A Novel Visual Psychometric Test For Light-Induced Discomfort Using Red And Blue Light Stimuli Under Binocular And Monocular Viewing Conditions

PURPOSE. To develop an objective psychophysical method to quantify light-induced visual discomfort, and to measure the effects of viewing condition and stimulus wavelength.METHODS. Eleven visually normal subjects participated in the study. Their pupils were dilated (2.5% phenylephrine) before the experiment. A Ganzfeld system presented either red (1.5, 19.1, 38.2, 57.3, 76.3, 152.7, 305.3 cd/m(2)) or blue (1.4, 7.1, 14.3, 28.6, 42.9, 57.1, 71.4 cd/m(2)) randomized light intensities (1 s each) in four blocks. Constant white-light stimuli (3 cd/m(2), 4 s duration) were interleaved with the chromatic trials. Participants reported each stimulus as either "uncomfortably bright'' or "not uncomfortably bright.'' The experiment was done binocularly and monocularly in separate sessions, and the order of color/viewing condition sequence was randomized across participants. The proportion of "uncomfortable'' responses was used to generate individual psychometric functions, from which 50% discomfort thresholds were calculated.RESULTS. Light-induced discomfort was higher under blue compared with red light stimulation, both during binocular (t((10)) = 3.58, P < 0.01) and monocular viewing (t((10)) = 3.15, P = 0.01). There was also a significant difference in discomfort between viewing conditions, with binocular viewing inducing more discomfort than monocular viewing for blue (P < 0.001), but not for red light stimulation.CONCLUSIONS. The light-induced discomfort characteristics reported here are consistent with features of the melanopsin-containing intrinsically photosensitive retinal ganglion cell light irradiance pathway, which may mediate photophobia, a prominent feature in many clinical disorders. This is the first psychometric assessment designed around melanopsin spectral properties that can be customized further to assess photophobia in different clinical populations.