Having sensitivity to light is a common symptom that my vertigo patients report. They often ask:
- Why do bright light or sunlight makes me feel more dizzy or nauseous?
- Why do LEDs or fluorescent lighting trigger symptoms of dizziness, vertigo, or nausea?
- Why do flashing or flickering lights affect my balance, cause dizziness, or trigger a headache?
- Why do I feel worse as soon as I turn on the light switch or step outside into the sunlight?
- Why do I want to close my eyes when the lights come on?
Feeling sensitive to light is also called light sensitivity, and technically called photophobia.
Some patients may notice sensitivity to light – or photophobia – when they experience dizziness or vertigo.
Is Photophobia Associated with Your Symptoms of Dizziness or Vertigo?
Sometimes photophobia can be experienced continuously and chronically. In other cases, it may be episodic, meaning it comes and goes.
The duration of photophobia is dependent upon the root cause so that information may help with the diagnostic process.
What To Do If You Have Sensitivity to Light
If you feel sensitivity to light when you experience dizziness or vertigo, you should report that symptom to your health care provider. Also, include any other co-occurring symptoms such as imbalance, nausea, or headache.
The presence and pattern of any light sensitivity can help guide the diagnostic process for patients with dizziness or vertigo. Make a note of the onset, trigger, and duration of these symptoms.
What are the Possible Root Causes of Feeling Sensitivity to Light?
Root Cause #1: Medication Side Effects
Some medications may cause people to feel sensitive to light. In these cases, light sensitivity is caused by a medication side effect.
What To Do
Talk to your primary care provider or pharmacist about your medications to determine if any of them have a possible side effect of light sensitivity. For more detailed information and examples of medications that can cause you to feel sensitive to light, click here.
Root Cause #2: Eye Condition
Certain medical conditions that affect the health of your eye can cause you to feel sensitivity to light. A very common example is dry eye. Light sensitivity is a classic symptom of dry eye, along with eye discomfort such as redness, burning, pain, stinging, and a sensation like something is in your eye.
Other examples of eye conditions that can cause you to feel sensitive to light include conjunctivitis (pink eye), keratitis, scleritis, uveitis, iritis, blepharitis, keratoconus, retinal tear or detachment, or corneal abrasion.
What To Do
Consult with an ophthalmologist to rule out any underlying eye condition that can cause light sensitivity. Report any other eye symptoms, such as discomfort, itching, redness, foreign body sensation, discharge, or pain in one or both eyes.
This step is a process of ruling out or identifying any medical condition that could cause light sensitivity. If you are diagnosed with dry eye or another eye condition, you may need medical management by an ophthalmologist.
Root Cause #3: Eye Care
Interestingly, sometimes light sensitivity may be caused by interventions that have been done to treat your eyes.
For example, contact lens irritation may cause light sensitivity. Some patients experience sensitivity to light after certain types of procedures or surgeries done to treat eye problems.
What To Do
If you think that your sensitivity may have developed after you received eye care, had eye surgery, or started wearing contact lenses, you should consult with your eye doctor for further recommendations.
Root Cause #4: Eye Strain
Some patients report developing light sensitivity gradually as they’re working on electronic devices. In these cases, more screen time often increases the symptom intensity.
Screens that can trigger light sensitivity include the phone, tablet, laptop, or desktop. In some cases, this may even occur while watching television or playing video games.
For example, the patient may be feeling fine when they start working on their computer. After a period of minutes to hours of screen time, they start to feel sensitive to the light of the screen. Sometimes this can be due to fatigue of the eye muscles.
What To Do
One helpful tip is to take a break every 20 minutes and focus on a target 20 feet away for 20 seconds. This 20/20/20 rule is a good computer habit that can give tired eyes a much-needed rest break.
If that doesn’t provide adequate relief, I suggest taking a break from computer work until the symptoms settle back down.
For patients who report the onset of light sensitivity while working on an electronic device or during screen time, I typically refer to a neuro-optometrist for a comprehensive eye evaluation. These patients may benefit from special computer glasses or vision therapy.
