Photophobia is simply an extreme form of light sensitivity, and it is an intolerance to light. Photophobia literally means “fear of light”, and it is a symptom (not a disease). Sunlight, fluorescent lighting, and other forms of lighting may cause sensitivity in these individuals. If you’re incredibly photophobic, you may not be able to open your eyes in the presence of light because it is painful, whereas people who are simply photosensitive may just have a small aversion to bright light in certain circumstances.
We’ve already discussed how the presentation of light can cause pain in some people, and this is the symptom of photophobia. Photophobia is intimately linked with pain because of the trigeminal nerve, which provides the pain receptors for the face. Many parts of the eye (specifically the cornea, conjunctiva, sclera, and uvea) contain densely populated trigeminal nerve endings and feel pain quite easily. Therefore, any condition which causes pain in these areas (such as a corneal abrasion) will contribute to photophobia. The retina, on the other hand, does not contain trigeminal nerves, so retinal detachments are painless.
Other parts of the eye orbit are sensitive to pain as well, such as the muscles and skin, and the blink reflex likely plays a role as well. For example, touch, sound, and light can all cause involuntary blinking, and photophobia causes an increase in blink rate.
There are other hypotheses to how photophobia may occur, and thalamic neurons may also play a role. The thalamus works to relay sensory information in the brain and is responsible for pain perception. What’s even more interesting is that those with poor vision, or even blindness (in the case of retinitis pigmentosa), can have light sensitivity. While there are so many potential circuits by which photophobia may occur, the truth remains that this can be a debilitating symptom for some people, and it’s one that isn’t always easy to solve.
The first line of treatment for any complaint of photophobia is to detect, diagnose, and properly treat the underlying cause. If that happens to be a corneal ulcer or a corneal abrasion, for example, antibiotics are warranted. If it’s uveitis or iritis, aggressive topical steroids should be prescribed in most cases. If migraines are the cause, treat the migraine appropriately.
With regard to tinted lenses, there is some research available that was done on red-tinted contact lenses for photophobia in individuals with cone disorders. Rose tinted glasses (with FL-41 tint) do seem to have some benefit for migraine sufferers as well. However, the results do not necessarily translate to other sufferers, and wearing tinted glasses or contact lenses may cause more of a reliance issue than is beneficial.
Of course, it makes sense to wear darkly tinted, polarized sunglasses whenever you’re outside and even on cloudy days. Even those without photophobia will benefit from this one because you’ll not only protect your eyes from damaging UV rays, but you’ll prevent some of the light sensitivity as well. A few of our favorite polarized sunglasses include those from Maui Jim and Costa.
Occasionally, treatment with antidepressants in those with depression may be helpful. The same goes for anxiety medications. Botox is often used for blepharospasm, and this can give relief for those patients. If corneal neuropathy is suspected, nerve pain medications may need to be prescribed to mitigate the painful photophobic response.
As you can see, the best forms of treatment involve treating the underlying cause, if it’s possible to diagnose one properly. Palliative measures such as sunglasses while outdoors can be very helpful.
Symptoms of photophobia may include any of the following:
There are quite a few conditions which can cause photophobia. First of all, some people may naturally be more light sensitive, and often these are individuals who have light eyes, light skin, and light hair. These people have much less melanin (pigment) in their features and in their body, making them more susceptible to natural photosensitivity.
If you have inflammation inside your eyes, such as anterior or posterior uveitis, you could experience severe photophobia. Other common causes include dry eye disease, corneal ulcers, corneal abrasions, and even conditions of the brain such as meningitis. Contact lens complications and detached retina can also contribute to photosensitivity.
Those who suffer from albinism are also known to be extremely photosensitive due to a lack of pigment. In addition, a few other diseases which often contribute to this symptom include concussions and traumatic brain injury (TBI), migraines, blepharospasm, botulism, mercury poisoning, rabies, some psychiatric conditions, and severe forms of color deficiency.
Some people are really sensitive to light naturally, and some are not. We do tend to see it a lot more in people that have very light hair, light skin, and bright blue eyes. These patients have less pigment in their body overall, and less pigment in their eyes for protection, thus making them more light sensitive. Such is the case in those with albinism. Of course, anyone of any skin or eye color can experience photophobia depending on other underlying conditions that may be present.
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