From the Guidelines
Photophobia is an increased sensitivity to light that causes discomfort or pain in the eyes, and it is often a symptom of other conditions, such as migraines, eye infections, or corneal abrasions, rather than a disease itself. This condition is not a fear of light as the name might suggest, but rather an intolerance that can range from mild discomfort to severe pain when exposed to bright light sources. According to the most recent study 1, photophobia can also be a symptom of neuropathic ocular pain, which can develop after ocular surgeries, postinfection, or as a result of chronic ocular surface abnormalities. Common causes of photophobia include migraines, eye infections, corneal abrasions, meningitis, and certain medications that dilate the pupils. People with lighter-colored eyes may also experience more sensitivity to light.
Treatment of photophobia focuses on addressing the underlying cause while managing symptoms. The study 1 recommends the use of protective eyeglasses, including correction of significant refractive errors and photochromic lenses or tinted lenses, to reduce photosensitivity. Tinted contact lenses may also be indicated for photophobia. Additionally, reversing the polarity on a computer or video magnifier, using a cap or visor pulled down low on the forehead, or a brimmed hat can reduce photosensitivity.
In terms of management strategies, the study 1 suggests that children with photophobia should be seated with their back to the window and may benefit from tinted eyeglasses. An individualized education plan (IEP) is recommended to facilitate an educational environment appropriate for each child's visual needs. The study 1 also recommends a multidisciplinary approach to manage neuropathic ocular pain, including the use of oral neuromodulators, topical nerve regenerative therapies, and complimentary therapies such as acupuncture, cognitive behavioral therapy, or hypnosis.
Overall, the most effective treatment for photophobia is to address the underlying cause, and management strategies should focus on reducing discomfort and improving quality of life. This can be achieved through a combination of protective eyeglasses, tinted lenses, and behavioral modifications, as well as a multidisciplinary approach to manage underlying conditions.
From the Research
Definition of Photophobia
- Photophobia is an abnormal intolerance to light, associated with various ophthalmic and neurologic conditions 2.
- It is characterized by a sensitivity to light, which can cause discomfort, pain, or other adverse reactions.
Conditions Associated with Photophobia
- Migraine, blepharospasm, and traumatic brain injury are common conditions associated with photophobia, especially when neurologic and ophthalmologic examinations are normal 2.
- Photophobia can also be a symptom of other conditions, such as migraine, which is characterized by a severe headache, nausea, photophobia, and/or phonophobia 3, 4.
Pathophysiology of Photophobia
- The intrinsically photosensitive retinal ganglion cells play a key role in the pathophysiology of photophobia 2.
- These cells and the neural pathways that mediate photophobia can be targeted by pharmacologic manipulation, although current therapies are primarily directed at the underlying cause of the photophobia and optical modulation of these cells and pathways 2.
Treatment of Photophobia
- Treatment of photophobia is often focused on addressing the underlying condition, such as migraine, rather than the photophobia itself 3, 4.
- Various treatments, including pharmacologic and non-pharmacologic approaches, can be effective in managing photophobia and related conditions, such as cognitive behavioral therapy for episodic migraine 5, 6.