Characteristics

Autosomal Dominant Compelling Helioopthalmic Outburst (ACHOO) Syndrome is characterized by uncontrollable sneezing in response to the sudden exposure to bright light, typically intense sunlight (1). This type of sneezing is also known as photic sneezing. About one in four individuals who already have a prickling sensation in their nose will sneeze in response to sunlight, but “pure” photic sneezing is far less common (2).

Sneezing is usually triggered by contact with infectious agents or after inhaling irritants, but the cause of photic sneezing is not fully understood. It may involve an over-excitability of the visual cortex in response to light, leading to a stronger activation of the secondary somatosensory areas (3).

Diagnosis/testing

The diagnosis of ACHOO syndrome is usually made by clinical history. Affected individuals report a “prickling sensation” or sneezing in response to a bright light. This response may be reproduced in the clinical setting by asking the individual to look at a bright light, although findings are unreliable.

The genetic basis of this syndrome is not yet known.

Management

Recommendations for management of ACHOO syndrome include using a hat or sunglasses to shield the eyes from direct sunlight whenever possible. Potential hazards include the possibility of drivers having an accident caused by sneezing brought on by, for example, exiting a road tunnel on a bright day. Similarly, airline pilots may be at risk (4).

Genetic counseling

ACHOO syndrome is inherited in an autosomal dominant manner (1). As such, if one parent is affected, their child has a 50% chance of inheriting the syndrome.

Acknowledgments

The author would like to thank Nicolas Langer, Endeavor Scientist at the Child Mind Institute, New York, for reviewing this summary.

References

1.

Forrester J.M. Sneezing on exposure to bright light as an inherited response. Human heredity. 1985;35(2):113–4. [PubMed: 3988295]

2.

Breitenbach R.A., Swisher P.K., Kim M.K., Patel B.S. The photic sneeze reflex as a risk factor to combat pilots. Military medicine. 1993;158(12):806–9. [PubMed: 8108024]

3.

Langer N., Beeli G., Jancke L. When the sun prickles your nose: an EEG study identifying neural bases of photic sneezing. PloS one. 2010;5(2):e9208. [PMC free article: PMC2821404] [PubMed: 20169159]

4.

Benbow E.W. Practical hazards of photic sneezing. The British journal of ophthalmology. 1991;75(7):447. [PMC free article: PMC1042420] [PubMed: 1854707]