Late consensual photophobia after contralateral ocular trauma

Ocular inflammation may cause irritation and intolerance to light, i.e., photophobia. The authors report three cases of severe late photophobia in a healthy eye caused by the chronically inflamed contralateral blind eye. The disabling photophobia started many years after the injury (trauma in two cases and multiple operations in one case). Patching of the diseased eye or its treatment with steroids and cycloplegia had only minor therapeutic effect. The photophobia disappeared after retrobulbar injection of 95% alcohol (single or repeated) to the blind eye and relief was maintained during a follow-up period of a few months to over a year. The suggested mechanism is that the exposure to light of the unaffected eye caused bilateral ciliary stimulation. The inflammatory response of the irritated injured eye was manifested as consensual photophobia in the seeing eye. The curative effect of the alcohol supports a neuronal transmission of the consensual effect.