Abstract

The Ocular Photosensitivity Analyzer (OPA), a new automated instrument to quantify the visual photosensitivity thresholds (VPT) in healthy and light sensitive subjects, is described. The OPA generates light stimuli of varying intensities utilizing unequal ascending and descending steps to yield the VPT. The performance of the OPA was evaluated in healthy subjects, as well as light sensitive subjects with achromatopsia or traumatic brain injury (TBI). VPT in healthy, achromatopsia, and TBI subjects were 3.2 ± 0.6 log lux, 0.5 ± 0.5 log lux, and 0.4 ± 0.6 log lux, respectively. Light sensitive subjects manifested significantly lower VPT compared to healthy subjects. Longitudinal analysis revealed that the OPA reliably measured VPT in healthy subjects.

© 2018 Optical Society of America under the terms of the OSA Open Access Publishing Agreement

Full Article  |  PDF Article
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2018 (3)

R. Noseda, D. Copenhagen, and R. Burstein, “Current understanding of photophobia, visual networks and headaches,” Cephalalgia 0(0), 333102418784750 (2018).
[Crossref] [PubMed]

K. B. Digre, “More Than Meets the Eye: The Eye and Migraine-What You Need to Know,” J. Neuroophthalmol. 38(2), 237–243 (2018).
[Crossref] [PubMed]

M. L. Callahan and M. M. Lim, “Sensory Sensitivity in TBI: Implications for Chronic Disability,” Curr. Neurol. Neurosci. Rep. 18(9), 56 (2018).
[Crossref] [PubMed]

2017 (5)

F. Barker, G. Cockerham, G. Goodrich, A. Hartwick, R. Kardon, A. B. Mick, and M. Swanson, “Brain injury impact on the eye and vision,” Optom. Vis. Sci. 94(1), 4–6 (2017).
[Crossref] [PubMed]

H. Laukkanen, M. Scheiman, and J. R. Hayes, “Brain injury vision symptom survey (BIVSS) questionnaire,” Optom. Vis. Sci. 94(1), 43–50 (2017).
[Crossref] [PubMed]

P. T. Yuhas, P. D. Shorter, C. E. McDaniel, M. J. Earley, and A. T. Hartwick, “Blue and red light-evoked pupil responses in photophobic subjects with TBI,” Optom. Vis. Sci. 94(1), 108–117 (2017).
[Crossref] [PubMed]

M. M. Cortez, N. A. Rea, L. A. Hunter, K. B. Digre, and K. C. Brennan, “Altered pupillary light response scales with disease severity in migrainous photophobia,” Cephalalgia 37(8), 801–811 (2017).
[Crossref] [PubMed]

Y. Wu and M. Hallett, “Photophobia in neurologic disorders,” Transl. Neurodegener. 6(1), 26 (2017).
[Crossref] [PubMed]

2016 (6)

A. Galor, R. C. Levitt, E. R. Felix, and C. D. Sarantopoulos, “What can photophobia tell us about dry eye?” Expert Rev. Ophthalmol. 11(5), 321–324 (2016).
[Crossref] [PubMed]

P. Rosenthal and D. Borsook, “Ocular neuropathic pain,” Br. J. Ophthalmol. 100(1), 128–134 (2016).
[Crossref] [PubMed]

B. J. Katz and K. B. Digre, “Diagnosis, pathophysiology, and treatment of photophobia,” Surv. Ophthalmol. 61(4), 466–477 (2016).
[Crossref] [PubMed]

S. M. Llop, J. E. Frandsen, K. B. Digre, B. J. Katz, A. V. Crum, C. Zhang, and J. E. A. Warner, “Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia,” J. Headache Pain 17(1), 34 (2016).
[Crossref] [PubMed]

C. S. Gilmore, J. Camchong, N. D. Davenport, N. W. Nelson, R. H. Kardon, K. O. Lim, and S. R. Sponheim, “Deficits in visual system functional connectivity after blast-related mild TBI are associated with injury severity and executive dysfunction,” Brain Behav. 6(5), e00454 (2016).
[Crossref] [PubMed]

J. Aboshiha, A. M. Dubis, J. Carroll, A. J. Hardcastle, and M. Michaelides, “The cone dysfunction syndromes,” Br. J. Ophthalmol. 100(1), 115–121 (2016).
[Crossref] [PubMed]

2015 (4)

B. P. Barnett and E. L. Singman, “Vision concerns after mild traumatic brain injury,” Curr. Treat. Options Neurol. 17(2), 329 (2015).
[Crossref] [PubMed]

K. B. Digre, “Benign essential blepharospasm–there is more to it than just blinking,” J. Neuroophthalmol. 35(4), 379–381 (2015).
[Crossref] [PubMed]

H. L. Rossi and A. Recober, “Photophobia in primary headaches,” Headache 55(4), 600–604 (2015).
[Crossref] [PubMed]

A. J. Zele and D. Cao, “Vision under mesopic and scotopic illumination,” Front. Psychol. 5(1594), 1594 (2015).
[PubMed]

2014 (1)

M. A. García-Pérez, “Adaptive psychophysical methods for nonmonotonic psychometric functions,” Atten. Percept. Psychophys. 76(2), 621–641 (2014).
[Crossref] [PubMed]

2012 (3)

Y. Sakanishi, M. Awano, A. Mizota, M. Tanaka, A. Murakami, and K. Ohnuma, “Age-related changes in spectral transmittance of the human crystalline lens in situ,” Ophthalmologica 228(3), 174–180 (2012).
[Crossref] [PubMed]

