Quantification of macular carotenoids using autofluorescence imaging in patients with photosensitive migraine and benign essential blepharospasm.

P hotophobia describes light sensitivity or abnormal intolerance of light. Patients with photophobia avoid light because of pain or discomfort. Photophobia may be reported by individuals with conditions not necessarily affecting the eye. Two such conditions are migraine and benign essential blepharospasm. We have previously demonstrated that patients with migraine or blepharospasm are more light sensitive than agematched control subjects. The pathophysiology of light sensitivity is unknown. We suspected that patients with photophobia might have abnormally low levels of the xanthophyll carotenoids lutein and zeaxanthin in their retinas. These carotenoids filter out phototoxic short-wavelength visible light and function as antioxidants. We have previously demonstrated that a rose-colored spectacle tint, FL-41, can ameliorate symptoms of light sensitivity in patients with blepharospasm. Because of the similarity between the transmission spectra of FL-41 and carotenoids, we hypothesized that photophobic individuals may have reduced levels of carotenoids in their maculae.