Photophobia (Light Sensitivity) Is Not What You May Think

People with this condition have difficulty being in bright artificial lighting or in sunlight. Light sensitivity causes symptoms like squinting, discomfort, and headaches. It is linked to various causes, including eye conditions, neurological diseases, and medications.

 

Related Symptoms

People with photophobia report feeling that lights are too bright or more intense than usual. Some also report pain and discomfort in and around their eyes.

Additional symptoms that may occur with photophobia, depending on the cause, can include:

• Seeing bright colored spots or dots even in the dark
• Difficulty focusing on text or pictures
• Headaches
• Squinting or closing the eyes
• Tearing or watering of the eyes
• Eye dryness
• Fatigue
• Nausea
• Dizziness
• Avoidance of bright spaces

 

Causes

Photophobia is linked to various health conditions and medications. It can be a temporary problem or a long-term one.

Eye Conditions

Various eye conditions can cause photophobia. When an eye problem causes light sensitivity, you may also experience additional symptoms like pain, redness, and vision changes.

The most common eye problem that causes photophobia is dry eyes. This condition occurs when a person’s tear production or quality is insufficient to provide adequate eye lubrication.

Additional eye conditions that cause photophobia are:

• Blepharitis (eyelid inflammation)
• Cataracts (clouding of the lens)
• Cone-rod dystrophy (a group of inherited eye disorders affecting light-sensitive cells of the retina)
• Corneal damage (from an injury or disease affecting the outermost clear dome-shaped layer of the eye)
• Cyclitis (inflammation of the ciliary body, a ring-shaped structure just behind the colored iris of the eye)
• Glaucoma (a disease that damages the optic nerve due to increased pressure in the eye)
• Iritis (inflammation of the iris, the colored ring of the eye)
• Keratitis (inflammation of the cornea)
• Retinitis pigmentosa (a group of rare eye diseases affecting the retina, the light-sensing layer at the back of the eye)
• Uveitis (inflammation of the middle layer of the eye)

Photophobia may also occur following eye surgery, including LASIK (laser-assisted in situ keratomileusis) surgery and cataract surgery. In these instances, the condition should improve over time, but it can be long-lasting in rare cases.

Neurological Conditions

Photophobia is linked to various neurological conditions, some more serious than others, such as:

• Blepharospasm (a condition that causes uncontrollable twitches or spasms that force the eyelid closed)
• Complex regional pain syndrome (a neurological condition that causes pain and other symptoms in the extremities, mainly the hands)
• Lesions of the thalamus (the brain’s relay station)
• Meningitis and encephalitis (infections of the brain and spinal cord)
• Primary headaches (head pain not caused by another condition, and includes migraine, tension headaches, and cluster headaches)
• Progressive supranuclear palsy (deterioration of brain cells)
• Secondary headaches (a headache from an underlying condition like dehydration or sinuses)
• Subarachnoid hemorrhage (bleeding of the area between the brain and the tissues covering it)
• Traumatic brain injury (TBI) (usually caused by an injury to the skull)

Psychological Conditions

Some psychological conditions cause photophobia are:

• Agoraphobia (a type of anxiety disorder that causes intense fear of being in certain situations and places)
• Anxiety disorder
• Depression
• Panic disorder

Other Medical Conditions

Some systemic (whole-body) medical conditions are linked to photophobia. Such conditions are:

• Albinism (a genetic disease characterized by a lack of pigment in the eyes, skin, and hair)
• Fibromyalgia (a musculoskeletal condition that causes widespread pain and an array of other symptoms)
• Inflammatory bowel disease (IBD) (a group of conditions, including Crohn’s disease and ulcerative colitis, that cause inflammation of tissue in the gastrointestinal tract)

Medications

Photophobia can be a side effect of certain medications used to treat health conditions, such as:

