Photophobia: what is it, symptoms, causes and treatment

We leave the house and the sunlight blinds us, having to wait a few moments for our eyes to adjust to the level of brightness. At night they focus a lamp or flashlight on our eyes and we close them, again annoying and with somewhat irritated eyes.

These are situations that we have all experienced on occasion and in which the level of light has caused us a certain feeling of discomfort. Although it is generally normal, there are many people for whom exposure to light is a frequent nuisance or who are especially sensitive to it. It is about those who suffer from photophobia.

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What is photophobia?

Photophobia is considered to be the presence of high sensitivity to light stimulation that generates a sensation of pain or discomfort when exposed to light sources of variable intensity. Those who suffer from it find the luminosity of some stimulating sources annoying. It can appear in varying degrees, ranging from superficial discomfort to very intense light sources to intolerance of most light sources.

These light sources can be both natural and artificial. It is usually noticeable especially in those situations in which there is an abrupt transition between environments with different luminosities.

When exposed to intense light sources, the subject usually feels the need to close their eyes, tearing and redness of the eyes. It is common for the subject with photophobia to present symptoms such as dizziness, headache (which is very prevalent), vision problems or gastrointestinal problems such as nausea and even vomiting.

Symptoms and effects

This can generate the presence of alterations in the daily life of the person with photophobia, being able to generate social and even labor adaptive problems (for example in the light emitted by computers) that involve behavioral avoidance, isolation, or feelings of inadequacy or low self-esteem in the face of the consequences of photophobia. It can also generate situations of great danger due to the ease of being dazzled in environments in which you are working with heavy machinery or require great precision and coordination oculomanual.

Photophobia is a very common problem that is generally not produced by any condition and does not pose a major problem, but sometimes and especially when it appears abrupt form or at low levels of illumination may be linked to the presence of another alteration of variable severity, being then a symptom of a disorder to treat.

Possible causes and contexts of appearance

Photophobia is considered to be caused mainly by the activation of nociceptors or pain receptors from the trigeminal nerve in the presence of excessive light. This activation is what causes the sensation of discomfort and eye pain that occurs when exposed to light..

Among the elements that can generate this activation, we usually find first the presence of problems or diseases of the globe itself. such as the presence of conjunctivitis, inflammation of the eye due to an infection such as herpes, diseases such as glaucoma or cataracts or the presence of injuries, scratches, surgical wounds or burns (including those derived from prolonged exposure to light solar). The regular use of contact lenses facilitates its appearance. It also usually appears after performing eye surgeries.

In addition to alterations directly linked to the eye, photophobia is possible and common in the presence of elements, injuries and diseases that affect the brain. An example is found in meningitis, or meningeal or brain tumors. It is also common in people with migraine (photophobia being the reason why they usually lock themselves in the dark until the headache passes). It is common in other situations such as drug or alcohol intoxication (hangover is quite common) or substance poisoning. Other diseases such as botulism or measles can also cause it.

But not only do we find elements linked to disorders and injuries, but there are also innate and non-harmful biological variables that also influence the probability of suffering from photophobia. One of them is the pigmentation of the eyes: it has been shown that those with light-colored eyes tend to be more intolerant of light intensity. The same is true of people with albinism. It is also very common that with age, with the aging of the eye, a certain degree of photophobia appears. Finally, it can also appear with the use of certain medications, such as those that cause pupillary dilation or some antibiotics.

Treatments

The treatment of photophobia must take into account that the main thing in the first place is to determine its causes, since in some cases it could derive from serious health problems. In general, the type of treatment will be linked to the phenomenon or cause of its appearance.

If it is due to an infection, it is common to use eye drops with antibiotic content that can stop it, as well as anti-inflammatories. In the case of problems such as cataracts or glaucoma, surgery may be necessary.

In the case of tumors in the eye or brain, resection or removal by surgery, radio and / or chemotherapy can greatly reduce symptoms. If photophobia occurs with injuries, surgical wounds or abrasions, it will be necessary to carry out specific treatment for each type of injury. In some cases, such as a superficial wound or after surgery, the problem will eventually resolve itself.

Either way, in all cases it is advisable to avoid exposure to bright lights, often prescribing the use of sunglasses both outdoors and indoors. It is also common to indicate the need to lower the light level of the usual environment if it gives problems. It is necessary that the eye is clean and properly hydrated, resorting to artificial tears if necessary. The consumption of vitamin B12 in our usual diet is also recommended. If it occurs on its own and in the absence of another medical condition that causes it and needs to be treated, it can be helpful and It is advisable to apply desensitization procedures so that the patient can gradually endure a greater brightness.

Given that it is not uncommon for some of these people to have photophobia and the measures taken for it to be a level of alteration in their life, Psychological therapy may be necessary in cases of depressive or anxiety symptoms. Likewise, depending on the conditions for which it is present (for example, a brain tumor) Psychological counseling and psychoeducation of the affected person and their environment.

Bibliographic references:

• Sharma, R. & Brunette, D.D. (2014). Ophthalmology. In: Marx, J.A., Hockberger, R.S.; Walls, R.M. et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Saunders.
• Kanski, J.J. (2004). Clinical Ophthalmology. 5 ed. Madrid: Elsevier.