Interictal Pattern‐Induced Visual Discomfort and Ictal Photophobia in Episodic Migraineurs: An Association of Interictal and Ictal Photophobia

Background.— Pattern-induced visual discomfort and photophobia are frequently observed symptoms in migraineurs. The presumed pathophysiologic mechanisms of pattern glare and photophobia seem to overlap anatomically within the central nervous system. Objective.— To assess the relationship between interictal pattern-induced visual discomfort and ictal photophobia in episodic migraineurs. Methods.— We compared pattern-induced visual discomfort among 3 groups: controls, migraineurs without ictal photophobia (MwoP), and migraineurs with ictal photophobia (MwP). Photophobia was assessed with a validated photophobia questionnaire. Visual discomfort tests were performed using 3 striped patterns with different spatial frequencies. After viewing the patterns for 10 seconds, subjects were asked to report the severity of visual discomfort using 4 scales (none, mild, moderate, and severe) and using a 0-10 visual analog scale (VAS). We compared the proportion of subjects choosing moderate-to-severe discomfort and the median values of VAS scores for each pattern among the 3 groups. Results.— We enrolled 35 controls, 18 MwoP, and 44 MwP, and there were no significant differences in clinical features among the 3 groups. MwP reported a significantly higher proportion of moderate-to-severe discomfort and higher median VAS scores than the controls and MwoP did. The intensity of discomfort increased with higher frequency of visual stimuli. Conclusions.— We conclude that MwP experienced more severe pattern-induced visual discomfort as compared with the controls and MwoP.