CC BY-NC-ND 4.0 · Asian J Neurosurg 2020; 15(03): 479-483
DOI: 10.4103/ajns.AJNS_187_19
Original Research Article

The onset and recovery timeline of visual photosensitivity following mild traumatic brain injury with special focus on habitual digital device screens users

Matuli Das
Department of Ophthalmology, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha
Narendra Das
1   Department of Neurosurgery, Kalinga Institute of Medical Sciences, Bhubaneswar, Odisha
› Author Affiliations

Primary Objective: Visual photosensitivity following mild traumatic brain injury (mTBI) can cause mild discomfort to significant pain and can affect a person's ability to lead a regular life and perform normal activities. The purpose of the present study is twofold: (1) To determine the recovery pattern of visual photosensitivity following mTBI and (2) to find out whether the onset of visual photosensitivity and its recovery pattern is any different among habitual screen users (HSU) (chronic exposure to digital device screens). Materials and Methods: This study was a hospital-based prospective, analytical, observational study. The study period was from July 2017 to March 2019. All the mTBI patients with visual photosensitivity who fulfilled the inclusion Criteria were followed up for 1 year to capture their recovery profile. Results: In 60% of the patients, the time of appearance of visual photosensitivity was at around 3 month's post-mTBI. Nearly 66.6% of patients suffering from visual photosensitivity following mTBI recovered within 3 months following the onset of their symptoms. The symptoms of visual photosensitivity appeared earlier among the HSU as compared to nonscreen users (P = 0.0039). The recovery from the symptoms of visual photosensitivity following mTBI is delayed in HSU (P = 0.0028). The patients in whom the symptoms of visual photosensitivity persisted beyond a year were predominantly HSU (P = 0.0062). Conclusions: The present study has given a new insight on the timeline of recovery for the patients with visual photosensitivity following mTBI. To the best of our knowledge, this is the only study which has shown how chronic exposure to blue light from digital device screens can affect the recovery of visual symptoms such as visual photosensitivity following mTBI.

Financial support and sponsorship


Publication History

Received: 23 June 2019

Accepted: 04 May 2020

Article published online:
16 August 2022

© 2020. Asian Congress of Neurological Surgeons. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

  • References

  • 1 Hyder AA, Wunderlich CA, Puvanachandra P, Gururaj G, Kobusingye OC. The impact of traumatic brain injuries: A global perspective. Neuro Rehabil 2007;22:341-53.
  • 2 Faul M, Xu L, Wald MM, Coronado VG. Traumatic Brain Injury in United States: Emergency Department Visits, Hospitalization and Deaths, 2002-2006. Atlanta GA: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control; 2010.
  • 3 Sutter PS. Rehabilitation and management of visual dysfunction following traumatic brain injury. In: Ashley MJ, Krych DK, editors. Traumatic Brain Injury Rehabilitation. Boca Raton, FL: CRC Press; 1995. p. 187-216.
  • 4 Capó-Aponte JE, Urosevich TG, Temme LA, Tarbett AK, Sanghera NK. Visual dysfunctions and symptoms during the subacute stage of blast-induced mild traumatic brain injury. Mil Med 2012;177:804-13.
  • 5 Das M, Mohapatra S, Mohapatra SS. New perspectives on central and peripheral immune responses to acute traumatic brain injury. J Neuroinflammation 2012;9:236.
  • 6 Guley NM. Mild Traumatic Brain Injury with Associated Visual System Dysfunction: Investigating Histopathology, Functional Correlates, and A Novel Therapeutic Immune Modulator. ProQuest LLC; 2016. p. 10113327.
  • 7 Kapoor N, Ciuffreda KJ. Vision disturbances following traumatic brain injury. Curr Treat Options Neurol 2002;4:271-80.
  • 8 Ciuffreda KJ, Kapoor N, Rutner D, Suchoff IB, Han ME, Craig S. Occurrence of oculomotor dysfunctions in acquired brain injury: A retrospective analysis. Optometry 2007;78:155-61.
  • 9 Katz BJ, Digre KB. Diagnosis, pathophysiology, and treatment of photophobia. Surv Ophthalmol 2016;61:466-77.
  • 10 Verriotto JD, Gonzalez A, Aguilar MC, Parel JM, Feuer WJ, Smith AR, et al. New method of quantification of visual photosensitivity thresold and symptoms. Transl Vis Sci Technol 2017;6:18.
  • 11 Tosini G, Ferguson I, Tsubota K. Effects of blue light on the circadian system and eye physiology. Mol Vis 2016;22:61-72.
  • 12 Grimm C, Wenzel A, Williams T, Rol P, Hafezi F, Remé C. Rhodopsin-mediated blue-light damage to the rat retina: Effect of photoreversal of bleaching. Invest Ophthalmol Vis Sci 2001;42:497-505.
  • 13 Center for Disease Control and Prevention. Report to Congress on Mild Traumatic Brain Injury in United States: Steps to Prevent a Serious Public Health Problem. Atlanta: Center for Disease Control and Prevention; 2003.
  • 14 Truong JQ, Ciuffreda KJ, Han MH, Suchoff IB. Photosensitivity in mild traumatic brain injury (mTBI): A retrospective analysis. Brain Inj 2014;28:1283-7.
  • 15 Craig SB, Kapoor N, Ciuffreda KJ, Suchoff IB, Han ME, Rutner D. Profile of selected aspects of visually-symptomatic individuals with acquired brain injury: A retrospective study. J Behav Optom 2008;19:7-10.
  • 16 Centers for Disease Control and Prevention. Report to Congress on Traumatic Brain Injury in the United Status. Centers for Disease control and prevention; 2015.
  • 17 Waddell PA, Gronwall DM. Sensitivity to light and sound following minor head injury. Acta Neurol Scand 1984;69:270-6.
  • 18 Hammeke TA, Mcrea M, Coats SM, Verber MD, Durgerian S, Flora K, et al. Acute and subacute changes in neural activation during the recovery from sport – Related concussion. J Int Neuropsychol Soc 2013;19:863-72.
  • 19 Kushner D. Mild traumatic brain injury: Towards understanding manifestation and treatment. Arch Intern Med 1998;158:1617.
  • 20 Alexander MP. Mild traumatic brain injury: Pathophysiology, natural history, and clinical management. Neurology 1995;45:1253-60.
  • 21 Levin HS, Mattis S, Ruff RM, Eisenberg HM, Marshall LF, Tabaddor K, et al. Neuro behavioural outcome following minor head injury. J Neurosurg 1987;66:234.