K. B. Digre and K. C. Brennan, “Shedding light on photophobia,” J. Neuroophthalmol. 32(1), 68–81 (2012).
[Crossref] [PubMed]

M. A. Mainster and P. L. Turner, “Glare’s causes, consequences, and clinical challenges after a century of ophthalmic study,” Am. J. Ophthalmol. 153(4), 587–593 (2012).
[Crossref] [PubMed]

2009 (1)

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

2006 (1)

W. H. Adams, K. B. Digre, B. C. Patel, R. L. Anderson, J. E. Warner, and B. J. Katz, “The evaluation of light sensitivity in benign essential blepharospasm,” Am. J. Ophthalmol. 142(1), 82–87 (2006).
[Crossref] [PubMed]

2005 (1)

B. Golebiowski, E. Papas, and F. Stapleton, “Corneal mechanical sensitivity measurement using a staircase technique,” Ophthalmic Physiol. Opt. 25(3), 246–253 (2005).
[Crossref] [PubMed]

2003 (1)

2001 (1)

M. A. García-Pérez, “Yes-no staircases with fixed step sizes: psychometric properties and optimal setup,” Optom. Vis. Sci. 78(1), 56–64 (2001).
[Crossref] [PubMed]

2000 (1)

A. Main, I. Vlachonikolis, and A. Dowson, “The wavelength of light causing photophobia in migraine and tension-type headache between attacks,” Headache 40(3), 194–199 (2000).
[Crossref] [PubMed]

1999 (1)

J. M. Bland and D. G. Altman, “Measuring agreement in method comparison studies,” Stat. Methods Med. Res. 8(2), 135–160 (1999).
[Crossref] [PubMed]

1998 (2)

J. Vanagaite Vingen and L. J. Stovner, “Photophobia and phonophobia in tension-type and cervicogenic headache,” Cephalalgia 18(6), 313–318 (1998).
[Crossref] [PubMed]

J. V. Vingen, J. A. Pareja, and L. J. Stovner, “Quantitative evaluation of photophobia and phonophobia in cluster headache,” Cephalalgia 18(5), 250–256 (1998).
[Crossref] [PubMed]

1997 (2)

A. Main, A. Dowson, and M. Gross, “Photophobia and phonophobia in migraineurs between attacks,” Headache 37(8), 492–495 (1997).
[Crossref] [PubMed]

J. Vanagaite, J. A. Pareja, O. Støren, L. R. White, T. Sand, and L. J. Stovner, “Light-induced discomfort and pain in migraine,” Cephalalgia 17(7), 733–741 (1997).
[Crossref] [PubMed]

1996 (1)

E. P. Chronicle and W. M. Mulleners, “Visual system dysfunction in migraine: a review of clinical and psychophysical findings,” Cephalalgia 16(8), 525–535 (1996).
[Crossref] [PubMed]

1983 (1)

D. G. Altman and J. M. Bland, “Measurement in Medicine: The Analysis of Method Comparison Studies,” Statistician 32(3), 307–317 (1983).
[Crossref]

1966 (2)

J. D. Wirtschafter and C. M. Bourassa, “Binocular Facilitation of Discomfort with High Luminances,” Arch. Ophthalmol. 75(5), 683–688 (1966).
[Crossref] [PubMed]

C. M. Bourassa and J. D. Wirtschafter, “Mechanism of binocular increase of discomfort to high luminance,” Nature 212(5069), 1503–1504 (1966).
[Crossref] [PubMed]

1963 (2)

J. C. Stevens and S. S. Stevens, “Brightness function: effects of adaptation,” J. Opt. Soc. Am. 53(3), 375–385 (1963).
[Crossref] [PubMed]

J. D. Wirtschafter, C. M. Bourassa, and R. S. Dow, “The Quantitative Study of Photophobia,” Trans. Am. Neurol. Assoc. 88, 291–293 (1963).
[PubMed]

1934 (1)

J. E. Lebensohn and J. Bellows, “The nature of photophobia,” Arch. Ophthalmol. 12(3), 380–390 (1934).
[Crossref]

Aboshiha, J.

J. Aboshiha, A. M. Dubis, J. Carroll, A. J. Hardcastle, and M. Michaelides, “The cone dysfunction syndromes,” Br. J. Ophthalmol. 100(1), 115–121 (2016).
[Crossref] [PubMed]

Adams, W. H.

W. H. Adams, K. B. Digre, B. C. Patel, R. L. Anderson, J. E. Warner, and B. J. Katz, “The evaluation of light sensitivity in benign essential blepharospasm,” Am. J. Ophthalmol. 142(1), 82–87 (2006).
[Crossref] [PubMed]

Altman, D. G.

J. M. Bland and D. G. Altman, “Measuring agreement in method comparison studies,” Stat. Methods Med. Res. 8(2), 135–160 (1999).
[Crossref] [PubMed]

D. G. Altman and J. M. Bland, “Measurement in Medicine: The Analysis of Method Comparison Studies,” Statistician 32(3), 307–317 (1983).
[Crossref]

Anderson, R. L.

W. H. Adams, K. B. Digre, B. C. Patel, R. L. Anderson, J. E. Warner, and B. J. Katz, “The evaluation of light sensitivity in benign essential blepharospasm,” Am. J. Ophthalmol. 142(1), 82–87 (2006).
[Crossref] [PubMed]

Awano, M.

