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What Causes Difficulty In Opening Eyelids In A Bright Environment?

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Posted on Thu, 8 Oct 2015
Question: Occasionally I cannot open my eyelids because the environment is to bright to look at. I have to close my eyes and relax and wait until it passes. This occurs indoors such as when in a store and outside as well. Generally this is accompanied with some sweats and a feeling of being about to pass out but I have never fainted.
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Answered by Dr. Dariush Saghafi (56 minutes later)
Brief Answer:
Vasovagal response caused by photosensitive reaction

Detailed Answer:
Good morning. I am a neurologist from XXXXXXX Ohio and would like to offer a brief comment on your condition. What you are describing is referred to as a vasovagal reaction caused by an intense photosensitive reaction in the eye. Almost any type of intense reaction experienced by the body (fear, anger, shock, XXXXXXX sudden pain, intensely bright light) can result in a massive stimulation of the vagus nerve by the brain. This can occur either through direct initiation of the impulse down the nerve from the brainstem centers where the nerve originates or it can be part of a more generalized reaction of the brain which could be suffering from a seizure or other electrically imbalanced phenomenon that itself causes intense stimulation of the vagal centers. When this occurs bodily reactions can be intense such as vomiting, massive sweating, and commonly SYNCOPE (passing out/fainting) or NEAR SYNCOPE (nearly passing out) can occur due to the bottoming out of blood pressure. Intense light suddenly striking the eye is one example of what could trigger such a vasovagal reaction.

However, one has to also consider the REVERSE as potentially occurring....In other words, as you say, "occasionally" the environment BECOMES TOO BRIGHT for you to open your eyes properly and sometimes this can progress to all the other symptoms mentioned. Therefore, it is possible that instead of the actual lighting in the room or area being ITSELF TOO BRIGHT for your eyes to handle the SYMPATHETIC NERVOUS system may become somehow activated through any of the sensory modalities mentions or circumstances of "Fight or Flight" which as one consequence causes your PUPILS TO DILATE and this then, leads to the sudden feeling that everything is too bright around you resulting in all the rest of what you said.

Conditions that most commonly could be associated with this type of situation include seizure disorders, small spontaneous brain bleeds, sudden onset of migraine headaches, neurodegenerative problems in the brain that can result in sudden sympathetic discharges such as lack of oxygen, toxic exposures, and trauma.

If this is a relatively new phenomenon that you are experiencing at age 58 then, my recommendation is that you go to a good neurologist who will examine you thoroughly for all causes of this type of clinical picture which should of course include, a detailed history of when the problem started, how it has evolved over the years, any family history of similar conditions or even neurological problems as well as appropriate testing to rule out intracranial abnormalities (stuff in the head that goes BUMP in the night!) using imaging and electrical testing techniques. It may even include a checkup of your heart, blood work, toxicology screen in your blood for unruly chemical substances that shouldn't be there, etc.

Obviously, finding the cause would be the best way to decide upon a treatment but no cause can be found after an exhaustive search then, your neurologist will work on strategies that you may be able to use in order to either predict when these events may be about to happen or otherwise, come up with a way of blocking the consequences once an episode is rolling down the track.

I hope these suggestions satisfactorily address your question and give some additional information you can discuss with your doctor for how to attack this problem. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other comments, may I ask you not forget to CLOSE THE QUERY on your end so the question can be transacted and archived for further reference by colleagues as necessary?

You are invited to direct more comments or inquiries to me in the future by going to my web address at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 43 minutes of physician specific time to read, research, and compile a return envoy to the patient.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2473 Questions

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What Causes Difficulty In Opening Eyelids In A Bright Environment?

Brief Answer: Vasovagal response caused by photosensitive reaction Detailed Answer: Good morning. I am a neurologist from XXXXXXX Ohio and would like to offer a brief comment on your condition. What you are describing is referred to as a vasovagal reaction caused by an intense photosensitive reaction in the eye. Almost any type of intense reaction experienced by the body (fear, anger, shock, XXXXXXX sudden pain, intensely bright light) can result in a massive stimulation of the vagus nerve by the brain. This can occur either through direct initiation of the impulse down the nerve from the brainstem centers where the nerve originates or it can be part of a more generalized reaction of the brain which could be suffering from a seizure or other electrically imbalanced phenomenon that itself causes intense stimulation of the vagal centers. When this occurs bodily reactions can be intense such as vomiting, massive sweating, and commonly SYNCOPE (passing out/fainting) or NEAR SYNCOPE (nearly passing out) can occur due to the bottoming out of blood pressure. Intense light suddenly striking the eye is one example of what could trigger such a vasovagal reaction. However, one has to also consider the REVERSE as potentially occurring....In other words, as you say, "occasionally" the environment BECOMES TOO BRIGHT for you to open your eyes properly and sometimes this can progress to all the other symptoms mentioned. Therefore, it is possible that instead of the actual lighting in the room or area being ITSELF TOO BRIGHT for your eyes to handle the SYMPATHETIC NERVOUS system may become somehow activated through any of the sensory modalities mentions or circumstances of "Fight or Flight" which as one consequence causes your PUPILS TO DILATE and this then, leads to the sudden feeling that everything is too bright around you resulting in all the rest of what you said. Conditions that most commonly could be associated with this type of situation include seizure disorders, small spontaneous brain bleeds, sudden onset of migraine headaches, neurodegenerative problems in the brain that can result in sudden sympathetic discharges such as lack of oxygen, toxic exposures, and trauma. If this is a relatively new phenomenon that you are experiencing at age 58 then, my recommendation is that you go to a good neurologist who will examine you thoroughly for all causes of this type of clinical picture which should of course include, a detailed history of when the problem started, how it has evolved over the years, any family history of similar conditions or even neurological problems as well as appropriate testing to rule out intracranial abnormalities (stuff in the head that goes BUMP in the night!) using imaging and electrical testing techniques. It may even include a checkup of your heart, blood work, toxicology screen in your blood for unruly chemical substances that shouldn't be there, etc. Obviously, finding the cause would be the best way to decide upon a treatment but no cause can be found after an exhaustive search then, your neurologist will work on strategies that you may be able to use in order to either predict when these events may be about to happen or otherwise, come up with a way of blocking the consequences once an episode is rolling down the track. I hope these suggestions satisfactorily address your question and give some additional information you can discuss with your doctor for how to attack this problem. If so, may I ask your favor of a HIGH STAR RATING with some written feedback? Also, if there are no other comments, may I ask you not forget to CLOSE THE QUERY on your end so the question can be transacted and archived for further reference by colleagues as necessary? You are invited to direct more comments or inquiries to me in the future by going to my web address at: bit.ly/drdariushsaghafi I would be honored to answer you quickly and comprehensively. Please keep me informed as to the outcome of your situation. The query has required a total of 43 minutes of physician specific time to read, research, and compile a return envoy to the patient.