Light sensitivity and eye pain are very common migraine symptoms. It isn’t only an aversion to light but it can also make the migraine pain more intense.
For people without headache disorders, light became too bright when it hit 23,000 lux (like a bright, sunny, cloudless day). Even at that intensity, 24% were not bothered at all by the brightness. In contrast, people with migraine experienced discomfort at between 500 and 1,000 lux (equivalent to an overcast day).Migraine.com
Unfortunately, light avoidance is not how we can deal with light sensitivity as that just makes us more and more sensitive to light.
Why is light so painful?
A special kind of cells called intrinsically photosensitive retinal ganglion cells (ipRGCs) have receptors that express a compound called melanopsin, explains Friedman. The ipRGCs project light information to the hypothalamus, the part of the brain that regulates our sleep and wake cycle, she says.
“The ganglion cells also project to a part of the brain called the thalamus, which is a part of the brain that senses pain. It’s thought that the projection to the thalamus is what causes the exposure to light to be painful during a migraine,” says Friedman.Everyday Health
But there is more research going on about why we can be so sensitive to light.
There is a second system, the melanopsin system, that does not participate in formed vision but specifically senses light. There are fewer of these cells in the retina of the eye, but once these cells get turned on, these cells do not turn off. We believe that both of these cells may set up a sense of brightness that can cause trouble. We now also know that these cells do connect with the trigeminal system in deep brain centers—and therefore can cause pain. The melanopsin system also explains why people who are blind (no formed vision) can still experience photophobia.
While migraine is the most common condition associated with continuous photophobia, there may be other causes of photophobia. Trigeminal pain fibers are in the cornea, the iris (colored part of the eye), and even the back of the eye. Even dry eyes may cause light sensitivity in some individuals.American Migraine Foundation
When does photophobia start with a migraine attack?
It can begin in the prodrome stage, early on in the migraine attack, in some people. But it will definitely kick in by the headache stage in others. It usually lasts for the duration of the headache stage and for some even lingers a bit after that.
Can bright lights trigger a migraine attack?
In my personal experience, they definitely can be a trigger.
Types of light that bothers people with migraine disease and be triggers
- Flickering lights
- Pulsing lights (This includes fluorescent lights which do pulsate even though that cannot be seen)
- Bright light
- Computer screens
- Movie screens
- Light glare
- Repetitive patterns
Can Photophobia become chronic?
I have photophobia from fibromyalgia as well but I definitely have severe photophobia. And there was research not long ago that said people with migraine can have photophobia between migraine attacks. But certainly, some people with migraine just become light-sensitive all the time. Since I have chronic migraine that makes sense for me but for others without chronic migraine the process makes less sense.
Although we don’t know the exact mechanism, it may be related to the reason people develop chronic migraine, she explains. “It seems to be caused by what we call central sensitization that occurs in the brain,” says Friedman.
Central sensitization is a condition of the central nervous system that can occur in people with chronic pain conditions; the system that mediates the pain becomes sensitized and is in a persistent state of high reactivity. This lowers the threshold for what causes pain, which means it takes less and less of a stimulus to produce a response, explains Friedman.
“That’s the same thing we see in the visual system. Over time, it takes less and less light to be bothersome; even with a dimmer or less bright light, some people will sometimes get the same response that they get when they have a migraine,” she says.Everyday Health
What can you do to help with photophobia?
I use two products all the time to help with photophobia that I highly recommend because they both help me immensely.
They block more blue light than any other glasses I have come across and they also block more problematic light in the spectrum while letting in the soothing green light. Some of the research done demonstrated that “white, blue, amber, and red light increased the subjects’ headache pain intensity, while green light was actually shown to reduce pain intensity” Avulux In other words, all the light in the spectrum that is aggravating to us is blocked and the light that soothes us is let in. So they are the best specs I have found for photophobia and my experience wearing them has proven that as well. I wear them all the time to help manage my photophobia and light triggers.
Green light is just the least unpleasant wavelength of light for us. We can tolerate it so much better. And when I have a migraine or light is seriously bothering me I just chill with my allay lamp. I actually tend to use it every night for a few hours of downtime.
But also in addition to these products, it is good to remember to not avoid light because that just increases light sensitivity. So while we are definitely inclined to do so with blackout curtains and sunglasses it is counterproductive. So I let light into the house as much as possible, indirect light if I can. And I wear Avulux glasses, especially outside and since they are not sunglasses they do not cause that issue.
When I found out that avoidance makes it worse though I had to increase my light exposure inside the house very slowly because I was so light-sensitive. So it was a bit at a time to adjust to it. It was a bit of a process. I assume since I have photophobia from fibro and migraine disease it may be pretty sensitive chronically forever but with the Avulux migraine specs and the Allay lamp they both help me tame that.