Y. Sakanishi, M. Awano, A. Mizota, M. Tanaka, A. Murakami, and K. Ohnuma, “Age-related changes in spectral transmittance of the human crystalline lens in situ,” Ophthalmologica 228(3), 174–180 (2012).
[Crossref] [PubMed]

Barker, F.

F. Barker, G. Cockerham, G. Goodrich, A. Hartwick, R. Kardon, A. B. Mick, and M. Swanson, “Brain injury impact on the eye and vision,” Optom. Vis. Sci. 94(1), 4–6 (2017).
[Crossref] [PubMed]

Barnett, B. P.

B. P. Barnett and E. L. Singman, “Vision concerns after mild traumatic brain injury,” Curr. Treat. Options Neurol. 17(2), 329 (2015).
[Crossref] [PubMed]

Bellows, J.

J. E. Lebensohn and J. Bellows, “The nature of photophobia,” Arch. Ophthalmol. 12(3), 380–390 (1934).
[Crossref]

Blackburn, M. K.

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

Bland, J. M.

J. M. Bland and D. G. Altman, “Measuring agreement in method comparison studies,” Stat. Methods Med. Res. 8(2), 135–160 (1999).
[Crossref] [PubMed]

D. G. Altman and J. M. Bland, “Measurement in Medicine: The Analysis of Method Comparison Studies,” Statistician 32(3), 307–317 (1983).
[Crossref]

Borsook, D.

P. Rosenthal and D. Borsook, “Ocular neuropathic pain,” Br. J. Ophthalmol. 100(1), 128–134 (2016).
[Crossref] [PubMed]

Bourassa, C. M.

C. M. Bourassa and J. D. Wirtschafter, “Mechanism of binocular increase of discomfort to high luminance,” Nature 212(5069), 1503–1504 (1966).
[Crossref] [PubMed]

J. D. Wirtschafter and C. M. Bourassa, “Binocular Facilitation of Discomfort with High Luminances,” Arch. Ophthalmol. 75(5), 683–688 (1966).
[Crossref] [PubMed]

J. D. Wirtschafter, C. M. Bourassa, and R. S. Dow, “The Quantitative Study of Photophobia,” Trans. Am. Neurol. Assoc. 88, 291–293 (1963).
[PubMed]

Brennan, K. C.

M. M. Cortez, N. A. Rea, L. A. Hunter, K. B. Digre, and K. C. Brennan, “Altered pupillary light response scales with disease severity in migrainous photophobia,” Cephalalgia 37(8), 801–811 (2017).
[Crossref] [PubMed]

K. B. Digre and K. C. Brennan, “Shedding light on photophobia,” J. Neuroophthalmol. 32(1), 68–81 (2012).
[Crossref] [PubMed]

Burstein, R.

R. Noseda, D. Copenhagen, and R. Burstein, “Current understanding of photophobia, visual networks and headaches,” Cephalalgia 0(0), 333102418784750 (2018).
[Crossref] [PubMed]

Callahan, M. L.

M. L. Callahan and M. M. Lim, “Sensory Sensitivity in TBI: Implications for Chronic Disability,” Curr. Neurol. Neurosci. Rep. 18(9), 56 (2018).
[Crossref] [PubMed]

Camchong, J.

C. S. Gilmore, J. Camchong, N. D. Davenport, N. W. Nelson, R. H. Kardon, K. O. Lim, and S. R. Sponheim, “Deficits in visual system functional connectivity after blast-related mild TBI are associated with injury severity and executive dysfunction,” Brain Behav. 6(5), e00454 (2016).
[Crossref] [PubMed]

Cao, D.

A. J. Zele and D. Cao, “Vision under mesopic and scotopic illumination,” Front. Psychol. 5(1594), 1594 (2015).
[PubMed]

Carroll, J.

J. Aboshiha, A. M. Dubis, J. Carroll, A. J. Hardcastle, and M. Michaelides, “The cone dysfunction syndromes,” Br. J. Ophthalmol. 100(1), 115–121 (2016).
[Crossref] [PubMed]

Chronicle, E. P.

E. P. Chronicle and W. M. Mulleners, “Visual system dysfunction in migraine: a review of clinical and psychophysical findings,” Cephalalgia 16(8), 525–535 (1996).
[Crossref] [PubMed]

Cockerham, G.

F. Barker, G. Cockerham, G. Goodrich, A. Hartwick, R. Kardon, A. B. Mick, and M. Swanson, “Brain injury impact on the eye and vision,” Optom. Vis. Sci. 94(1), 4–6 (2017).
[Crossref] [PubMed]

Copenhagen, D.

R. Noseda, D. Copenhagen, and R. Burstein, “Current understanding of photophobia, visual networks and headaches,” Cephalalgia 0(0), 333102418784750 (2018).
[Crossref] [PubMed]

Cortez, M. M.

M. M. Cortez, N. A. Rea, L. A. Hunter, K. B. Digre, and K. C. Brennan, “Altered pupillary light response scales with disease severity in migrainous photophobia,” Cephalalgia 37(8), 801–811 (2017).
[Crossref] [PubMed]

Crum, A. V.

S. M. Llop, J. E. Frandsen, K. B. Digre, B. J. Katz, A. V. Crum, C. Zhang, and J. E. A. Warner, “Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia,” J. Headache Pain 17(1), 34 (2016).
[Crossref] [PubMed]

Davenport, N. D.

C. S. Gilmore, J. Camchong, N. D. Davenport, N. W. Nelson, R. H. Kardon, K. O. Lim, and S. R. Sponheim, “Deficits in visual system functional connectivity after blast-related mild TBI are associated with injury severity and executive dysfunction,” Brain Behav. 6(5), e00454 (2016).
[Crossref] [PubMed]

Digre, K. B.