You can search for a neuro-optometrist (a specialized optometrist who can figure out your prescription for glasses/contacts and help you with vision therapy exercises to strengthen your eye muscles) in your area using the doctor locator tool at COVD.org.
Root Cause #5: Allergies
If allergies are affecting your eyes, one symptom maybe light sensitivity. For example, sometimes redness or itchy eyes are a symptom of allergies.
That can eventually cause allergic conjunctivitis which is pink eye caused by allergies.
What To Do
In order to address light sensitivity at the deepest root cause, some patients need interventions to manage their allergies. This may include eyedrops, taking an over-the-counter allergy medication, taking a prescription medication, or receiving allergy shots.
If your eyes start feeling sensitivity to light when your allergies flared up, you may want to consult with an allergist in addition to an ophthalmologist. The allergist can recommend interventions that are appropriate for your individual situation.
If you are noticing that your eyes feel sensitive to light, I encourage you to work with your health care team to identify a medication side effect, an eye condition, eye care, eye strain, or another health condition, such as allergies, that may need medical management as part of your comprehensive treatment plan.
Root Cause #6: Migraines
For patients who feel sensitive to light intermittently, migraines may be a potential root cause (Here are some helpful tips to deal with migraines). The diagnostic criteria for migraines should be reviewed and considered when evaluating a patient who reports light sensitivity that waxes and wanes.
Migraines typically last from five minutes to 72 hours. In atypical cases, a migraine may occur daily for weeks to months. A migraine episode usually includes a severe headache, usually throbbing one on side of the head. Other symptoms may include sensitivity to sound (phonophobia), a heightened sense of smell, motion sensitivity, nausea, and dizziness.
What To Do
If a migraine episode is suspected as a root cause of light sensitivity, then migraine management may be the best course of action. Avoidance of triggers and medication management tend to be helpful for people with migraines.
Patients with migraines may want to consult with a neurologist and a physical therapist.
Root Cause #7: Vestibular Migraines
There are many different types of migraines, depending on which part of the brain is firing in a disorganized manner during the migraine event. Vestibular migraines are a specific type of migraine that should be considered as a possible root cause of intermittent light sensitivity.
This discussion is relevant for patients with a personal or family history of migraines. Patients must have either currently or previously met the diagnostic criteria for migraines, in order to be diagnosed with vestibular migraines.
Vestibular migraines may occur with the onset of symptoms such as light sensitivity, sensitivity to sound, heightened sense of smell, nausea, motion sensitivity, and dizziness, — with or without a headache.
Whenever a patient describes feeling sensitive to light sometimes but not all the time, I consider vestibular migraines as a potential root cause.
Root Cause #8: Post-Concussion Syndrome
Whenever a patient tells me they have sensitivity to light, I ask them when this symptom started.
If they describe that the light sensitivity started around the same time or shortly after the onset of their dizziness or vertigo, I want to rule out post-concussion syndrome. This is especially important to consider if the light sensitivity is relatively constant on a daily basis.
Sometimes a concussion may be caused by an obvious major event. In other cases, a concussion may be due to the cumulative effect of minor head bonks over time.
Root Cause #9: Long COVID
For patients who feel sensitive to light after having a COVID infection or getting a COVID shot, the possibility of long COVID should be considered as a potential root cause.
Root Cause #10: Brain Inflammation
Inflammation of the brain can cause you to feel sensitive to light. Neuroinflammation may have root causes other than a concussion or long COVID.
Other possible causes of brain inflammation may include meningitis or encephalitis. These conditions are usually caused by some kind of infection, so they usually require medical attention and medical treatment.
To rule out this possibility, your doctor may refer you to a neurologist for a full diagnostic work up. Some patients with severe brain inflammation may need emergency medical care.
That’s why it’s important to report light sensitivity to your doctor. This symptom may or may not be related to the root cause of dizziness or vertigo.
This blog is provided for informational purposes only. The content and any comments by Dr. Kim Bell, DPT are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. The details of any case mentioned in this post represent a typical patient that Dr. Bell might see and do not describe the circumstances of a specific individual.