Visual photosensitivity threshold and objective photosensitivity luminance in healthy human eyes assessed using an automated ocular photosensitivity analyser: a step towards translation of a clinical tool for assessing photophobia

Abstract

To evaluate the visual photosensitivity threshold and objective photosensitivity luminance in healthy eyes, thereby providing a normative dataset that will lead to a better understanding of diseases causing photophobia. Methods:This was a prospective cross-sectional study. Emmetropes whose visual acuity was better than 0.18 logMAR (6/9) with no other ocular abnormality were included. Headache Impact Test-6 and visual light sensitivity questionnaires were administered. Visual photosensitivity threshold was measured subjectively using the ocular photosensitivity analyser. Objective photosensitivity luminance was assessed manually by evaluating videos recorded using an infrared camera and noting the intensity of light at the first squeezing reflex.Results: Seventy five normal subjects (age range, 7-71 years) were included.Median age was 32.7 years (inter-quartile range, 20.3-47.9 years). Forty (53.3%) were males. Median Headache Impact Test score was 38 (inter-quartile range, 36-42) and visual light sensitivity questionnaire score was 11 (inter-quartile range, 8-15). Mean (standard deviation) right eye, left eye and binocular visual photosensitivity threshold was 3.34 (0.78), 3.33 (0.81) and 3.37 (0.78) loglux, respectively.There was a significant negative correlation of visual light sensitivity questionnaire scores with right eye, left eye and binocular visual photosensitivity thresholds, and positive correlation of age with binocular visual photosensitivity thresholds. Mean (standard deviation) right eye, left eye and binocular objective photosensitivity luminance was 3.25 (0.55), 3.35 (0.47) and 3.15 (0.52) loglux, respectively. Age was only positively correlated with binocular objective photosensitivity luminance, and there was no correlation between age and right eye or left eye objective photosensitivity luminance. Conclusions:The study characterised, for the first time, objective photosensitivity luminance and established normative data for both visual photosensitivity

Vision-related quality of life, photoaversion, and optical rehabilitation in achromatopsia

“…Our study has limitations. When investigating photoaversion and the effect of light-absorbing filters, it would have been preferable to have objective measures of photoaversion; this is, however, difficult as there is no validated method to do so, and the methods under development, e.g., the ocular photosensitivity analyzer, 13,14 are not commercially available. Another limitation is the lack of standardized lighting conditions when testing the different filters.…”

Correlations between the Michigan Retinal Degeneration Questionnaire and visual function parameters in patients with retinitis pigmentosa

“…Currently, there are no widely used functional measures to assess photosensitivity, even though IRD patients may experience a high burden from it. The ocular photosensitivity analyzer (OPA) was developed as a subjective functional measure of visual photosensitivity, although not many studies have adopted its use yet (Durgam et al., 2022; Verriotto et al., 2017). The MRDQ along with other questionnaires, such as the 17‐item Utah Photophobia Symptom Impact Scale (UPSIS‐17), 8‐item Korean Photophobia Questionnaire (KUMC‐8), Leiden Visual Sensitivity Scale (L‐VISS) and Visual Light Sensitivity Questionnaire‐8 (VLSQ‐8) remain the only options for patient‐reported evaluation of photosensitivity (Verriotto et al., 2017).…”

Correlation between higher-order aberration and photophobia after cataract surgery

“…Gender is an important factor in pain sensitivity differences [ 66 ]. Females are 2–3 times more likely than males to have migraines due to hormonal differences [ 67 ] while no gender differences exists in photophobia in visually normal people [ 36 ], and males have higher brightness perception than discomfort [ 35 ]. In our results, females had significantly higher subjective photophobia scores than males, suggesting the influence of postoperative subthreshold trigeminal inputs that a patient never perceive because females demonstrate heightened central sensitization [ 68 ].…”

“…In our results, females had significantly higher subjective photophobia scores than males, suggesting the influence of postoperative subthreshold trigeminal inputs that a patient never perceive because females demonstrate heightened central sensitization [ 68 ]. Visual photosensitivity threshold was reported to increases with age in visually normal subjects [ 36 ]. Although the effect of age was not observed in photophobia scores in our data, this might be because patients underwent surgery for visual impairment due to cataracts; thus were older and had a relatively narrower range of age.…”

“…Furthermore, to address the possibility of misunderstanding our data with a single linear regression analysis alone, a linear mixed model was used for a total of 2 x 3, which is six sets of data; two sets of data for all patients and PP concerned patients, and three sets of data for preoperative, postoperative and both. In the model, subjective photophobia score was the response, RMS of each HOA group (total coma (μm) and total trefoil), gender and age were fixed effects and individuals were the random effect because light sensitivity is associated both with gender [ 35 ] and age [ 36 ]. A p-value of <0.05 was considered statistically significant in multivariate analysis.…”