

Abstract

SIGNIFICANCE:This study reports the prevalence and relative risk of photophobia in patients with traumatic brain injury (TBI).OBJECTIVES: This study aimed to conduct a systematic review and meta-analysis to determine the prevalence and relative risk of photophobia in patients with TBI.DATA SOURCES: Three databases were used for literature search: PubMed, EMBASE, and Cochrane Library.STUDY APPRAISAL AND SYNTHESIS METHODS: Publications reporting the prevalence of photophobia after TBI in patients of any age were included. A series of meta-regression analyses based on a generalized linear mixed model was performed to identify potential sources of heterogeneity in the prevalence estimates.RESULTS: Seventy-five eligible publications were identified. The prevalence of photophobia was 30.46% (95% confidence interval [CI], 20.05 to 40.88%) at 1 week after the injury. Prevalence decreased to 19.34% (95% CI, 10.40 to 28.27%) between 1 week and 1 month after TBI and to 13.51% (95% CI, 5.77 to 21.24%) between 1 and 3 months after the injury. The rapid decrease in the prevalence of photophobia in the first 3 months after a TBI injury was significant (P < .001). Three months post-TBI, the prevalence of photophobia leveled off to a near plateau with nonsignificant variability, increasing between 3 and 6 months (17.68%; 95% CI, 9.05 to 26.32%) and decreasing between 6 and 12 months since TBI (14.85%; 95% CI, 6.80 to 22.90%). Subgroup analysis of 14 publications that contained control data showed that the estimated risk ratio for photophobia was significantly higher in the TBI than in the control group during the entire 12 months after TBI. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS:This study demonstrates that photophobia is a frequent complaint after TBI, which largely resolves for many individuals within 3 months after the injury. For some patients, however, photophobia can last up to 12 months and possibly longer. Developing an objective quantitative methodology for measuring photophobia, validating a dedicated photophobia questionnaire, and having a specific photophobia International Classification of Diseases, Tenth Revision code would greatly improve data gathering and analysis.

Factors related to adverse long-term outcomes after mild traumatic brain injury in children: a scoping review

“…We found 15 systematic reviews of one or more risk factors for various mTBI outcomes. [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Eligibility criteria for these reviews varied and follow-up was not well defined, leading to diverse findings. For example, two reported older children had poorer outcomes 15 16 ; however, these included different age ranges (>20 years vs 2-18 years), outcomes (PCS vs quality of life) and methods, so comparisons are more nuanced.…”

Mild-to-Moderate Traumatic Brain Injury: A Review with Focus on the Visual System

“…A significant percentage of patients with mTBI report visual symptoms. Among the most common of these is photophobia, a form of light sensitivity in which light exposure causes eye and head pain [70][71][72]. Photophobia and its associated migraine-like symptoms are major sources of functional impairment in TBI [73].…”

Montreal Brain Injury Vision Screening Test for General Practitioners

“…Most studies estimate the prevalence of photophobia to be between 30 and 40% in the early stages. Even after a year, 20% of all patients will continue to report disturbance to ambient light (Merezhinskaya et al, 2021 ). Since these symptoms can be managed by the prescription of tinted glasses (Jackowski et al, 1996 ; Clark et al, 2017 ), a positive response to this question should also warrant a referral to a neuro-optometrist.…”