Photophobia in viral conjunctivitis

Viral conjunctivitis commonly is associated with upper respiratory tract infections

and is usually caused by an adenovirus. This is the type of conjunctivitis that
occurs in epidemics of pink eye. The patient normally complains of both eyes
being gritty and uncomfortable, although symptoms may begin in one eye. There
may be associated symptoms of a cold and a cough. The discharge is usually
watery. Viral conjunctivitis usually lasts longer than bacterial conjunctivitis and
may go on for many weeks; patients need to be informed of this.1
Photophobia is an abnormal sensitivity to light that accompanies with iris
inflammation, either alone or secondary to corneal inflammation. Patients with
conjunctivitis have normal light sensitivity.2
Photophobia, or intolerance of light, is not completely understood as a symptom. It
has been divided into ocular and central types. Photophobia and discomfort may
be severe if the patient goes on to develop discrete corneal opacities. In uveitis
anterior photophobia due to inflammation and ciliary spasm. The pain may be
worse when the patient is reading and contracting the ciliary muscle.1
Cornea has a lot of pain fibers, most lesions of the cornea, either superficialis or
profundus (corneal foreign body, corneal abrasion, phlyctenule, interstisisal
keratitis) can causing pain and photophobia.

Photophobia in corneal disease is

caused by contraction of the iris inflammation. Iris vessel dilatation is a reflex

phenomenon caused by irritation of the nerve endings of the cornea.3

The photophobia in conjunctivitis could be happen if there is corneal involvement.

So, the patophysiology is almost same , that there is a reflex phenomenon because
of irritation in corneal nerve endings.
Reference
1. Khaw, PT, et al. 2004. Abc of eyes. Ed.4th. BMJ Publishin group
2. Bradford, C.A. Basic of ophtalmology . American academy

of

ophtalmology. Ed 7th 1999.

3. Vaughan, Daniel G et al. 2002.Oftalmologi Umum edisi-14. Jakarta: Widya
Medika.Hal: 129 152