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.

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.

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.

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.

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.