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JAMA Ophthalmology Clinical Challenge
December 2018

Photophobia After Laser Eyebrow Epilation

Author Affiliations
  • 1Department of Ophthalmology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
JAMA Ophthalmol. 2018;136(12):1408-1409. doi:10.1001/jamaophthalmol.2018.2311

A 29-year-old white woman presented for a second opinion of left eye pain, blurred vision, and photophobia. Six weeks before, she received eyebrow laser epilation with an 800-nm diode laser (LightSheer; Lumenis). During the session, the physician assistant removed the metal eye shield for better exposure, immediately after which the patient developed eye pain and blurred vision. She was initially treated for acute iritis with difluprednate, 4 times daily, which was tapered to once daily, with minimal improvement in her symptoms. The patient reported a negative review of systems and denied recent travel, trauma, use of antibiotics, or pregnancy. Her examination was notable for best-corrected visual acuity of 20/20 OU, anterior chamber (AC) pigment and flare in the left eye, and iris irregularities, including decreased iris reactivity, peripupillary transillumination defects (Figure, A), and posterior synechiae. She had mild intraocular pressure (IOP) asymmetry of 12 mm Hg OD and 17 mm Hg OS.

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