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Photophobia, or photosensitivity, is a condition where light exposure is linked with eye pain and discomfort. It can be caused by a light source such as sunlight, incandescent light, or fluorescent light. Light sensitivity is a common symptom of migraine and other neurological disorders.
Sensitivity to bright light can also be a distinguishing feature of eye conditions linked with multiple sclerosis (MS). These include:
“I started developing sensitivity to light after my MS diagnosis. I have severe light sensitivity in all light settings,” one MyMSTeam member shared.
People with MS sometimes report extreme sensitivity to natural light and artificial light. This is often followed by eye pain, eye strain, or eye irritation.
“Lately, I’ve been sensitive to house lights, car lights, and the television. It’s like my eyes are always tired, and I have to close them to feel better,” one MyMSTeam member described.
“I have the same problem,” another replied. “Daylight hurts and irritates my eyes.”
Some members reported feeling confused and disoriented when faced with too much light. “If I’m in a room with bright light or glare, I start to feel a bit vague and then become confused,” one member said. “I forget names and have to ask my partner. Sometimes, it takes me a bit longer to say things out loud.”
Other members mentioned that light sensitivity affects their daily lives. “The bright lights in my office bother me so much,” one member shared.
Another replied, “I also have problems driving at night because the lights on the cars bother my eyes.”
Vision problems, including vision loss and double vision, are often some of the first symptoms of MS. One small study noted a higher rate of photosensitivity among people with MS compared to those without it. But more research is needed on the rate of photophobia in people living with multiple sclerosis.
Several studies on MS-related vision problems discuss the symptom of photophobia. One study found uveitis to be 10 times greater in people with MS compared to the general population. Another study found that half of the people diagnosed with optic neuritis had a 15-year risk of developing MS.
Headaches, which can be associated with photophobia, are also frequently reported among people with MS. Studies estimate that up to two-thirds of people with MS experience headaches. Migraine is the most common, followed by tension-type headaches. A tension-type headache is a mild-to-moderate headache that feels like a tight band is wrapped around the head.
Multiple sclerosis affects the nervous system by attacking the myelin that protects the nerve fibers throughout the central nervous system (CNS). This includes the brain, brainstem, spinal cord, and optic nerve. The process of demyelination results in lesions (scarring) in the CNS. This disrupts messages between the brain and the body.
The retina is a light-sensitive layer of tissue at the back of the eye. In the topmost layer of the retina, there are neurons called retinal ganglion cells. The axons of these cells make up the nerve fibers of the optic nerve. Retinal ganglion cells help to carry the light information from the retina. It’s then transmitted into a signal through the optic nerve to the brain.
The underlying cause of photophobia remains unclear. But scientists have proposed a few possible explanations for why people with MS might have a lower tolerance to light. Some believe demyelination can cause structural nerve damage and abnormal transmission of the neural pathways between the retinal layer, the optic nerve, and the brainstem. In fact, photophobia can be seen after optic neuritis.
Other scientists suggest that MS photophobia may be due to more nerve impulses in the trigeminal pain neural pathways. The trigeminal nerve is one of 12 pairs of nerves attached to the brain. It’s responsible for sensations from the face to the brain and may play a role in some sensory symptoms of MS. It also contains the ophthalmic nerve. This supplies sensory information from the eyes, upper eyelids, and forehead.
People with MS have a tendency toward headaches. Migraine attacks are especially common. Studies show around 30 percent of people living with MS experience migraine. About 80 percent of people with migraine have light sensitivity.
Common triggers for recurrence of both MS symptoms and migraine attacks include:
Many members of MyMSTeam report experiencing headaches, including migraine headaches. “Too much sunlight will trigger a migraine,” one MyMSTeam member explained. “So whenever I go outside, I wear sunglasses.”
Disease-modifying therapies (DMTs) have been proven to slow MS progression and reduce the rate of MS relapses. Studies have reported that the interferon class of DMT has a common side effect of increasing the severity of headaches in people with MS. Natalizumab (Tysabri, Tyruko) and fingolimod (Gilenya, Tascenso ODT) have also been associated with headaches as a side effect.
Other common drugs and medications that may cause photophobia include:
Other neurological conditions — including meningitis and traumatic brain injury (TBI) — can cause photophobia. Eye conditions, such as chronic dry eye, cataracts, eye infections, and eye allergies, can cause photophobia as well. You may also experience it when recovering from eye surgery.
People with light-colored eyes (blue, green, or gray) are more sensitive to light compared to those with dark-colored eyes, such as brown. This is because lighter-colored eyes have less pigmentation to protect the retina from the sun and other light sources. The more light that passes through the eyes, the more nerve cells in the eye are stimulated.
Because photophobia is a symptom of an underlying medical condition, it’s important to manage your MS and other conditions well. Work with your healthcare provider to pinpoint the exact cause of your light sensitivity and explore treatment options to reduce symptoms.
Certain lifestyle changes can make photophobia easier to manage. Ophthalmologists recommend wearing sunglasses that block out blue wavelengths. Polarized sunglasses with ultraviolet (UV) protection are a great option and can be found at your local optical shop. Rose-colored sunglasses can also help block out undesirable wavelengths and may be a more affordable option.
“My doctor told me I do not have optic neuritis but suggested I wear indoor and outdoor glasses that can block out the blue color in light,” wrote one member.
“Wearing sunglasses with UVA and UVB protection has also helped me,” said another.
You can also ease photophobia at home by avoiding direct sunlight, closing your eyes during bright flashes of light, adjusting the settings on your devices, wearing dark glasses, and darkening the room.
Seek immediate medical care if your pain feels moderate or severe even in low-light settings, or if you begin to experience headaches, eye redness, blurred vision, or loss of vision.
On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.
Have you experienced photophobia with MS? Let others know in the comments below.
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I use special experimental contacts, dark brown filters for photophobia and a mild prescription for blurred vision. I also wear sunglasses on top of the contacts. And sometimes a baseball cap. Depends… read more
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