K. B. Digre, “More Than Meets the Eye: The Eye and Migraine-What You Need to Know,” J. Neuroophthalmol. 38(2), 237–243 (2018).
[Crossref] [PubMed]

M. M. Cortez, N. A. Rea, L. A. Hunter, K. B. Digre, and K. C. Brennan, “Altered pupillary light response scales with disease severity in migrainous photophobia,” Cephalalgia 37(8), 801–811 (2017).
[Crossref] [PubMed]

S. M. Llop, J. E. Frandsen, K. B. Digre, B. J. Katz, A. V. Crum, C. Zhang, and J. E. A. Warner, “Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia,” J. Headache Pain 17(1), 34 (2016).
[Crossref] [PubMed]

B. J. Katz and K. B. Digre, “Diagnosis, pathophysiology, and treatment of photophobia,” Surv. Ophthalmol. 61(4), 466–477 (2016).
[Crossref] [PubMed]

K. B. Digre, “Benign essential blepharospasm–there is more to it than just blinking,” J. Neuroophthalmol. 35(4), 379–381 (2015).
[Crossref] [PubMed]

K. B. Digre and K. C. Brennan, “Shedding light on photophobia,” J. Neuroophthalmol. 32(1), 68–81 (2012).
[Crossref] [PubMed]

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

W. H. Adams, K. B. Digre, B. C. Patel, R. L. Anderson, J. E. Warner, and B. J. Katz, “The evaluation of light sensitivity in benign essential blepharospasm,” Am. J. Ophthalmol. 142(1), 82–87 (2006).
[Crossref] [PubMed]

Dow, R. S.

J. D. Wirtschafter, C. M. Bourassa, and R. S. Dow, “The Quantitative Study of Photophobia,” Trans. Am. Neurol. Assoc. 88, 291–293 (1963).
[PubMed]

Dowson, A.

A. Main, I. Vlachonikolis, and A. Dowson, “The wavelength of light causing photophobia in migraine and tension-type headache between attacks,” Headache 40(3), 194–199 (2000).
[Crossref] [PubMed]

A. Main, A. Dowson, and M. Gross, “Photophobia and phonophobia in migraineurs between attacks,” Headache 37(8), 492–495 (1997).
[Crossref] [PubMed]

Dubis, A. M.

J. Aboshiha, A. M. Dubis, J. Carroll, A. J. Hardcastle, and M. Michaelides, “The cone dysfunction syndromes,” Br. J. Ophthalmol. 100(1), 115–121 (2016).
[Crossref] [PubMed]

Earley, M. J.

P. T. Yuhas, P. D. Shorter, C. E. McDaniel, M. J. Earley, and A. T. Hartwick, “Blue and red light-evoked pupil responses in photophobic subjects with TBI,” Optom. Vis. Sci. 94(1), 108–117 (2017).
[Crossref] [PubMed]

Felix, E. R.

A. Galor, R. C. Levitt, E. R. Felix, and C. D. Sarantopoulos, “What can photophobia tell us about dry eye?” Expert Rev. Ophthalmol. 11(5), 321–324 (2016).
[Crossref] [PubMed]

Frandsen, J. E.

S. M. Llop, J. E. Frandsen, K. B. Digre, B. J. Katz, A. V. Crum, C. Zhang, and J. E. A. Warner, “Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia,” J. Headache Pain 17(1), 34 (2016).
[Crossref] [PubMed]

Fuld, K.

Galor, A.

A. Galor, R. C. Levitt, E. R. Felix, and C. D. Sarantopoulos, “What can photophobia tell us about dry eye?” Expert Rev. Ophthalmol. 11(5), 321–324 (2016).
[Crossref] [PubMed]

García-Pérez, M. A.

M. A. García-Pérez, “Adaptive psychophysical methods for nonmonotonic psychometric functions,” Atten. Percept. Psychophys. 76(2), 621–641 (2014).
[Crossref] [PubMed]

M. A. García-Pérez, “Yes-no staircases with fixed step sizes: psychometric properties and optimal setup,” Optom. Vis. Sci. 78(1), 56–64 (2001).
[Crossref] [PubMed]

Gilmore, C. S.

C. S. Gilmore, J. Camchong, N. D. Davenport, N. W. Nelson, R. H. Kardon, K. O. Lim, and S. R. Sponheim, “Deficits in visual system functional connectivity after blast-related mild TBI are associated with injury severity and executive dysfunction,” Brain Behav. 6(5), e00454 (2016).
[Crossref] [PubMed]

Golebiowski, B.

B. Golebiowski, E. Papas, and F. Stapleton, “Corneal mechanical sensitivity measurement using a staircase technique,” Ophthalmic Physiol. Opt. 25(3), 246–253 (2005).
[Crossref] [PubMed]

Goodrich, G.

F. Barker, G. Cockerham, G. Goodrich, A. Hartwick, R. Kardon, A. B. Mick, and M. Swanson, “Brain injury impact on the eye and vision,” Optom. Vis. Sci. 94(1), 4–6 (2017).
[Crossref] [PubMed]

Gross, M.

A. Main, A. Dowson, and M. Gross, “Photophobia and phonophobia in migraineurs between attacks,” Headache 37(8), 492–495 (1997).
[Crossref] [PubMed]

Hallett, M.

Y. Wu and M. Hallett, “Photophobia in neurologic disorders,” Transl. Neurodegener. 6(1), 26 (2017).
[Crossref] [PubMed]

Hardcastle, A. J.

