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Family Practice Vol. 20, No. 4, 425-427
© Oxford University Press 2003

Clinical Research

The predictive value of the penlight test for photophobia for serious eye pathology in general practice

John Yaphe and Kulwant Singh Pandhera

Department of Family Medicine, Rabin Medical Centre-Beilinson Campus, Petach Tikvah, Israel 49100 and
a Kidlington Health Centre, Kidlington, Oxon OX5 1AP, UK.

Correspondence to Dr John Yaphe; E-mail: yonahyaphe{at}hotmail.com

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).

Conclusion. The penlight test for photophobia was found to be a useful test for distinguishing serious from benign eye pathology in a general practice population.

Keywords. Eye diseases, photophobia, primary health care.


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