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V Scorcia, G Scorcia, F Scarinci, M Fratto, G Carnovale-Scalzo, V Piccirillo, D Richichi, J Feher; Photophobia:: A light induced Ocular Pain. Is It the Third Pathway for Light Perception? . Invest. Ophthalmol. Vis. Sci. 2002;43(13):2644.
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Purpose:Light induced pain is a common symptom of several inflammatory eye diseases affecting either the anterior or posterior segment. However, it may also occur in some chorioretinal degenerations, and the pathomechanism of photophobia is poorly understood in these conditions. The aim of our studies was to reveal the association of photophobia with chorioretinal degenerations and to learn more on the pathophysiology of photophobia Methods:During a year of period all out patients visited our department were evaluated by questioner about photophobia and associated eye conditions Results:Approximately one fifth of our out patients referred various degree of photophobia almost always as a secondary symptom. Most of them were affected by uveal or corneal inflammation. Ocular surface inflammations ("dry eye") were also always associated with various degree of photophobia. The rest of the photophobia patients were affected by posterior pole degeneration (55%), peripheral retinal dystrophy (35%), and approximately 10% of the photophobia cases were no ocular disease but almost all suffered from headache, mostly migraine. These latter reported photophobia even between migraine attack Conclusion:Photophobia is a common subjective symptom which may call ophthalmologist's attention to "silent" but potentially harmful retinal diseases. While corneal and uveal inflammation may cause hyperalgesia in the ciliary body, in cases of chorioretinal degenerations the choroidal sensory nerve involvement seems to be responsible for the photophobia. These observations suggested that, besides visual and retino-hypothalamic pathways, choroidal sensory nerves may also contribute the light "perception".
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