• Barbiturates (a class of sedating medicines used to treat conditions including seizure disorders and insomnia)
• Benzodiazepines (used to treat mental health conditions and seizure disorders)
• Chloroquine (used to treat malaria and other parasitic illnesses)
• Lithium (a mood stabilizer used to treat bipolar disorder)
• Ritalin (methylphenidate) (used to treat attention deficit hyperactivity disorder)
• Viagra (sildenafil) (used to treat erectile dysfunction and pulmonary arterial hypertension)

 

Link to Migraines

A migraine is a severe headache that can present with symptoms like nausea, vomiting, changes in mood, extreme tiredness, and sensitivity to light, noise, and smells. Triggers for migraines include strong smells or fumes, stress, environmental changes, and hormone shifts.

Photophobia is a common symptom of migraine headaches. It is possible for people who experience migraines to experience photophobia before a migraine has even started.

Some people with photophobia related to migraines may experience pain with light sensitivity and sensitivity to sounds and smells. Others struggle to adjust to different levels or types of light. Discomfort increases at higher levels of brightness.

 

Prescribed Treatments

A healthcare provider can diagnose photophobia and its underlying cause. To assist in diagnosis, they will ask about current symptoms and your medical history, perform medical and eye exams, and order specialized tests if needed.

Treating photophobia starts with determining the cause. When the cause is an underlying medical condition, treating that condition may relieve or even stop light sensitivity.

For example, if an eye condition causes light sensitivity, you may need medication or surgery. If migraines cause it, your healthcare provider may recommend over-the-counter (OTC) or prescription treatments. If a medication you use to treat another condition is the cause, changing or discontinuing treatment may bring relief.

Some research suggests that transcutaneous electrical nerve stimulation (TENS) therapy may help people with photophobia linked to eye pain. If you think this option may benefit you, talk to your healthcare provider before trying it.

Botox (onabotulinumtoxinA) injections may help people with photophobia who have not benefited from other treatments. Botox injections can treat a variety of conditions, and treatments are generally safe, although side effects are possible.

 

Self-Care Remedies

Managing photophobia with self-care can also bring about relief, including:

• Wear sunglasses when outdoors during daylight hours.
• Reduce your exposure to sunlight.
• Dim lights and open window coverings to let in natural light.
• Increase your light exposure slowly upon awakening or entering a lighted area from a dark one (such as exiting after being in a movie theater).
• Reduce the brightness of electronic devices.
• Use FL-41 migraine glasses or blue light–blocking glasses.
• Use eye drops to ease discomfort.
• Remove fluorescent lighting in your home, which can cause photophobia, with or without an underlying eye condition. The limited spectrum from fluorescent lighting is primarily blue light, which, after prolonged periods, can adversely affect the eyes.
• Use a green light lamp: Research shows that green light can reduce migraine severity and photophobia. It is a noninvasive and relatively inexpensive therapy and can be achieved with a green light lamp or green light bulbs.

 

When to See an Eye Specialist

Your primary care provider may refer you to an ophthalmologist, a medical doctor who is experienced in diagnosing and treating eye diseases, including performing surgery. You can also make an appointment directly with an eye specialist if your health insurance does not require a referral from a primary care provider.

If photophobia worsens or affects your quality of life, make an appointment with an eye specialist. This is especially important if you are experiencing:

• Severe pain
• Blurred or double vision
• Frequent headaches
• Severe nausea
• Photophobia with a sudden onset or no apparent cause

Both medications and self-care can help you to manage the causes of photophobia and reduce its effects. If you can manage its underlying cause, its effects can be short-term and reversible.

 

Summary

Photophobia is light sensitivity. It can be accompanied by discomfort, pain, and the urge to avoid lighted areas. Photophobia results from various underlying causes, including eye conditions, neurological diseases, other medical conditions, and medications.

If you are experiencing severe or persistent symptoms, consult a healthcare provider. They can determine the cause and recommend treatments. You can also manage symptoms with self-care remedies like wearing sunglasses and migraine glasses, avoiding bright light, and using eye drops.