Photophobia – Causes, Complications, and Diagnosis.

What is photophobia?

Photophobia is not a fear of light, as the name might suggest, but rather it is an intolerance or sensitivity to light that can lead to extreme pain and discomfort. Sources of light such as fluorescent light, sunlight, and incandescent light can all be responsible for causing discomfort, and headaches are frequently associated with light sensitivity.

Photophobia

One important fact to keep in mind is that photophobia is not a form of eye disease. Instead, it is a symptom of some other condition such as inflammation or infection, which can irritate the eyes. Light sensitivity can also be a symptom of underlying diseases that wouldn’t directly impact the eyes, such as a disease caused by a virus.

Why are our eyes sensitive to light?

There are many reasons why someone might suffer from sensitivity to light. Photophobia is not a disease or disorder. rather, it is a symptom of many different diseases, disorders, and conditions. For example, an infection or inflammation that irritates the eyes can cause photophobia. It can be a symptom of an underlying disease such as a viral illness, or it can be caused by a severe headache or migraine.

When the cornea is compromised or stressed for any reason, it naturally responds by inflaming. Just as a bee sting causes pain, swelling, and tenderness, a similar inflammation response occurs when stress is placed on the cornea. During this response, fluid builds up within the cornea, causing light to scatter abnormally, which leads to extreme photophobia. Light sensitivity caused by infections or inflammation usually subsides once the underlying problem is treated.

Structure of an Eye

A person’s eye color can also influence their sensitivity to light. People with lighter colored eyes experience greater light sensitivity than people with darker colored eyes. The extra pigment in darker colored eyes is thought to protect against harsh lighting and bright sunlight.

Some people are born with large pupils. The pupil is the black center of each eye that allows light to enter. In reality, the pupil is the window of the eye. A kitchen with large windows will let in more natural light than a kitchen with small windows.

The same goes for pupil sizes. Each person’s pupil is a different size. Some people experience more sensitivity than others due to larger pupils.

Common Causes and risk factors

• Wearing of contact lenses for long periods, or wearing badly fitted contact lenses
• Eye disease, injury, or infection
• Burns to the eye
• Acute iritis or uveitis (inflammation inside eye)
• Corneal abrasion
• Corneal ulcer
• Drugs such as amphetamines, atropine, cocaine, cyclopentolate, idoxuridine, phenylephrine, scopolamine, trifluridine, tropicamide, quinine, belladonna, tetracycline, doxycycline, cocaine, and vidarabine
• Eye testing in which the eyes have been dilated
• Anterior segment disease: Cyclitis, blepharitis, dry eyes and dry eyes syndrome (a very common cause of photophobia), corneal neuropathy
• Intracranial conditions: meningeal irritation from meningitis, sub-arachnoid hemorrhage, or pituitary tumors or apoplexy
• Migrane (the most common photophobia cause)
• LASIK
• Posterior segment disease: retinal dystrophies, retinitis pigmentosa, cone dystrophies, hemeralopia, frequent photopsias, Alström syndrome
• Traumatic Brain Injury (TBI)
• Blepharospasm
• Encephalitis
• Progressive Suparnuclear Palsy (PSP)
• Psychiatric conditions: agoraphobia, seasonal affective disorder, bipolar depression, neurasthenia

Photophobia Symptoms

Photophobia is in some causes actually a common symptom and in many cases is not caused by any causal illness or eye difficulty. Photophobia which is severe can be linked to problems with the eye and can cause serious eye pain even in very low light.

This condition has some symptoms other than just sensitivity to light and they include:

• Inflammation of eye when tears may or may not be present
• Atrophy of optic nerve caused by excessive use of alcohol
• Irritation of brain and nerves caused by excessive use of alcohol
• Swelling of the eyes
• Redness
• Discharge
• Shooting pains in the head as well as the temples
• Headaches
• Nausea
• Dizziness
• Stiff neck

Diagnosing Photophobia – When to See Your Eye Doctor?

If you feel you are experiencing photophobia more often than you should be, you should seek medical attention from an eye care specialist. To diagnose you, your eye doctor will ask you several questions about the light sensitivity and additional symptoms you may be experiencing.

