The predictive value of the penlight test for photophobia for serious eye pathology in general practice.
BACKGROUND
Photophobia has been described as a useful sign in distinguishing severe from benign eye pathology.


OBJECTIVE
This observational study was performed to assess the utility of the penlight test for photophobia in patients presenting with a red eye in general practice.


METHODS
Thirty patients presenting with a red eye to one GP in 1 year were studied. All patients were examined with a penlight flashlight for photophobia. This was followed by slit-lamp examination for diagnosis of serious or benign eye pathology.


RESULTS
The penlight test was positive in eight out of 10 (80%) patients with serious pathology (mainly uveitis and keratitis) and was negative in 21 out of 26 (81%) patients with less serious pathology (mainly conjunctivitis). The positive predictive value of the test was 60% and the negative predictive value was 90% (chi-squared = 7, P = 0.001, odds ratio = 17, 95% confidence interval 2-179).


CONCLUSIONS
The penlight test for photophobia was found to be a useful test for distinguishing serious from benign eye pathology in a general practice population.
Yaphe
John
J
Department of Family Medicine, Rabin Medical Centre-Beilinson Campus, Petach Tikvah, Israel 49100. yonahyaphe@hotmail.com
Pandher
Kulwant Singh
KS
D003937:Diagnosis, Differential; D003941:Diagnostic Techniques, Ophthalmological / Q000295:instrumentation*; D005194:Family Practice / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020795:Photophobia / Q000175:diagnosis* / Q000503:physiopathology; D012680:Sensitivity and Specificity