Understanding Light Sensitivity and Eye Pain in Migraine

Understanding Light Sensitivity and Eye Pain in Migraine

If you live with migraine, you're probably all too familiar with the experience of light sensitivity and eye pain. In fact, photophobia, or sensitivity to light, is one of the most common migraine symptoms. Up to around 90% of people with migraine report struggling with light sensitivity during attacks.

Light sensitivity can range from mildly annoying to completely debilitating. When it's severe, even low levels of light can worsen head pain and other migraine symptoms. This photophobia makes it difficult to carry out normal activities when migraine strikes.

Why does light sensitivity occur with migraine? What can you do to manage eye pain and photophobia during attacks? Read on as we answer some common questions about this challenging migraine symptom.

What Causes Light Sensitivity With Migraine?

Researchers aren't entirely sure why migraine attacks increase sensitivity to light. But they have some theories about the possible mechanisms behind photophobia.

One is that the nerves involved in processing light signals in the brain become overexcited during a migraine. So even normal ambient light levels get perceived as painfully bright. The visual cortex and thalamus regions seem especially prone to this hypersensitivity.

Another possible explanation involves the trigeminal nerve system. The trigeminal nerve carries pain signals from the face and head to the brain. During migraine attacks, trigeminal nerve activity increases. Researchers think this heightened activity could translate light signals into pain perceptions.

Inflammation may also play a role. Some small studies show people with migraine have higher levels of inflammatory markers during and between attacks. Neuroinflammation could make the trigeminal nerve and other light processing pathways more excitable.

In short, several different mechanisms related to excitability and inflammation might explain why migraineurs develop temporary light sensitivity.

Why Do My Eyes Hurt With Migraine?

Light sensitivity seems closely linked to eye pain in migraine. In fact, some experts think photophobia actually causes the eye discomfort associated with attacks.

Here's how it may work. When ambient light levels feel painfully bright to your hypersensitive brain, one natural response is to squint. Squinting helps limit the amount of light entering your eyes. This involuntary squinting response strains the muscles around the eyes, resulting in eye pain.

Eye pain can also occur because of referred pain from migraine. Referred pain means you feel pain in an area other than the actual source. With migraine, you may feel eye pain because of referred pain signals from irritated nerves and blood vessels in the brain.

What's the Connection Between Light Sensitivity and Headache Pain?

Research shows an interesting link between photophobia and head pain levels in migraine.

In one study, people with migraine reported how different light levels affected their head pain. Not surprisingly, bright light provoked more head pain than dim light.

But here's the really interesting part - the study found light sensitivity developed before headache pain intensified. So photophobia seems to be an early warning sign that head pain is about to get worse.

What does this mean? It suggests that light sensitivity directly contributes to escalating migraine pain. Again, experts think overexcited light processing pathways in the brain generate the sensation of photophobia. All this neural excitability then activates the trigeminal nerve system, leading to worsening head pain.

The bottom line: light sensitivity doesn't just happen to occur with migraine headaches. Rather, it directly exacerbates head pain once migraine is already underway.

Can You Have Photophobia Without Headache?

For most people, light sensitivity only happens during actual migraine attacks. But some people do report experiencing photophobia at other times too.

Having photophobia without head pain tends to be more common among people who have chronic migraine. Chronic migraine means experiencing at least 15 headache days per month, with symptoms lasting 4 hours or more daily.

One study found around 17% of people with chronic migraine had photophobia even on days with no headache. Experts think this may result from persistent excitability of light processing pathways in the brain.

Occasional light sensitivity without headache can also happen during migraine phases called the premonitory and postdromal stages:

• Premonitory symptoms start up to 48 hours before head pain begins.
• Postdromal symptoms occur within 48 hours after a migraine attack resolves.

So in short, it is possible to sometimes have photophobia between headaches. But isolated light sensitivity should become less common if you gain better control over chronic migraine.

Should I See an Eye Doctor for Migraine-Related Photophobia?

Sometimes people worry their light sensitivity stems from an eye problem rather than migraine. But there's usually no need to see an optometrist or ophthalmologist unless you're experiencing other vision changes too.

Here are some signs that do warrant an eye exam:

• Vision getting progressively worse
• Loss of peripheral or color vision
• Seeing flashes, floaters, or spots
• Eye pain even without headaches
• Double vision
• Eyelid drooping
• Eyes not appearing aligned

Photophobia from migraine doesn't cause these types of vision changes. Blurry vision can happen during migraine attacks. But it resolves once the attack ends and shouldn't progressively decline over time.

If examination shows your eyes are healthy, the eye doctor will attribute your light sensitivity to migraine. You can then focus on photophobia treatment strategies.

Should I Get Tinted Glasses for Migraine-Related Photophobia?

Tinted glasses are a simple tool that can provide major relief from migraines aggravated by light sensitivity. They work by filtering out some wavelengths of light to lessen their impact.

The best tint option for migraine varies by person. But here are some popular choices:

• Gray lenses: Block bright sunlight, reduce glare, and increase contrast.
• Brown or amber lenses: Also block bright light while preserving color perception.
• Rose-colored lenses: Reduce blue light emission from screens that can trigger attacks.
• FL-41 lenses: Filter out the specific light wavelengths most likely to worsen migraine.

Tinted lenses are available both for prescription and non-prescription eyeglasses. Using clip-on sunglass lenses offers an affordable option too. Try out a few different shades to find your perfect match.

Just be sure to choose tints that don't seem too dark for indoor use. Oversaturated lenses can backfire by causing eye strain.

Should I Just Stay in a Dark Room During Migraine Attacks?

Darkness often soothes migraine pain and photophobia. But staying in a pitch black room usually isn't realistic or healthy long-term.

Here are some healthier ways to limit light exposure during migraine attacks:

• Draw the blinds or curtains in the room(s) you use.
• Dim bright overhead lights.
• Use lamp lighting instead of overhead fixtures.
• Face away from windows and bright doorways.
• Wear a wide-brimmed hat, sunglasses, or an eye mask.
• Try switching light bulbs to softer wavelengths.

Creating an environment with low, indirect lighting goes a long way. You can also make a "cave" with blankets when needed for added darkness and soothing pressure.

How Do Migraine Medications Help with Photophobia?

Along with lifestyle measures, medication can help tackle the root causes of light sensitivity.

Experts think migraines happen when nerve cell activity fluctuates in the brain. Migraine medications aim to calm this electrical "storm" by adjusting brain chemicals.

For example, prescription pills like Topamax and Depakote suppress excitability in nerve pathways involved in light processing. B

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.