PHOTOPHOBIA
PHOTOPHOBIA: Excerpt from Algorithmic Diagnosis of Symptoms and Signs
Ask the Following Questions:
- Is there a history of exposure to drugs or toxins? Quinine, cocaine, atropine, and ApresolineŽ are just a few of the drugs that may cause photophobia.
- Are there abnormalities on the eye examination? Almost any condition of the eye may cause photophobia, including conjunctivitis, blepharitis, keratitis, iritis, corneal ulcers, and retinitis.
- Are there abnormal tonometry readings? The eye may appear normal, but the tonometry may disclose glaucoma.
- Is there nuchal rigidity? The presence of nuchal rigidity, especially with fever, would suggest meningitis. Without fever or with only a low-grade fever, the presence of nuchal rigidity should suggest subarachnoid hemorrhage.
DIAGNOSTIC WORKUP
A careful eye examination including tonometry and slit lamp examination should be done. A referral to an ophthalmologist may be necessary to accomplish this. If there is nuchal rigidity, a CT scan followed by a spinal tap should be done in conjunction with a neurologic consultation. If there is fever without nuchal rigidity, the workup can proceed as outlined on
page 168
. A histamine test may be helpful in diagnosing migraine.
Book Source Details
- Book Title: Algorithmic Diagnosis of Symptoms and Signs
- Author(s): R. Douglas Collins
- Year of Publication: 2003
- Copyright Details: Algorithmic Diagnosis of Symptoms and Signs, Copyright © 2003 Lippincott Williams & Wilkins.
More About Photophobia
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Copyright notice for book excerpts: Copyright © 2008 Lippincott Williams & Wilkins. All rights reserved.
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