You will also undergo a routine eye exam to check the refraction of light by the eye, or how the eyes bend to focus light to produce vision. An eye exam has seven major components:

• Visual acuity exam
• Refraction exam
• Visual field exam
• External exam
• Slit lamp exam
• Tonometry
• Ophthalmoscopic exam

Each of these tests can help your eye doctor determine what is causing the photophobia. For some of these examinations, your eye doctor may use eye drops that dilate your pupils, which will increase or worsen the photophobia for a short time.

Once a correct diagnosis is made, your eye doctor will create an appropriate treatment plan to reduce your light sensitivity and any other symptoms you may be experiencing.

Photophobia Treatment

The first step in countering light sensitivity is to diagnose and treat what is triggering this response. The individual might need to change contact lenses, get treatment for any underlying condition, discontinue drug use or switch to a different medication. If this condition happens after having refractive surgery, the eye might simply need more time to heal and the problem might resolve itself.

Drugs or medications used to treat photophobia may include:

• Acular
• Voltaren ophthalmic

Treatment options include:

• Behavior therapy
• Anti-anxiety medication
• Medical conditions such as meningitis – antibiotics

True phobic or fear of lights is treated as a phobia and include the following management:

• Psychotherapy
• Behavioral therapy
• Cognitive-behavioral therapy
• Exposure therapy
• Relaxation techniques – controlled breathing, visualization
• Medication for anxiety

Some individuals resort to remedies such as wearing sunglasses, staying in dark rooms with blinds closed as well as doing whatever is necessary to generally avoid sunlight. If this condition continues indoors with very little light or the pain is extremely severe than that individual should see a physician to seek medical treatment and management.

The physician will examine the eye with a biomicroscopy which will check the iris, lens and cornea as well as eyelid. He/she may also suggest a corneal scraping and also in some cases a lumbar puncture also referred to as a spinal tap.

The individual may also wear wide-brimmed hats as well as UV sunglasses from the protection of harsh light sources.

Some individuals with photophobia which is serious may need prosthetic prescription safety glasses that prevent large amount of lights from entering the eyes.

Home Remedies for Photophobia or Sensitivity to Light

Treatment for photophobia or sensitivity to light can prove highly effective using natural supplements and home remedies. Most of the cases of photophobia or sensitivity to light can be dealt with home remedies or lifestyle changes. Nevertheless, certain severe cases may need medical treatment or input from a medical professional.

 

• You can manage light sensitivity due to a short-term condition by wearing tinted glasses, closing the eyes and by avoiding sunlight.

 

• Furthermore, Vitamin B2 present in foods like wolfberries aids in reversing eye sensitivity.
• Vitamin A and carotene present in carrots supports eye health and thereby manages light sensitivity.
• L-carnosine and Vitamin E are other supplements which aids in treating more pervasive eye conditions.

 

What Can I do To Prevent Photophobia?

As mentioned above, in some cases – such as when a person is born with larger pupils—photophobia cannot be prevented. Even in these types of situations, however, there are steps you can take to reduce your light sensitivity. Here are some prevention tips for photophobia:

• Avoid smoking
• Wear sunglasses with polarized lenses when outdoors, even in the shade.

 

• Take vitamins and eat foods that contain antioxidants; for example, light sensitivity is sometimes a sign of a vitamin A deficiency
• Let as much natural light as possible into indoor settings.
• Dim or turn off indoor lights; close curtains in windows if too much light enters.
• Get treatment for any underlying condition you may have, such as dry eyes or conjunctivitis.
• Wear wide-brimmed hats when outdoors.
• Close your eyes for a while.
• Leave driving until tomorrow. Drive only during the day. Even good lighting at night such as in a big city can be bothersome to someone with night blindness or sensitivity to light.
• Increase driving vision by cleaning headlights of the car
• Slow down. This gives you more time to react to any hazards
• Try to avoid the triggers that cause you to have migraine headaches.
• Prevent conjunctivitis by practicing good hygiene, not touching your eyes, and not sharing eye makeup.
• Reduce your risk of getting meningitis by avoiding contact with people who are infected, washing your hands often, and getting immunized against bacterial meningitis.
• Help prevent encephalitis by washing your hands frequently.
• Getting vaccinations against encephalitis and avoiding exposure to mosquitoes and ticks can also help. Talk to your doctor if you are experiencing severe photophobia or for more suggestions to reduce your symptoms.