Consideration for people with photosensitive epilepsy . . .

Posted: June 6, 2011 in Epilepsy
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 Many people living with epilepsy lead normal day-to-day lives.  But there is a subset of this population who face challenges each day due to environmental issues.  Per the Epilepsy Foundation, epilepsy affects more than three million Americans.  About 3 percent of them can have seizures triggered by exposure to flashing lights at certain intensities or to certain visual stimuli. This condition is known as photosensitive epilepsy.

In the early day’s my son’s seizures were triggered by lights.  His situation was not atypical photosensitive epilepsy.  His epilepsy was triggered by the bright sun, reflection off of snow, fluorescent lighting, and other bright light conditions.  He was so sensitive that physicians could not do a pupil test using a flashlight.  This situation made life very difficult for us.  We had to be very cautious about our surroundings.  For example, we found that the fish/seafood department in grocery stores commonly used low hung fluorescent lighting.  Every time we would go to the grocery store and pass the fish/seafood area my son would have a seizure.  It got to the point that we had to either not take him to the grocery store with us, or avoid the aisle entirely.  Unfortunately it is always located near the meat aisle and we were not ready to be vegetarians.

Early mornings were a typical time for a seizure to be triggered from the bright sunrise, which was torture for him.  He also had hard times during the bright sunshine days in the winter, when the snow sparkles with the light.  So, once again to avoid the situation he would stay inside at home or not go to recess at school.  Another event would be bright lightning. In the case of my son, along with his fear of thunderstorms, the brightness of the lightning was a trigger for his seizures.

I can not tell you how many days we would drive to school with a blanket over his head.  It was the only way we could travel without triggering seizures.  With time his sensitivity to light has lowered.  Yet, over the years I have recognized that there are many environmental events that most likely affect this group of people with photosensitive epilepsy.

There are a few industries such as the music, movie and video game industry that I think need to be more aware of the entertainment product they create and how it affects this population of people.  It is not right that individuals with photosensitive epilepsy can’t go to a movie because of the light affects being used, or to watch a music video that has flash affects or to concerts which have the extreme light shows.  I am also surprised that the group that is in every community to protect us, which includes police departments, fire departments, and EMS services, use reflective strobe lights on their vehicles. I realize the strobe affect or the reflectors are eye-catching, but for those who are photosensitive this “safety lighting”  is actually harmful for their health.

Now there is not much one can do about sunshine, or lightning, or the sparkle of the snow.  But here are a few triggers that frustrated us over the years that could be preventable with a little consideration:

  • Police vehicles with reflective lights
  • Emergency vehicles with reflective lights,  light bars, or strobe lights
  • School busses with reflective strobe-like light
  • Music Videos with flashing lights
  • Movies with flashing lights
  • Building exit locations during an emergency or a practice emergency with their strobe lights
  • Beacons, such as the kind that the local car dealer uses
  • The flash of a camera
  • Video games
  • TV screens
  • Computer screens

Certain visual patterns, especially stripes of contrasting colors, may also cause seizures. Not all televisions, video games, computer monitors, and strobe lights trigger seizures, however. Even in predisposed individuals, many factors must combine to trigger the photosensitive reaction.

Examples include:

  • frequency of the flash (that is, how quickly the light is flashing)
  • brightness
  • contrast with background lighting
  • distance between the viewer and the light source
  • wavelength of the light
  • whether a person’s eyes are open or closed

The frequency or speed of flashing light that is most likely to cause seizures varies from person to person. Generally, flashing lights most likely to trigger seizures are between the frequency of 5 to 30 flashes per second (Hertz), but in the case of my son this was not true.

Photosensitive epilepsy is more common in children and adolescents, especially those with generalized epilepsy, in particular juvenile myoclonic epilepsy. It becomes less frequent with age, with relatively few cases in the mid twenties.

If you are diagnosed with photosensitive epilepsy, your doctor may prescribe medication and suggest that you:

  1. avoid exposure to certain kinds of flashing lights; and
  2. cover one eye and turn away from the direct light source when in the presence of flashing lights.

Visual Fire Alarm Strobe Lights

Under the Americans with Disabilities Act, most workplaces and places serving the public, including theaters, restaurants, and recreation areas, are required to have fire alarms, which flash as well as ring so that people who cannot hear or cannot hear well will know that there is an emergency.

To reduce the likelihood of the strobe light triggering a seizure, the Epilepsy Foundation’s professional advisory board recommends that

  • the flash rate be kept to under 2 Hertz with breaks every so often between flashes; and
  • flashing lights should be placed at a distance from each other and set to flash together at the same time to avoid an increase in the number of individual flashes.

Here are some suggestions for dealing with photosensitivity that we have used over the years:

Television Screens

  • Watch television in a well-lit room to reduce the contrast between light from the set and light in the room.
  • Reduce the brightness of the screen.
  • Keep as far back from the screen as possible.
  • Avoid watching for long periods of time.
  • Wear polarized sunglasses to reduce glare.

Video games

  • Sit at least 2 feet from the screen in a well-lit room.
  • Reduce the brightness of the screen.
  • Do not play video games if tired.
  • Take frequent breaks from the games and look away from the screen every once in a while. Do not close and open eyes while looking at the screen – blinking may facilitate seizures in sensitive individuals.
  • Cover one eye while playing, alternating which eye is covered at regular intervals

Computer Monitors

  • Use a flicker-free monitor (LCD display or flat screen).
  • Use a monitor glare guard.
  • Wear non-glare glasses to reduce glare from the screen.
  • Take frequent breaks from tasks involving the computer.

Exposure to Strong Environmental Lights

  • Cover one eye (either one) with one hand until the stimulus is over. Closing both eyes or turning your eyes in another direction will not help.
  • Or, like we did, cover up with a blanket while riding in the car, or wear a baseball cap with a good brim.


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