April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Custom Contact Lens Therapy For Management Of Photosensitive Seizures: A Novel Approach
Author Affiliations & Notes
  • Negin Ashki
    Department of Ophthalmology, University of Ottawa Eye Institute, Ottawa, Ontario, Canada
  • Daniella Pohl
    Department of Neurology, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
  • Munger Rejean
    Department of Ophthalmology, University of Ottawa Eye Institute, Ottawa, Ontario, Canada
  • Staurt Coupland
    Department of Ophthalmology, University of Ottawa Eye Institute, Ottawa, Ontario, Canada
  • Michael O'Connor
    Department of Ophthalmology, University of Ottawa Eye Institute, Ottawa, Ontario, Canada
  • Footnotes
    Commercial Relationships  Negin Ashki, None; Daniella Pohl, None; Munger Rejean, None; Staurt Coupland, None; Michael O'Connor, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 5705. doi:
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      Negin Ashki, Daniella Pohl, Munger Rejean, Staurt Coupland, Michael O'Connor; Custom Contact Lens Therapy For Management Of Photosensitive Seizures: A Novel Approach. Invest. Ophthalmol. Vis. Sci. 2011;52(14):5705.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : To quantify the wavelength dependence of photosensitive epilepsy in order to develop an optimized approach to its management.

Methods: : Two pedatric patients (ages 5 and 13 years) with a history of photosensitive epilepsy underwent novel clinical testing to determine the characteristics of their light-induced seizures. Briefly, patients were exposed to a controlled, variable-intensity light source while simultaneously undergoing electroencephalography to detect epileptiform activity. The LED stimulator used wavelengths of 470 nm, 525 nm, and 640 nm to probe spectral regions associated with the cone’s spectral sensitivity.

Results: : In both patients, induction of seizures was not wavelength dependent while, increasing light intensity was directly associated with increased seizure activity. Based on these individual data, patients were prescribed individual contact lenses with a customized amount of wavelength neutral reduction of light delivered to the eyes. One patient has remained seizure-free, while the other has reported a dramatic reduction in seizure frequency with use of the tinted contact lenses, as well as a significant improvement in quality of life.

Conclusions: : Previous reports in the literature have emphasized the use of colored or polarized lenses to reduce photic seizures. In contrast, our study suggests that it is the total amount of light energy transmission to the eyes that is critical in inducing these seizures, rather than the particular wavelength of light. By determining the light-induced seizure threshold, contact lenses can be custom-tinted as required to maximize visual function while minimizing seizure risk in photogenic epilepsy.

Keywords: protective mechanisms • visual impairment: neuro-ophthalmological disease • electrophysiology: clinical 
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