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Photo phobia, easily fatigued, muscle weakness, depression. Cure for photo phobia?

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Practicing since : 2000
Answered : 101 Questions
Hello Doctor,

I am 39, female, 94 pounds, 5'0" tall.

I have some photo phobia symptoms, so firstly maybe you
can help explain a bit how the eye deals with light.

1. How does the eye sense light?

2. How does the eye measure light intensity? How much is too much?
What if it is too much? What harm will it cause?

3. How to control intensity?

I have some pre-existing conditions. I feel tired easily. I have
muscle weakness in my arms and legs. I am sensitive to noise, pain,

I am also diagnosed by a psychologist to have depression.

My symptoms with the eyes are:

When I go outside and the sun shines directly towards me, I cannot
look forward because I feel it's too bright.
When I am in a room, and the sun shines from outdoors, I cannot look
towards the window
When I am in supermarket and there is strong light shining down, it
bothers me. I want to close my eyes or look elsewhere.
If I look at computer monitor for a few minutes, my eyes feel very
tired and I have to stop.

These symptoms started about two years ago but recently have worsen
significantly to make my daily life very difficult.

I don't know what my problems are. Someone told me it may be my pupils
cannot contract properly, or cannot stay contracted properly. Is there
a way to check whether this is true? When I see an ophthalmologist,
what should I tell him to test?

What are the other physical problems that would cause my symptoms? Or
could these have neurological or psychological causes?

Could you tell me a list of all the exams/tests that I should
undertake to pin-point the cause of my photo phobia?

For each specific test, could you tell me if there could be a harmful
side effect (e.g., if performing the test would damage my eye and
worsen the symptoms)?

As a side-note, an ophthalmologist tested my eyes about a year ago.
She just told me everything with my eyes were normal without telling
me what she tested. So I just want to make sure this time I will be
more prepared and be able to help the doctor diagnose my problem.
Posted Fri, 13 Apr 2012 in Vision and Eye Disorders
Answered by Dr. Mihir Shah 10 hours later

Thanks for posting your query.

Firstly let me begin by explaining how the eye works.You have to imagine the eye as a camera. Every camera has a diaphragm in the front with a central aperture (hole). The size of this aperture can be controlled by the user of the camera. A larger aperture will allow more light to enter the camera. Similarly the eye has a diaphragm (iris), and the iris has an aperture (pupil). The size of the pupil is constantly changing and it is controlled by the brain. Whenever we view towards bright light, the size of the pupil becomes smaller so as to block the excess light. This is controlled by the brain and neural pathways.

After the light enters the eye, it will pass through the crystalline lens and fall on the retina. The retina has light receptors ('rods' for dim light and 'cones' for bright light). These receptors sense the light coming inside the eye and send the info. to the brain.

Abnormal sensitivity to bright light (photophobia) can be due to :

1. Any abnormality in the size and functioning of the pupil.
2. Inflammation in the anterior part of the eye (iritis).
3. Some disorder of the receptors (rods and cones).
4. Neurological cause.

I would recommend the following tests in a eye clinic:
1. Pupil size and reaction measurement.
2. Intraocular pressure measurement.
3. Slitlamp anterior segment examination (for iritis).
4. Electroretinogram(ERG) for receptor abnormalities.

There is no harm in performing these tests.

In addition to this, I would also recommend a Neurologist opinion.

Hope this information is helpful. I will be available for follow up queries if any.

Above answer was peer-reviewed by
Follow-up: Photo phobia, easily fatigued, muscle weakness, depression. Cure for photo phobia? 40 hours later
Hello Doctor,

I have two follow-up questions:

1. If my pupil is indeed found to have problems, is it curable? Are operations needed, or can it be cured by medication only? Generally, what's the prospect of full recovery?

2. During the exams, is it necessary to point lights into my eyes? If so, and if I have some problems with my receptors, will the receptors be damaged during the exam, and thus make my problems worse?

Answered by Dr. Mihir Shah 11 hours later
Dear loi,

Thank you for the follow up.

1.If your pupil size is abnormal, it can be made normal by medications.In some cases, surgery(pupiloplasty) is required.Generally, the prospects of recovery are good.

2.Most of the eye exams require light to be shone onto your eyes.Routine eye exams do not have any damaging effect on the receptors. (It is only UV radiations(bright sunlight) which is harmful to the receptors.)

Best regards,

Dr.Mihir Shah
Above answer was peer-reviewed by
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