Transient Light-Sensitivity Syndrome

Synonyms

Delayed acute photophobia; Good acuity plus photophobia; TLSS

Definition

An episode of acute photophobia after femtosecond laser LASIK in absence of other clinical signs and symptoms. The onset of TLSS is typically 2–4 weeks postoperatively (Stonecipher et al. 2006), and virtually no signs at the slit lamp have been described. In most cases, visual acuity is not affected. A good response to topical steroids suggests an inflammatory origin.

Higher laser energy settings (raster and side cut energy) in the early days of femtosecond laser LASIK were associated with the higher incidence of TLSS. A reduction of the laser energy led to significant decrease of TLSS incidence.

Histology

Anecdotal reports of confocal in vivo microscopy showed a higher prevalence of activated keratocytes at the flap stroma (Stonecipher et al. 2006).

Differential Diagnosis

Another condition that lead to photophobia after LASIK is, in particular, diffuse lamellar keratitis (DLK) (Linebarger et al. 2000)....