My child seems to hate the bright light

Chapter 99 My child seems to hate the bright light

Although mild photophobia is fairly common in normal young children, photophobia must be taken seriously as there are a wide variety of conditions including serious disorders such as infantile glaucoma and anterior visual pathway tumors which may present with photophobia.

The approach to a photophobic child

It is critical that a good rapport is built with the child and as much information as possible gathered before formal examination is attempted. The lighting in the examination room should be lowered to aid the child’s comfort. The differential diagnosis for photophobia is considerable. Taking into consideration the age of the child (see Table 99.1) and getting a good history (see Table 99.2) help to focus the examination toward finding the diagnosis.

Table 99.1 Important causes of photophobia in each age group

Young children
School-age children

Table 99.2 Questions and considerations in photophobia

Recent onset or present since very young?
Associated watering?
Associated redness of eyes?
One or both eyes?
Constant or intermittent?
Reduced vision?
Family history or history of consanguinity?
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