Original article
The Evaluation of Light Sensitivity in Benign Essential Blepharospasm

https://doi.org/10.1016/j.ajo.2006.02.020Get rights and content

Purpose

To test light sensitivity thresholds rigorously in patients with benign essential blepharospasm (BEB) compared with patients who have known light sensitivity (migraineurs) and to normal control subjects.

Design

Prospective, observational, case control study.

Methods

We recruited a total of 87 subjects into each of three groups: BEB, migraine, and normal control subjects. A modified slit-lamp chin rest, heat shield, light meter, and halogen light that was modulated by a rheostat were used to measure light sensitivity thresholds. Participants were tested without spectacles, with gray-tinted spectacles, and with FL-41–tinted spectacles.

Results

Light discomfort thresholds for subjects with BEB were significantly lower compared with normal control subjects (P ≤ .009) and similar to the migraine group. Both gray and FL-41–tinted lenses improved light sensitivity thresholds in all groups (P ≤ .0005). There was no observed difference in the improvement in light sensitivity when the gray and FL-41–tinted lenses were compared.

Conclusion

Patients with BEB are considerably more sensitive to light than control subjects and as sensitive to light as patients with migraine. Physicians who care for patients with BEB should consider using tinted lenses to help ameliorate symptoms.

Section snippets

Methods

This study and data accumulation were carried out with approval from the University of Utah Institutional Review Board, and informed consent was obtained from each subject before participation. The study is in accord with Health Insurance Portability and Accountability Act (HIPAA) regulations. We recruited 29 subjects with documented BEB (without migraine), 29 subjects with migraine (without BEB) as defined by International Headache Society criteria, and 29 control subjects (no personal history

Demographics and baseline characteristics of the study subjects

Participant demographics and questionnaire data regarding light sensitivity are summarized in TABLE 1, TABLE 2. Because of photophobia, nearly one third of subjects with BEB and one fourth of migraineurs wear tinted lenses indoors, and most subjects in both groups wear them outdoors. During asymptomatic periods, both subjects with BEB and subjects with migraine reported that strong light was unpleasant and could provoke symptoms. Most subjects reported unpleasant sensations when exposed to

Discussion

The subjects with BEB in our study reported an impaired ability to perform specific ADL related to photophobia (avoidance of light) and photo-oculodynia (eye pain associated with exposure to light). It has been shown previously that BEB adversely impacts perceived quality of life.20 A more recent study used the FIGURE E1, FIGURE E2, FIGURE E3, FIGURE E4, FIGURE E5, FIGURE E6 to show that patients with BEB have a reduced health-related quality of life and are more prone to symptoms of depression

Wesley H. Adams, MD, attended the University of Utah, School of Medicine Salt Lake City, Utah and completed his transitional internship at Sacred Heart Medical Center in Spokane, Washington. Dr Adams is currently an Ophthalmology Resident at the Wake Forest University Eye Center in Winston-Salem, North Carolina.

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    Wesley H. Adams, MD, attended the University of Utah, School of Medicine Salt Lake City, Utah and completed his transitional internship at Sacred Heart Medical Center in Spokane, Washington. Dr Adams is currently an Ophthalmology Resident at the Wake Forest University Eye Center in Winston-Salem, North Carolina.

    Bradley J. Katz, MD, PhD, is an Assistant Professor of Ophthalmology and Neurology at the John A. Moran Eye Center, University of Utah Health Sciences Center in Salt Lake City, Utah. He is a principal investigator for Grant NIH K23 RR16427, “Clinical Characterization and Genetics of Optic Nerve Drusen.” Dr Katz is also co-principal investigator for a Grant from the Benign Essential Blepharospasm Research Foundation to study the electrophysiologic effects of FL-41 tinted spectacles on blepharospasm.

    Supplemental Material available at AJO.com.

    Supported by National Institutes of Health grant T35 HL07744 (W.H.A.); a grant from the Benign Essential Blepharospasm Research Foundation, Beaumont, Texas (K.B.D., B.J.K.); NIH K23 RR16427 (B.J.K.) and an unrestricted grant to the Department of Ophthalmology and Visual Sciences from Research to Prevent Blindness, Inc, New York, New York.

    We thank Stephen C. Alder, PhD, of the Department of Family and Preventive Medicine, University of Utah Health Sciences Center, for his assistance with statistical analysis of the data.

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