Researchers at the University of Utah are working to better understand photophobia, or light sensitivity – though management of it remains difficult. “Light sensitivity is a very common problem, and most ophthalmologists – most physicians in general don’t know what to do with it,” says Kathleen B. Digre, MD, professor of ophthalmology and neurology at the University of Utah in Salt Lake City. “They need to know that this is a real symptom and not a figment of someone’s imagination. Dr. Digre notes that there are many references to psychiatric disease among people with photophobia, with suggestions that photophobia does not have any pathophysiology. Co-investigator Bradley J. Katz, MD, PhD, says, “Photophobia is not a psychological problem. It is a neurologic problem, and physicians should take it seriously.”

Photophobia is a symptom, and a key to managing it is to identify and treat the underlying condition. Iritis, uveitis and corneal disease can all produce photophobia, as can migraine. About 80% of people who have migraines also have photophobia. It is one of the diagnostic criteria and is considered one of the predictors of migraine nearly 98% of the time. People who have chronic migraines are more light-sensitive than people who have sporadic migraines. And, research has shown that migraineurs also have a low threshold of tolerance to loud noises, and are more vulnerable to motion sickness.

While photophobia is not a psychiatric disorder, people with depression, bipolar disorder, seasonal affective disorder and agoraphobia are more light-sensitive than are people without these conditions. Dr. Digre notes, “In fact, people can tell how depressed they are by how light sensitive they are.”

The most important step in finding relief is to diagnose and treat associated conditions. Dr. Digre urges people not to wear sunglasses indoors. “People who wear dark glasses can actually dark-adapt themselves and increase their photosensitivity. Sunglasses outside, of course, are fine, but the darker the glasses inside, the more light-sensitive the person will become.”     Eye Net Magazine   American Academy of Ophthalmology    2013

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