Could You Have Photophobia, a Light Sensitivity Condition?

Other neurological conditions

Pituitary tumors, meningitis and traumatic brain injury can cause light sensitivity. For example, about one in three people experience photophobia one week after a traumatic brain injury; for one in seven, photophobia sticks around for as long as three months. TBI may stimulate neural pathways underlying light sensitivity.

Medications

Some medications, such as antihistamines, benzodiazepines, furosemide (used to treat high blood pressure or fluid retention and swelling due to conditions such as congestive heart failure), methylphenidate (for ADHD), trifluridine (prescribed for viral eye infections) and certain antidepressants, have been linked to photophobia. If you have started on a new medication and are experiencing light sensitivity, connect with your prescriber who may consider adjusting your medications.

Eye conditions

A number of eye conditions are linked to photophobia: chronic dry eyes, cataracts, corneal abrasion, corneal neuropathy, optic neuritis (sometimes linked to multiple sclerosis), eye infections, uveitis (an inflammation of the eye), eye allergies and LASIK surgery.

People who have light-colored eyes can be more prone to sensitivity, says Lama A. Al-Aswad, an ophthalmology professor at the Scheie Eye Institute at Penn Medicine in Radnor, PA, “because the iris doesn’t have as much pigment, which normally decreases the amount of light that goes into the eye.”

Mental health issues

There’s some indication that depression, anxiety, panic disorder, among other psychiatric conditions, may also have light-adverse tendencies. What’s more, these conditions may occur alongside others on this list, like migraine. For example, depression may be a driving factor behind light sensitivity that occurs between migraine attacks.

What are the symptoms of photophobia?

Signs that you may have photophobia include:

• Avoidance of light conditions
• Blinking often
• Eye discomfort or pain in the presence of light
• Frequent squinting or blocking light with your hands
• Headaches that are triggered by light
• Wearing sunglasses, even on overcast days
• Worsening of pain in light

Diagnosis of photophobia

Your provider can identify photophobia by talking to you about your symptoms — but that’s not where it ends. While there are things you can do to manage light sensitivity, identifying the underlying cause is most important. Doctors will do that by:

• Reviewing your health history, including a discussion of when you first started noticing light sensitivity, what it feels like, how it affects your behavior, what medications you’re using and your eye care habits.
• Conducting a comprehensive eye exam to look at your eye health overall. This can identify conditions like cataracts, dry eye, optic neuritis, and more.
• Considering additional evaluations or testing to rule out issues like neurological disorders.

Other vision-related conditions that involve light sensitivity, such as photo-oculodynia (eye pain from non-painful sources like ambient lighting) or hemeralopia (day blindness), may resemble photophobia but require different management. That’s why an accurate diagnosis is essential.

Unfortunately, diagnosis isn’t always clear-cut. One-quarter of people who went to an eye care center for photophobia left without a diagnosis, according to a 2022 study. While eye care providers excel at diagnosing eye-related causes of photophobia, neurologists are better suited to identify neurological causes. Therefore, deciding who to see for a diagnosis can be challenging.

Your primary care provider (PCP) is a good starting point for addressing photophobia. They can guide you to an appropriate specialist — such as an ophthalmologist, neurologist, or neuro ophthalmologist, the latter of who are particularly specialized in this area. However, neuro-ophthalmologists may be harder to find depending on your location. If you leave an eye care center without a diagnosis, consider consulting a neurologist.

Photophobia treatments

The first step in treating photophobia is figuring out what’s causing the symptom; then you can tackle the underlying condition.

“Intermittent photophobia associated with migraine, for example, usually responds to medications such as triptans, nonsteroidals [NSAIDS],” Silberstein says. “Or we might try something to keep the attacks from occurring in the first place, like a beta-blocker or topiramate.”

For those with dry eyes, your doctor might prescribe medicated eye drops or drugs that stimulate tear production.

Lifestyle changes can also make light sensitivity easier to manage. Sunglasses with UV protection and polarized lenses can block bright sunlight or glares bouncing off reflective surfaces. However, “the biggest mistake that people make is wearing really dark sunglasses indoors or putting dark shades on their windows,” Digre says. “That only makes things worse because you become dark-adapted.”

One strategy to minimize sensitivity is to gradually transition from darkness to light, giving the eyes an adjustment period, Silberstein says.

Certain wavelengths of light can may also affect sensitivity. “Sunlight has all of them, but it’s the blue frequencies of light which seem to cause the most discomfort,” Silberstein says. A 2016 study, cited in the journal Brain, found that shades of green light seem to be the most soothing, particularly for those suffering from migraines. “I actually use it when examining patients with light sensitivity to make it more comfortable for them,” Digre says.

You can buy specially tinted lenses to block that bothersome blue light. Digre recommends FL-41 tinted lenses, which have a special rose tint to filter out blue wavelengths and decrease light sensitivity. The lenses can be obtained without a prescription, but, Digre cautions, not all so-called FL-41 lenses are the real deal. “Some of these lenses have not been tested properly,” she says. “We did a study where we took a bunch of lenses that claimed to block blue light. Some did and some didn’t.”

Al-Aswad suggests trying on lenses at an optical shop and wearing a trial pair for a few days to see if they improve your symptoms. If you buy lenses, be sure the store will allow returns if they don’t work.

Migraine researchers from Harvard Medical School have come up with yet another way to combat photophobia: lamps designed specifically for those suffering from headaches triggered by light sensitivity. It emits a narrow band of green light which is believed to be gentler on the eyes than multicolored everyday light. Although the price tag may be steep, it may be worth the investment for those seeking relief.