J. Aboshiha, A. M. Dubis, J. Carroll, A. J. Hardcastle, and M. Michaelides, “The cone dysfunction syndromes,” Br. J. Ophthalmol. 100(1), 115–121 (2016).
[Crossref] [PubMed]

Hartwick, A.

F. Barker, G. Cockerham, G. Goodrich, A. Hartwick, R. Kardon, A. B. Mick, and M. Swanson, “Brain injury impact on the eye and vision,” Optom. Vis. Sci. 94(1), 4–6 (2017).
[Crossref] [PubMed]

Hartwick, A. T.

P. T. Yuhas, P. D. Shorter, C. E. McDaniel, M. J. Earley, and A. T. Hartwick, “Blue and red light-evoked pupil responses in photophobic subjects with TBI,” Optom. Vis. Sci. 94(1), 108–117 (2017).
[Crossref] [PubMed]

Hayes, J. R.

H. Laukkanen, M. Scheiman, and J. R. Hayes, “Brain injury vision symptom survey (BIVSS) questionnaire,” Optom. Vis. Sci. 94(1), 43–50 (2017).
[Crossref] [PubMed]

Holubkov, R.

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

Hunter, L. A.

M. M. Cortez, N. A. Rea, L. A. Hunter, K. B. Digre, and K. C. Brennan, “Altered pupillary light response scales with disease severity in migrainous photophobia,” Cephalalgia 37(8), 801–811 (2017).
[Crossref] [PubMed]

Kardon, R.

F. Barker, G. Cockerham, G. Goodrich, A. Hartwick, R. Kardon, A. B. Mick, and M. Swanson, “Brain injury impact on the eye and vision,” Optom. Vis. Sci. 94(1), 4–6 (2017).
[Crossref] [PubMed]

Kardon, R. H.

C. S. Gilmore, J. Camchong, N. D. Davenport, N. W. Nelson, R. H. Kardon, K. O. Lim, and S. R. Sponheim, “Deficits in visual system functional connectivity after blast-related mild TBI are associated with injury severity and executive dysfunction,” Brain Behav. 6(5), e00454 (2016).
[Crossref] [PubMed]

Katz, B. J.

S. M. Llop, J. E. Frandsen, K. B. Digre, B. J. Katz, A. V. Crum, C. Zhang, and J. E. A. Warner, “Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia,” J. Headache Pain 17(1), 34 (2016).
[Crossref] [PubMed]

B. J. Katz and K. B. Digre, “Diagnosis, pathophysiology, and treatment of photophobia,” Surv. Ophthalmol. 61(4), 466–477 (2016).
[Crossref] [PubMed]

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

W. H. Adams, K. B. Digre, B. C. Patel, R. L. Anderson, J. E. Warner, and B. J. Katz, “The evaluation of light sensitivity in benign essential blepharospasm,” Am. J. Ophthalmol. 142(1), 82–87 (2006).
[Crossref] [PubMed]

Lamb, R. D.

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

Langeberg, W. J.

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

Laukkanen, H.

H. Laukkanen, M. Scheiman, and J. R. Hayes, “Brain injury vision symptom survey (BIVSS) questionnaire,” Optom. Vis. Sci. 94(1), 43–50 (2017).
[Crossref] [PubMed]

Lebensohn, J. E.

J. E. Lebensohn and J. Bellows, “The nature of photophobia,” Arch. Ophthalmol. 12(3), 380–390 (1934).
[Crossref]

Levitt, R. C.

A. Galor, R. C. Levitt, E. R. Felix, and C. D. Sarantopoulos, “What can photophobia tell us about dry eye?” Expert Rev. Ophthalmol. 11(5), 321–324 (2016).
[Crossref] [PubMed]

Lim, K. O.

C. S. Gilmore, J. Camchong, N. D. Davenport, N. W. Nelson, R. H. Kardon, K. O. Lim, and S. R. Sponheim, “Deficits in visual system functional connectivity after blast-related mild TBI are associated with injury severity and executive dysfunction,” Brain Behav. 6(5), e00454 (2016).
[Crossref] [PubMed]

Lim, M. M.

M. L. Callahan and M. M. Lim, “Sensory Sensitivity in TBI: Implications for Chronic Disability,” Curr. Neurol. Neurosci. Rep. 18(9), 56 (2018).
[Crossref] [PubMed]

Llop, S. M.

S. M. Llop, J. E. Frandsen, K. B. Digre, B. J. Katz, A. V. Crum, C. Zhang, and J. E. A. Warner, “Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia,” J. Headache Pain 17(1), 34 (2016).
[Crossref] [PubMed]

Main, A.

A. Main, I. Vlachonikolis, and A. Dowson, “The wavelength of light causing photophobia in migraine and tension-type headache between attacks,” Headache 40(3), 194–199 (2000).
[Crossref] [PubMed]

A. Main, A. Dowson, and M. Gross, “Photophobia and phonophobia in migraineurs between attacks,” Headache 37(8), 492–495 (1997).
[Crossref] [PubMed]

Mainster, M. A.

M. A. Mainster and P. L. Turner, “Glare’s causes, consequences, and clinical challenges after a century of ophthalmic study,” Am. J. Ophthalmol. 153(4), 587–593 (2012).
[Crossref] [PubMed]

McClane, R. W.

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

McDaniel, C. E.

