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Ophthalmology & Optometry/Sudden Onset Light Sensitivity/Photophobia

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In June of 2014, In a 3-week period, I had 2 ophthalmological appointments, and in each was dilated with what I was later told was Mydriacil and/or Proparicane, although I did not see the bottles.  After the first dilation, I was fine.  But the day after the second dilation, I developed EXTREME light sensitivity and headaches, which I had never experienced before.  This condition has persisted for a year and a half.  If I am in the sun for 1-2 minutes, even with very dark sunglasses (often 2 pairs, or moreóregular and fit-over) and a hat, I experience a sense of burning/heat/swelling in the far back of my eyes and aching in the eyes.  A headache soon develops, and the eye pain increases and persists for about 2-3 days, with a sensation of grittiness in my eyes. The headache is deep and may be a migraine.  I have experimented with sun glasses up to 6 times normal darkness (with layers of post-myrdriatic spectacle plastic and even welding goggle lenses) and I have sealed all the gaps on the top and sides of the sun glasses with duct tape, but I still cannot be in the sun for more than about 10 minutes.  I now am also sensitive to bright fluorescent overhead lights.  I AM able to walk at night, although Iím sensitive to car headlights if the brights are pointed directly at me.  I AM able to swim face-down in pools with a snorkel and sunglasses glued over the mask.  An ophthalmologist and a neuro-opthalmologist  at Bascom palmer have both said that I seem to have had an adverse reaction to the dilation drops and that I should not be dilated again.  One claimed my eyes were dry, but Systane Ultra drops made no difference.  One said I may have had a reaction to the preservative in the eye drops.  No one had any further suggestions, and the situation has not gotten any better.  I do have a traumatic cataract in my left eye, but that has been stable for 35 years.  I take Coumadin for a blood clots, hydrocodone for back/neck pain, and theophylline for asthma.  I used to love the beach and the walking/bicycling in the sun, and now my entire life must essentially be indoors.  Do you have any ideas about causes/solutions to this issue?

Answer
Although rare, adverse or hypersensitivity reactions to dilating eye drops can occur.  When it does occur , patients often manifest symptoms of photophobia. Headaches , burning and general ocular discomfort .  Polaroid dark glasses and a large brimmed hat should be worn until symptoms are relieved and sun avoidance is recommended. Further , if dilation in the future is ever required , insist on the weakest formula of 0.5% Mydriacyl or Tropicamide.  If symptoms still not relieved, ask you eye doctor for a pupillary constructive eye drop for temporary use. Good luck. Dr Berger  

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DR. KENNETH BERGER

Expertise

Any and all questions with regard to ocular ailments, eye diseases as cataracts, glaucoma, macular degeneration, diabetic retinopathy, etc , eye and visual sympomatology, eyeglasses, contact lenses, low or subnormal vision, pediatric vision conditions,and special and unique ailments will be discussed.

Experience

36 years of clinical experience in opticianry and therapeutic optometry. Still in private practice with special interests in vision conditions, diagnosing and treating ocular ailments, prescibing treatment plans which include medicine, eyeglasses, and contact lenses primarily. Although surgery is not within the realm of my area of expertise, I co-manage many pre and post -op surgical cases which include Lasik and PRK procedures.

Organizations
New Jersey Society of Optometric Physicians American Optometric Association

Education/Credentials
B.A.,1968, Hunter College of the City University of New York B.S.,1970, Pennsylvania College of Optometry O.D.,1973, Pennsylvania College of Optometry Therapeutic Pharmaceutical Administration Certification, New Jersey 1992

Awards and Honors
Clinical Efficiency Award, 1973, Pennsylvaania College of Optometry

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