Sensitivity to Light (Photophobia)

What photophobia is

Photophobia is not a fear of light. It is a heightened response of the visual and pain systems to light. Signals from light-sensitive cells in the retina travel to the brain along pathways that connect with the trigeminal nerve, which carries pain from the eyes and head. When these pathways are sensitized, by migraine, inflammation or injury, ordinary light feels uncomfortable or painful.

Causes of light sensitivity

Headache and brain causes

• Migraine: the most common cause of photophobia. Most people with migraine are sensitive to light during attacks, and many between them. Sound and smell sensitivity, nausea and a throbbing headache are typical.
• Tension-type and cluster headaches: cluster headache causes severe one-sided eye pain with a watery, red eye.
• Concussion: light sensitivity is common in the days after a head injury and can persist in post-concussion syndrome.
• Meningitis: infection of the brain's lining causes fever, headache, stiff neck, light sensitivity and vomiting.
• Subarachnoid hemorrhage: bleeding around the brain with a sudden thunderclap headache.
• Encephalitis, brain tumors and pituitary problems (rare).

Eye causes

• Dry eye: gritty, burning eyes with light sensitivity, worse with screens and wind.
• Uveitis and iritis: inflammation inside the eye causes a deep ache, redness around the colored part of the eye, blurred vision and marked light sensitivity.
• Corneal problems: a corneal abrasion (scratch), infection (keratitis) or corneal ulcer, especially with contact lenses.
• Conjunctivitis: mild light sensitivity with redness and discharge.
• Acute angle-closure glaucoma: sudden eye pain, blurred vision, halos and vomiting.
• After eye surgery or dilating drops.
• Light-colored eyes and albinism: less pigment in the iris lets more light in.
• Cataracts: cause glare from bright lights and headlights.

Medicines and other causes

• Medicines: some antibiotics (doxycycline, tetracycline), quinine, furosemide, and drugs that dilate the pupils
• Withdrawal from alcohol, opioids or benzodiazepines
• Depression, anxiety and chronic fatigue syndrome
• Blepharospasm, a condition of involuntary eyelid closure

Light sensitivity with other symptoms

How doctors diagnose the cause

The doctor will ask about headaches, eye symptoms, contact lens use, injuries, medicines and other illnesses, and will examine the eyes, including with a slit lamp and fluorescein dye to look for corneal damage. Eye pressure and a dilated eye exam check for glaucoma and inflammation. A neurological examination is done if headache or head injury is involved. Tests may include brain imaging (CT or MRI) and a lumbar puncture if meningitis or bleeding is suspected.

Treatment and relief

Treating the cause

• Migraine: acute treatments such as triptans and NSAIDs, and preventive medicines for frequent attacks
• Dry eye: lubricating drops, warm compresses and lid care
• Uveitis: steroid eye drops and dilating drops prescribed by an eye doctor
• Corneal infection: antibiotic, antiviral or antifungal drops
• Meningitis: emergency antibiotics or antivirals

Managing light sensitivity

• Wear sunglasses outdoors, and a brimmed hat.
• Avoid wearing sunglasses indoors or staying in the dark for long periods. This can increase sensitivity over time (dark adaptation).
• Tinted lenses such as FL-41 (a rose tint) reduce migraine-related photophobia for some people.
• Reduce screen brightness, use warm color settings and take breaks.
• Replace flickering fluorescent lights and use indirect, warm lighting.
• After concussion, gradually increase light exposure as guided by your clinician.

Frequently asked questions

Why are my eyes suddenly sensitive to light?

Sudden light sensitivity is often due to a migraine, an eye infection, a corneal scratch, uveitis or dry eye. If it comes with fever and stiff neck, a sudden severe headache, a head injury, or a painful red eye with blurred vision, get emergency care.

Is light sensitivity a sign of a brain problem?

It can be. Meningitis, bleeding around the brain and concussion all cause light sensitivity, usually with headache and other symptoms. Most photophobia, however, comes from migraine or eye conditions. New photophobia with headache, fever or confusion needs urgent assessment.

Can anxiety cause light sensitivity?

Yes. Anxiety and depression are linked with increased sensitivity to light and other sensory input. Treating anxiety, improving sleep and gradual exposure can help. Rule out eye and migraine causes first, especially if light sensitivity is new.

What glasses help with light sensitivity?

Sunglasses help outdoors. For migraine and post-concussion light sensitivity, FL-41 rose-tinted lenses reduce discomfort for many people indoors. Avoid wearing dark sunglasses inside for long periods, which can make the eyes more sensitive over time.