P. T. Yuhas, P. D. Shorter, C. E. McDaniel, M. J. Earley, and A. T. Hartwick, “Blue and red light-evoked pupil responses in photophobic subjects with TBI,” Optom. Vis. Sci. 94(1), 108–117 (2017).
[Crossref] [PubMed]

Michaelides, M.

J. Aboshiha, A. M. Dubis, J. Carroll, A. J. Hardcastle, and M. Michaelides, “The cone dysfunction syndromes,” Br. J. Ophthalmol. 100(1), 115–121 (2016).
[Crossref] [PubMed]

Mick, A. B.

F. Barker, G. Cockerham, G. Goodrich, A. Hartwick, R. Kardon, A. B. Mick, and M. Swanson, “Brain injury impact on the eye and vision,” Optom. Vis. Sci. 94(1), 4–6 (2017).
[Crossref] [PubMed]

Mizota, A.

Y. Sakanishi, M. Awano, A. Mizota, M. Tanaka, A. Murakami, and K. Ohnuma, “Age-related changes in spectral transmittance of the human crystalline lens in situ,” Ophthalmologica 228(3), 174–180 (2012).
[Crossref] [PubMed]

Mulleners, W. M.

E. P. Chronicle and W. M. Mulleners, “Visual system dysfunction in migraine: a review of clinical and psychophysical findings,” Cephalalgia 16(8), 525–535 (1996).
[Crossref] [PubMed]

Murakami, A.

Y. Sakanishi, M. Awano, A. Mizota, M. Tanaka, A. Murakami, and K. Ohnuma, “Age-related changes in spectral transmittance of the human crystalline lens in situ,” Ophthalmologica 228(3), 174–180 (2012).
[Crossref] [PubMed]

Nandedkar, S. D.

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

Nelson, N. W.

C. S. Gilmore, J. Camchong, N. D. Davenport, N. W. Nelson, R. H. Kardon, K. O. Lim, and S. R. Sponheim, “Deficits in visual system functional connectivity after blast-related mild TBI are associated with injury severity and executive dysfunction,” Brain Behav. 6(5), e00454 (2016).
[Crossref] [PubMed]

Noseda, R.

R. Noseda, D. Copenhagen, and R. Burstein, “Current understanding of photophobia, visual networks and headaches,” Cephalalgia 0(0), 333102418784750 (2018).
[Crossref] [PubMed]

Ohnuma, K.

Y. Sakanishi, M. Awano, A. Mizota, M. Tanaka, A. Murakami, and K. Ohnuma, “Age-related changes in spectral transmittance of the human crystalline lens in situ,” Ophthalmologica 228(3), 174–180 (2012).
[Crossref] [PubMed]

Papas, E.

B. Golebiowski, E. Papas, and F. Stapleton, “Corneal mechanical sensitivity measurement using a staircase technique,” Ophthalmic Physiol. Opt. 25(3), 246–253 (2005).
[Crossref] [PubMed]

Pareja, J. A.

J. V. Vingen, J. A. Pareja, and L. J. Stovner, “Quantitative evaluation of photophobia and phonophobia in cluster headache,” Cephalalgia 18(5), 250–256 (1998).
[Crossref] [PubMed]

J. Vanagaite, J. A. Pareja, O. Støren, L. R. White, T. Sand, and L. J. Stovner, “Light-induced discomfort and pain in migraine,” Cephalalgia 17(7), 733–741 (1997).
[Crossref] [PubMed]

Patel, B. C.

W. H. Adams, K. B. Digre, B. C. Patel, R. L. Anderson, J. E. Warner, and B. J. Katz, “The evaluation of light sensitivity in benign essential blepharospasm,” Am. J. Ophthalmol. 142(1), 82–87 (2006).
[Crossref] [PubMed]

Rea, N. A.

M. M. Cortez, N. A. Rea, L. A. Hunter, K. B. Digre, and K. C. Brennan, “Altered pupillary light response scales with disease severity in migrainous photophobia,” Cephalalgia 37(8), 801–811 (2017).
[Crossref] [PubMed]

Recober, A.

H. L. Rossi and A. Recober, “Photophobia in primary headaches,” Headache 55(4), 600–604 (2015).
[Crossref] [PubMed]

Rosenthal, P.

P. Rosenthal and D. Borsook, “Ocular neuropathic pain,” Br. J. Ophthalmol. 100(1), 128–134 (2016).
[Crossref] [PubMed]

Rossi, H. L.

H. L. Rossi and A. Recober, “Photophobia in primary headaches,” Headache 55(4), 600–604 (2015).
[Crossref] [PubMed]

Sakanishi, Y.

Y. Sakanishi, M. Awano, A. Mizota, M. Tanaka, A. Murakami, and K. Ohnuma, “Age-related changes in spectral transmittance of the human crystalline lens in situ,” Ophthalmologica 228(3), 174–180 (2012).
[Crossref] [PubMed]

Sand, T.

J. Vanagaite, J. A. Pareja, O. Støren, L. R. White, T. Sand, and L. J. Stovner, “Light-induced discomfort and pain in migraine,” Cephalalgia 17(7), 733–741 (1997).
[Crossref] [PubMed]

Sarantopoulos, C. D.

A. Galor, R. C. Levitt, E. R. Felix, and C. D. Sarantopoulos, “What can photophobia tell us about dry eye?” Expert Rev. Ophthalmol. 11(5), 321–324 (2016).
[Crossref] [PubMed]

Scheiman, M.

H. Laukkanen, M. Scheiman, and J. R. Hayes, “Brain injury vision symptom survey (BIVSS) questionnaire,” Optom. Vis. Sci. 94(1), 43–50 (2017).
[Crossref] [PubMed]

Shorter, P. D.

