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To the Editor.
—Some years ago a student not satisfied with textbook explanations of photophobia convinced me that an additional unrecognized component is involved. This, I demonstrated, is the vascular trigeminal pupillary reflex that accompanies any more or less painful stimulation of the fifth nerve through simultaneous stimulation of antidromic vasodilator fibers from the Gasserian ganglion to the blood vessels of the iris and ciliary body; and whereas the reaction to light of the normal iris is painless, that of the congested iris is painful. True photophobia is always pathologic and a cure of the pathologic basis is the best remedy, though alleviation is possible by immobilization of the pupil by atropine, analgesics, dark sunglasses, or vascular decongestants (Lebensohn, J.E.: Nature of Photophobia, Arch Ophthal12:284, 1934; Photophobia: Mechanism and Implications, Amer J Ophthal34:1294, 1951). A recent article (Bresnick, G.H., and Gay, A.J.: Rubeosis Iridis Associated With
Lebensohn JE. PHOTOPHOBIA. Arch Ophthalmol. 1967;77(6):847. doi:10.1001/archopht.1967.00980020849034