The Unmet Challenge of Diagnosing and Treating Photophobia in Children (P2-9.010)

Abstract

<h3>Objective:</h3> The purpose of this study was to determine the most common causes of photophobia in the pediatric population in order to address this knowledge gap. <h3>Background:</h3> Photophobia, an abnormal sensitivity to light, is associated with a number of ophthalmic and neurologic conditions. Because photophobia is often perceived as an “eye problem,” patients with photophobia may first present to an optometrist or ophthalmologist for care. We’ve previously found that nearly 70% of pediatric patients presenting to a tertiary eye care facility with a chief complaint of photophobia leave their evaluation without a diagnosis. <h3>Design/Methods:</h3> This study was approved by the University of Utah IRB. We identified patients aged less than 18 years who presented with a chief complaint of photophobia, but who had left the visit without a diagnosis. The families were then contacted and the patients were brought back to the Eye Center to be evaluated by a neuro-ophthalmologist with expertise in the diagnosis and treatment of photophobia. <h3>Results:</h3> We identified 47 children for inclusion in the study. Twenty-six families did not respond to our invitation or declined to participate. Seven families reported that their child’s photophobia had spontaneously resolved. Four children were diagnosed by our team with migraine, one child was diagnosed with dry eye syndrome, and one child was diagnosed with misuse of atropine drops. An additional 8 children have not yet been evaluated. <h3>Conclusions:</h3> Photophobia is associated with several ophthalmic conditions, but in the pediatric population, photophobia can be caused by undiagnosed migraine. Our long-term goal is to better educate eye care professionals about the causes of photophobia in the pediatric population. We are developing a curriculum to address this knowledge gap, with a special emphasis on teaching eye care professionals how to identify undiagnosed migraine. <b>Disclosure:</b> Miss Shapiro has nothing to disclose. Mrs. Keeney has nothing to disclose. Dr. Caskey has nothing to disclose. Mr. Arbon has nothing to disclose. Dr. Seay has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for various attorneys. Dr. Warner has received intellectual property interests from a discovery or technology relating to health care. The institution of Dr. Digre has received personal compensation in the range of $0-$499 for serving on a Scientific Advisory or Data Safety Monitoring board for Invex therapeutics. Dr. Digre has received personal compensation in the range of $0-$499 for serving as an officer or member of the Board of Directors for American Headache Society. The institution of Dr. Digre has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Journal of Neuro-ophthalmology. The institution of Dr. Digre has received personal compensation in the range of $0-$499 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Utah Womens Health Review. Dr. Digre has received intellectual property interests from a discovery or technology relating to health care. Dr. Digre has received intellectual property interests from a discovery or technology relating to health care. Dr. Digre has received intellectual property interests from a discovery or technology relating to health care. Dr. Digre has received publishing royalties from a publication relating to health care. Dr. Digre has received publishing royalties from a publication relating to health care. Bradley J. Katz, MD, PhD has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for axon optics, LLC. Bradley J. Katz, MD, PhD has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for self employed. Bradley J. Katz, MD, PhD has received stock or an ownership interest from Pfizer. Bradley J. Katz, MD, PhD has received intellectual property interests from a discovery or technology relating to health care.