P. T. Yuhas, P. D. Shorter, C. E. McDaniel, M. J. Earley, and A. T. Hartwick, “Blue and red light-evoked pupil responses in photophobic subjects with TBI,” Optom. Vis. Sci. 94(1), 108–117 (2017).
[Crossref] [PubMed]

Singman, E. L.

B. P. Barnett and E. L. Singman, “Vision concerns after mild traumatic brain injury,” Curr. Treat. Options Neurol. 17(2), 329 (2015).
[Crossref] [PubMed]

Smith, A. G.

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

Sponheim, S. R.

C. S. Gilmore, J. Camchong, N. D. Davenport, N. W. Nelson, R. H. Kardon, K. O. Lim, and S. R. Sponheim, “Deficits in visual system functional connectivity after blast-related mild TBI are associated with injury severity and executive dysfunction,” Brain Behav. 6(5), e00454 (2016).
[Crossref] [PubMed]

Stapleton, F.

B. Golebiowski, E. Papas, and F. Stapleton, “Corneal mechanical sensitivity measurement using a staircase technique,” Ophthalmic Physiol. Opt. 25(3), 246–253 (2005).
[Crossref] [PubMed]

Stevens, J. C.

Stevens, S. S.

Støren, O.

J. Vanagaite, J. A. Pareja, O. Støren, L. R. White, T. Sand, and L. J. Stovner, “Light-induced discomfort and pain in migraine,” Cephalalgia 17(7), 733–741 (1997).
[Crossref] [PubMed]

Stovner, L. J.

J. Vanagaite Vingen and L. J. Stovner, “Photophobia and phonophobia in tension-type and cervicogenic headache,” Cephalalgia 18(6), 313–318 (1998).
[Crossref] [PubMed]

J. V. Vingen, J. A. Pareja, and L. J. Stovner, “Quantitative evaluation of photophobia and phonophobia in cluster headache,” Cephalalgia 18(5), 250–256 (1998).
[Crossref] [PubMed]

J. Vanagaite, J. A. Pareja, O. Støren, L. R. White, T. Sand, and L. J. Stovner, “Light-induced discomfort and pain in migraine,” Cephalalgia 17(7), 733–741 (1997).
[Crossref] [PubMed]

Stringham, J. M.

Swanson, M.

F. Barker, G. Cockerham, G. Goodrich, A. Hartwick, R. Kardon, A. B. Mick, and M. Swanson, “Brain injury impact on the eye and vision,” Optom. Vis. Sci. 94(1), 4–6 (2017).
[Crossref] [PubMed]

Tanaka, M.

Y. Sakanishi, M. Awano, A. Mizota, M. Tanaka, A. Murakami, and K. Ohnuma, “Age-related changes in spectral transmittance of the human crystalline lens in situ,” Ophthalmologica 228(3), 174–180 (2012).
[Crossref] [PubMed]

Turner, P. L.

M. A. Mainster and P. L. Turner, “Glare’s causes, consequences, and clinical challenges after a century of ophthalmic study,” Am. J. Ophthalmol. 153(4), 587–593 (2012).
[Crossref] [PubMed]

Vanagaite, J.

J. Vanagaite, J. A. Pareja, O. Støren, L. R. White, T. Sand, and L. J. Stovner, “Light-induced discomfort and pain in migraine,” Cephalalgia 17(7), 733–741 (1997).
[Crossref] [PubMed]

Vanagaite Vingen, J.

J. Vanagaite Vingen and L. J. Stovner, “Photophobia and phonophobia in tension-type and cervicogenic headache,” Cephalalgia 18(6), 313–318 (1998).
[Crossref] [PubMed]

Vingen, J. V.

J. V. Vingen, J. A. Pareja, and L. J. Stovner, “Quantitative evaluation of photophobia and phonophobia in cluster headache,” Cephalalgia 18(5), 250–256 (1998).
[Crossref] [PubMed]

Vlachonikolis, I.

A. Main, I. Vlachonikolis, and A. Dowson, “The wavelength of light causing photophobia in migraine and tension-type headache between attacks,” Headache 40(3), 194–199 (2000).
[Crossref] [PubMed]

Warner, J. E.

W. H. Adams, K. B. Digre, B. C. Patel, R. L. Anderson, J. E. Warner, and B. J. Katz, “The evaluation of light sensitivity in benign essential blepharospasm,” Am. J. Ophthalmol. 142(1), 82–87 (2006).
[Crossref] [PubMed]

Warner, J. E. A.

S. M. Llop, J. E. Frandsen, K. B. Digre, B. J. Katz, A. V. Crum, C. Zhang, and J. E. A. Warner, “Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia,” J. Headache Pain 17(1), 34 (2016).
[Crossref] [PubMed]

M. K. Blackburn, R. D. Lamb, K. B. Digre, A. G. Smith, J. E. A. Warner, R. W. McClane, S. D. Nandedkar, W. J. Langeberg, R. Holubkov, and B. J. Katz, “FL-41 tint improves blink frequency, light sensitivity, and functional limitations in patients with benign essential blepharospasm,” Ophthalmology 116(5), 997–1001 (2009).
[Crossref] [PubMed]

Wenzel, A. J.

White, L. R.

J. Vanagaite, J. A. Pareja, O. Støren, L. R. White, T. Sand, and L. J. Stovner, “Light-induced discomfort and pain in migraine,” Cephalalgia 17(7), 733–741 (1997).
[Crossref] [PubMed]

Wirtschafter, J. D.

