Photophobia (Sensitivity to Light)

Photophobia can develop at any age and is usually not serious. In some situations, however, there may be a recurrence of the experience or development due to an underlying medical condition affecting the eye or the nervous system.

Sensitivity to light is developed in both eyes simultaneously and it is on very rare occasions that one develops photophobia in only one eye.

Some of the common symptoms of photophobia are:

• Sensitivity to light; even dim lights appear too bright
• Aversion to light
• Mild to sharp pain or discomfort when looking at a source of light
• Squinting when exposed to light
• Pain in the forehead or nausea
• Seeing bright coloured spots even with the eyes closed
• Tears from the eyes when exposed to light
• Dryness in the eyes

As mentioned above, photophobia is considered a symptom and not a condition in itself. However, even as a symptom, photophobia can present itself due to a variety of underlying conditions, ranging from direct eye problems to something related to the nervous system.

This sensitivity to light is attributed to a poor connection between the nerves that connect the eyes to the brain and the cells in the eyes that are known to detect light or brightness.

Here are some of the common conditions of the brain where photophobia presents as a symptom:

• Migraine: One of the common symptoms of headaches caused by migraine is photophobia. Direct exposure to light that leads to headaches, nausea or squinting of the eyes are commonly associated with photophobia and worsen as the exposure to or the brightness of the light source increases. It is estimated that about 80% of people with migraines also get photophobia along with their headaches, and can continue to be light sensitive even when they don’t get their migraine-induced headaches.
  There are other forms of headaches that also report light sensitivity as a symptom, such as cluster headaches or those who have conditions such as stress.
• Meningitis: Meningitis is caused due to an inflammation of the membranes in the brain and the spinal cord, hence the clinical manifestation of photophobia is sometimes seen in people during this disease.
• Brain injury: Any injury that damages the brain cells is known as a brain injury, and it can be either due to external or internal factors. Photophobia is also known to be a symptom of a trauma to the brain.
• Encephalitis: An inflammation of the brain caused by a viral infection, encephalitis, which can be life-threatening, also shows up with sensitivity to light as a symptom.
• Progressive supranuclear palsy: Supranuclear palsy is another type of brain dysfunction that causes an imbalance in the body including difficulty in walking and even the movement of the eyes—photophobia is also seen among patients.

Some of the conditions of the eye where light sensitivity occurs as a symptom are:

• Ocular albinism: A genetic condition of the eyes which reduces the pigmentation of the iris and the retina: the former gives the eyes their distinct colour, while the latter is the light sensitive tissue in the eyes. Ocular albinism is also a condition where light sensitivity develops as a symptom.
• Corneal abrasion: The outermost layer of the eye can suffer cuts, scratches or injury if dirt, sand or another irritant gets into the eyes, leading to corneal abrasions. Corneal ulcers can also develop due to this, and light sensitivity can be one of the first symptoms. 
• Dry eye
• Uveitis: Inflammation in uvea in the eye wall.
• Conjunctivitis or pink eye
• Iritis: Inflammation of the iris
• Cataracts
• If you have undergone some kind of eye surgery
• Trauma to the eye
• Dilated pupils: The pupils may be dilated during an eye exam (which is why ophthalmologists recommend you shouldn't go out in the sun or in a brightly lit area for about an hour afterwards). Pupils can also be dilated as a result of taking psychotropic drugs.

Along with these conditions, the consumption of certain antibiotics and drugs have also been known to cause light sensitivity. These drugs include amphetamine, atropine and cocaine, among others.

Light sensitivity in itself may be difficult to control. However, some lifestyle and behavioural changes can help you prevent the onset of photophobia induced discomfort or manage it better. These include:

• If you have a history of migraine headaches, try to avoid the triggers that can lead to them.
• Follow and maintain proper hygiene for the eyes to prevent eye problems such as conjunctivitis. Do not touch your eyes with dirty hands, and do not use anyone else's eye make-up.
• Maintain hand hygiene to avoid infectious diseases.
• Ensure that you and your family are always properly vaccinated against disease outbreaks common to your region or area, especially if there are mosquito/tick infestations.
• Remember to attend all immunisation campaigns against deadly diseases and outbreaks and cut out the risk of contracting meningitis.
• In some cases, wearing dark glasses at all times can also help in keeping the eyes safe from exposure to direct light.
• Closing your eyes often or keeping the rooms dark can also help in easing the discomfort caused by light sensitivity.

Light sensitivity is quite easy to identify, due to the obvious discomfort it causes to the eyes when exposed to light. If light exposure is causing you discomfort on a regular basis or interrupting your daily life, it is best to visit a doctor for an examination. The doctor will likely ask you about your medical history and whether or not you have any underlying medical conditions.

The doctor will also ask you questions about your general eye health as well as any conditions relating to the brain or if you have been facing any kind of psychological issues recently. The doctor may decide the next logical step based on your symptoms.

Some of the common tests can include an eye test. In some cases, imaging tests such as an MRI could also be prescribed to get a closer look at your eyes.

Another way to check for a condition such as dry eyes is to examine the amount of tears your eyes make, to correlate it with light sensitivity.

In some cases, a patient facing this problem may be required to seek immediate medical attention, especially in the case of meningitis or encephalitis, or after having suffered a direct trauma to the head or the eyes.

While the treatment of some underlying conditions may take a long, there are also some immediate ways to get relief from photophobia:

• Treat the prevailing condition that is causing it—this could be a medicine or drug that is causing an adverse reaction.
• Wearing dark coloured glasses also helps in controlling the amount of light that enters your eyes.
• Some eye drops can also help in reducing the inflammation being experienced in the eyes, or a doctor can prescribe certain medications to treat the headaches that are causing this discomfort.
• Certain antibiotics for specific eye conditions such as pink eye or corneal abrasions may also be advised.
• Minimising exposure to direct light and treatment for bacterial meningitis are also known to relieve the symptoms of light sensitivity.
• A conservative approach such as plenty of rest, drinking a lot of fluids in the case of encephalitis and other anti-inflammatory medications can also help alleviate the symptoms of photophobia.