Bringing migraine-related light sensitivity out of the shadows
“Photophobia,” a term used interchangeably with “photosensitivity,” refers to an abnormal and extreme sensitivity to light and is a common symptom of migraine. While everyone is sensitive to light to some degree, people with photophobia are hypersensitive: bright fluorescent lights, changes in light levels and even natural light alone can exacerbate the pain of a migraine. Many people with migraine cite bright light as a migraine trigger, and retreating to a dark or dimly lit room provides relief for some during an attack.
Causes of Photophobia
Migraine is the most common condition associated with photophobia: they occur together so frequently that light sensitivity is itself a diagnostic criterion for migraine. Other causes of photophobia can include ocular conditions, such as dry eyes and irritation; central nervous system disorders; and blepharospasm: an abnormal, involuntary blinking or spasm of the eyelids. But migraine and photophobia are so closely linked that in the absence of an ocular or central nervous system condition, the appearance of photophobia without head pain can still result in a diagnosis of migraine. Dr. Rami Burstein, a neuroscience professor at Harvard Medical School and vice-chair of Anesthesia, Critical Care and Pain Medicine Research at Beth Israel Deaconess Medical Center, says photophobia is exceedingly common in people with migraine — between 85 and 90% of people with migraine experience sensitivity to light.
Living with Photophobia
People living with photophobia are sensitive to both natural and artificial light, so it’s recommended that patients prepare themselves to face both. While it’s tempting to shield yourself from light when it causes you pain, living in darkness will ultimately increase your sensitivity and make it harder to function in environments you can’t control. If you have been limiting your exposure to light, slowly increase the brightness of your environment to build your tolerance. If you live or work somewhere with artificial light, sit closer to the windows and avoid flickering lights or sources of glare.
Sunglasses can shield your eyes from brightness and prevent irritation indoors and outdoors, and they’re one of several tools you can use to adjust the wavelength, or tint, of the light around you. Blue-tinted light is typically the most painful hue; it’s also the color most commonly emitted by computer and smartphone screens. Filtering blue light through yellow, orange or red lenses offers some people relief. Consider investing in light bulbs that emit green light, the only band of light that has been shown to not aggravate migraine.
Burstein says it’s important that people with migraine educate the people in their lives regarding the need to dim light during a migraine attack. Think of adjustments to your environment as legitimate, necessary treatments, and communicate the severity of your need. “Make it clear that you need to do that to continue to function,” Burstein said.
To alleviate or resolve your photophobia, you will ultimately need to identify the underlying cause. You can rule out less severe catalysts by treating individual symptoms, like dry eyes or exhaustion, to see if that solves the problem. If your symptoms persist, it’s time to see a doctor, who can diagnose the root cause of your symptoms and prescribe more effective treatment. If you are diagnosed with migraine-related photophobia, prompt treatment of the migraine attack usually aborts the symptoms. However, photophobia may occur prior to the pain beginning or after the pain has resolved. It can also occur in between migraine attacks with headache.
Light sensitivity and migraine are inherently linked. For information about photophobia and other migraine symptoms, visit the American Migraine Foundation’s resource library. If you suspect your photophobia may be caused by migraine, schedule an appointment with a headache specialist in your area to receive a diagnosis and a treatment plan.