J. D. Wirtschafter and C. M. Bourassa, “Binocular Facilitation of Discomfort with High Luminances,” Arch. Ophthalmol. 75(5), 683–688 (1966).
[Crossref] [PubMed]

C. M. Bourassa and J. D. Wirtschafter, “Mechanism of binocular increase of discomfort to high luminance,” Nature 212(5069), 1503–1504 (1966).
[Crossref] [PubMed]

J. D. Wirtschafter, C. M. Bourassa, and R. S. Dow, “The Quantitative Study of Photophobia,” Trans. Am. Neurol. Assoc. 88, 291–293 (1963).
[PubMed]

Wu, Y.

Y. Wu and M. Hallett, “Photophobia in neurologic disorders,” Transl. Neurodegener. 6(1), 26 (2017).
[Crossref] [PubMed]

Yuhas, P. T.

P. T. Yuhas, P. D. Shorter, C. E. McDaniel, M. J. Earley, and A. T. Hartwick, “Blue and red light-evoked pupil responses in photophobic subjects with TBI,” Optom. Vis. Sci. 94(1), 108–117 (2017).
[Crossref] [PubMed]

Zele, A. J.

A. J. Zele and D. Cao, “Vision under mesopic and scotopic illumination,” Front. Psychol. 5(1594), 1594 (2015).
[PubMed]

Zhang, C.

S. M. Llop, J. E. Frandsen, K. B. Digre, B. J. Katz, A. V. Crum, C. Zhang, and J. E. A. Warner, “Increased prevalence of depression and anxiety in patients with migraine and interictal photophobia,” J. Headache Pain 17(1), 34 (2016).
[Crossref] [PubMed]

Am. J. Ophthalmol. (2)

M. A. Mainster and P. L. Turner, “Glare’s causes, consequences, and clinical challenges after a century of ophthalmic study,” Am. J. Ophthalmol. 153(4), 587–593 (2012).
[Crossref] [PubMed]

W. H. Adams, K. B. Digre, B. C. Patel, R. L. Anderson, J. E. Warner, and B. J. Katz, “The evaluation of light sensitivity in benign essential blepharospasm,” Am. J. Ophthalmol. 142(1), 82–87 (2006).
[Crossref] [PubMed]

Arch. Ophthalmol. (2)

J. E. Lebensohn and J. Bellows, “The nature of photophobia,” Arch. Ophthalmol. 12(3), 380–390 (1934).
[Crossref]

J. D. Wirtschafter and C. M. Bourassa, “Binocular Facilitation of Discomfort with High Luminances,” Arch. Ophthalmol. 75(5), 683–688 (1966).
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Supplementary Material (1)

NameDescription
» Visualization 1       Demonstration of custom LabVIEW software interface used to post-process infrared video recordings of a healthy subject (ID#6).

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Figures (13)

Fig. 1
Fig. 1 The Ocular Photosensitivity Analyzer viewed from three perspectives. Operator View: A. Humidity and temperature meter, B. Table height adjustment controller; Side View: C. LED light source, D. Computer and graphical user interface, E. Lux meter; Subject View: F. LED concave array panel and integrated near infrared video camera, G. Handheld push-button, H. Single blinking white LED for fixation, I. Head-chin rest.
Fig. 2
Fig. 2 Normalized emission spectrum of the OPA and Halogen source (Ianebeam halogen lamp with heat filter controlled by a rheostat as used by Vanagaite et al. [12] and Adams et al. [8]) from 350 to 950 nm. The visible spectrum range (400 to 700 nm) [33] is indicated by the two vertical black dashed lines.
Fig. 3
Fig. 3 Custom software interface used to post-process infrared video recordings. The software outputs the following physiologic parameters: pupil diameter, palpebral fissure height, and inter-blink interval (see Visualization 1).
Fig. 4
Fig. 4 Example of a response curve. The software automatically assesses the subject’s visual photosensitivity threshold from the mean of 10 response reversals (For clarity, the green triangles and blue points have been added to delineate between response reversals and the orange diamonds represent catch trials).
Fig. 5
Fig. 5 Ocular Photosensitivity Analyzer Testing protocol and testing paradigm flowchart.
Fig. 6
Fig. 6 The OPA testing a healthy subject and graphical user interface displaying subject’s visual photosensitivity threshold in real-time.
Fig. 7
Fig. 7 Longitudinal visual photosensitivity thresholds assessment of healthy subjects at varying time points.
Fig. 8
Fig. 8 The mean visual photosensitivity threshold (log lux) per time point: 0, 2, 12, 40, and 379 days ( ± Standard Error) of healthy subjects.
Fig. 9
Fig. 9 Visual photosensitivity thresholds of healthy, achromatopsia, and TBI subjects ( ± Standard Error).
Fig. 10
Fig. 10 Bland-Altman scatterplot of pupil diameter measurements comparing manual and automatic segmentation methods ( ± two Standard Deviations (SD)).
Fig. 11
Fig. 11 Bland-Altman scatterplot of palpebral fissure height measurements comparing manual and automatic segmentation methods ( ± two Standard Deviations (SD)).
Fig. 12
Fig. 12 Baseline pupil diameter (mm) and percent change in pupil diameter of six healthy and six achromatopsia subjects with respect to VPT (log lux).
Fig. 13
Fig. 13 Baseline palpebral fissure height (mm) and percent change in palpebral fissure height of six healthy and six achromatopsia subjects with respect to VPT (log lux).

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