Photophobia – It’s a Sensitive Subject

Written by Dr. David Evans   Last modified on August 6, 2018

I spent last week with some good friends enjoying the ACC men’s basketball tournament in Brooklyn, NY, which meant I had a couple cross-country flights to catch up on some reading.

There was an interesting new article in EyeWorld about a potential application for botulinum toxin (aka Botox) in ophthalmology that caught my eye. I thought this might be an interesting topic for the blog given the immense popularity of Botox cosmetic. But the crux of the study related to Botox as a treatment for photophobia. Given that we didn’t have any information on Better Vision Guide related to photophobia, I thought that it was perhaps a better starting point. The Botox study will be described at a later date.

What is Photophobia?

Contrary to what the name might suggest, photophobia is not a fear of photos; it’s merely a severe sensitivity (or intolerance) to light. The sensitivity includes a wide variety of light sources – everything from sunlight, to artificial fluorescent or incandescent light. And it’s not purely reserved for bright lights. Any sort of mild lighting can be bothersome for certain people dealing with photophobia.

Although it affects the eyes, photophobia is not actually a specific eye condition. Rather, it’s a symptom of other conditions; most typically associated with an eye infection or inflammation. Notably, photophobia is also a common symptom of migraine headaches. (If you’ve ever experienced a migraine, you can attest to the associated light sensitivity.) It’s not uncommon to find a migraine sufferer sitting in a dark room in effort to avoid any/all light and the associated discomfort.

In addition to migraines, photophobia has been linked with albinism of the eye, an abrasion of the cornea, inflammation of the uvea (middle layer of the eye), meningitis, retinal detachment, refractive surgery, contact lens discomfort and even sunburn.

The color of your eyes can also be a risk factor for photophobia. Darker-colored eyes tend to have more pigment which serves as something of a protective filter against light sensitivity. This of course means that people with lighter-colored eyes may be more prone to sensitivity; especially outdoors in bright sunshine.

How is it Treated?

Because photophobia is a symptom of a condition, rather than a condition itself, treatment is focused on the underlying cause. For instance, if you suffer from migraines and have associated sensitivity to light, there are preventive medications that you can take that reduce the severity and/or frequency of attacks. Medications are also available for use during migraine attacks to counter symptoms like photophobia.

It might sound rather obvious, but if you are prone to light sensitivity, you should avoid bright lights, or make plans to better protect yourself. If you love spending summer days at the beach, but hate the associated sensitivity you experience, experiment with different types of polarized sunglasses such as wraparounds that afford maximum protection at all angles. You might also consider wearing brimmed hats to provide additional light-blocking protection.

For indoor-sourced sensitivity, install dimmer switches on your lights so that you can control the light level. You can use some of the newer lightbulb options like Philips Hue and LIFX, which are smart bulbs that not only allow control of the light level, but the color as well. Create a custom light environment that best suits your eyes.

If you are prone to severe bouts of photophobia, you might even consider something like non-corrective colored contact lenses that can help minimize the amount of light that enters the eyes. (Think of them like sunglasses for your eyeballs that you can wear indoors or at night.) Carotenoid supplementation can also reduce light sensitivity by boosting the layer of pigment that protects the macula, or the very central part of your vision. The carotenoids are like sunglasses inside the eye. And as we discussed above, persons with light skin and light eyes should be more proactive with their protection, as their natural defenses for light sensitivity are not as strong.

Speak with your eye doctor about your light sensitivity issues. He/she can work with you to determine the root cause of your photophobia and develop the best course of treatment to counter it. As for the Botox-photophobia connection, stay tuned to this thread for future updates.

Now that you understand photophobia, we will discuss how Botox can be used to potentially treat it in a future blog post.