What Is Photophobia & Can It Be Treated?

Extreme light sensitivity, often called photophobia, is a common migraine symptom. Learn how photophobia and migraine are related—plus, answers to some common questions about light sensitivity.

By: Kathleen B. Digre, MD

Photophobia, or extreme light sensitivity, is a common symptom of migraine and is one of the criteria used to diagnose migraine. However, some individuals may experience photophobia even when they are not experiencing other migraine symptoms, with the most severe cases involving daily, disabling sensitivity to light. For being such a common migraine symptom, photophobia has been under-researched and is often misunderstood.

So what is photophobia, how is it related to migraine, and can it be treated? Read on below to learn more.

Photophobia Symptoms

Sometimes individuals with photophobia perceive light as “too bright,” meaning there is an increase in the sensitivity to typical light levels. Others will complain of pain associated with light. Everyone has some level of light sensitivity—think of going from a dark movie theater to a bright sunny day—but any discomfort when adjusting to different levels or types of light is usually brief. However, people with photophobia experience much more frequent difficulty adjusting to high levels of brightness and may even find that normal light levels cause pain or discomfort.

For most people with photophobia, the brighter the light, the greater the discomfort. The wavelength of light (color) may also be important—for example, blue light causes more trouble than other colors of light. The typical light levels in one’s home or office can also impact symptoms, meaning that if you’re used to low, warmer types of light, you may have a sensation of colder tones or outside light as being even brighter.

What causes photophobia?

No one knows the exact area of the brain that causes light sensitivity, but recent studies have helped to expand our understanding of this symptom. Light is carried through the visual pathways to the brain by way of the retina, a layer of tissue at the back of the eye. There are cells in the retina that are responsible for detecting light and transforming it into electrical signals that can be decoded/interpreted by the brain—this is how light is translated into vision when reading letters or seeing images.

There is a second system, called the melanopsin system, that does not participate in how we see shapes, objects, or words, but specifically senses light. There are fewer of these cells in the retina of the eye, but once these cells get turned on, they do not turn off. We believe that both the light-sensing cells in the retina and the melanopsin system may contribute to a sense of brightness that can cause trouble in people with photophobia. We now also know that these cells connect with the trigeminal nerve, which is responsible for sensations in the face and neck and plays a key role in migraine pain. The melanopsin system also explains why people who are blind (no formed vision) can still experience photophobia.

While migraine is the most common condition associated with continuous photophobia, there may be other causes of photophobia. Trigeminal pain fibers can be found in the cornea, the iris (colored part of the eye), and even the back of the eye. Even dry eyes may cause light sensitivity in some individuals.

Other neurological conditions can also cause photophobia, including pituitary tumors and meningitis (inflammation of the meninges, the protective layers around the brain and spinal cord). The two most common causes of photophobia are migraine and blepharospasm (a movement disorder that causes frequent blinking). Dry eyes can complicate chronic photophobia, so speaking with an ophthalmologist may be helpful.

Treatment for Photophobia

Depending on the diagnosis, there are several possible treatments for photophobia. For example, when dry eyes are the cause of photophobia, a doctor may suggest artificial tears, gels, and ointments to alleviate symptoms. Intermittent photophobia with migraine usually responds to acute medications such as triptans and non-steroidals. Preventive treatment of migraine may help reduce chronic photophobia.

Tinted lenses—in particular FL-41 tint—as well as blue-blocking lenses and red lenses have been reported to decrease and improve light sensitivity. These can be obtained without a prescription by talking with your eye doctor. Exposure to pure green wavelengths (not just green tint) may also be helpful. Additionally, wearing sunglasses outside frequently helps with light sensitivity in the sun.

Comorbidities of photophobia like sleep disorders, depression, and anxiety may require treatment as well.

Frequently Asked Questions About Photophobia

Why do I have light sensitivity?

There are many causes of light sensitivity, which is why your medical provider will do a careful examination to determine the contributing factors. The most common causes of light sensitivity include migraine, blepharospasm, and dry eyes.

What can I do to make my light sensitivity go away?

First, it’s important to treat the cause of your photophobia if it’s known. That means, for example, that if you have dry eyes you should treat that symptom first. Second, be sure you do not keep yourself in dark environments regularly—e.g. no darkened rooms and darkened windows. Slowly increase the amount of light in your daily environment so that you are more tolerant of higher light levels. Get adequate sleep and treat any depression or anxiety, which can make your symptoms worse.

Will tinted lenses work for me?

There is no way to be sure that you will benefit from tinted lenses, and sometimes the process can involve trial and error. Minimizing your use of tinted lenses while you are inside is best, because the darker the environment you’re used to, the more the light will bother you.

How do FL-41 lenses work?

Although we are not really sure why FL-41 lenses improve light sensitivity, we think it has something to do with the wavelengths of light (color) that are filtered out. FL-41 blocks blue light. Blue wavelengths are thought to be a problem for patients with light sensitivity.

Can FL-41 filter be added to any glasses?

FL-41 filter is best absorbed by the regular (CR-39) plastic lens material. It may be more difficult to add FL-41 to glasses made of certain plastics with reflective coatings.

Where can I get FL-41 filter?

Many optical shops can get FL-41 tint. OPI has the tint available. Be sure that the company you choose has tested the filter to see that it has the correct characteristics.

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