Eye Care: The Causes of Light Sensitivity

Q: My eyes are sore and bright light makes them water. It feels better when I wear sunglasses. Can you tell me what this could be?

A: Sounds like you have a few things going on with your eyes, so let’s try and figure it out. You say bright light makes your eyes water, while sunglasses help them feel better. These are big clues that you are experiencing a fairly common condition known as photophobia. This is a fancy term for light sensitivity or intolerance to light. There are different degrees of photophobia. Some people are sensitive only to sunlight, and others to any type of brightness, including fluorescent or incandescent light. When experiencing this sensitivity, folks may even notice some squinting or the need to close their eyes.

Even though light sensitivity may be a minor annoyance for many people, there is the possibility of it being triggered by an eye problem (corneal abrasion) or medical condition (meningitis) that causes eye pain, soreness and severe photophobia, even in very low-lighting conditions. There are several things your health-care professional may need to know to help determine the cause of your light sensitivity:

• How long has it been going on?
• Is the sensitivity constant or every now and then?
• Are dark glasses needed outside, inside or both?
• What makes it better or worse?
• Have your pupils recently been dilated with medications?
• Have you had exposure to chemicals, dust, pollen, sun or wind?
• Do you use any soaps, cosmetics or shampoo in or around your eyes?

This brings me to the part of your question relating to eye soreness. To better understand, it would be very helpful to know the following:

• When did the soreness begin?
• Is the pain or sore feeling in or around your eyes?
• Does it feel as if there is something in your eyes?
• Do you have other symptoms (fever, joint aches)?
• Do your eyes burn?
• Is the pain worse when you move your eyes?

It is important to know that your symptoms can run the gamut from minor to major concerns. For example, tired or sore eyes after a long period of working at your computer (eye strain) is minor and is not the type of pain needing urgent medical attention. However, it would be best to immediately call your eye specialist if your pain is severe, constant and includes any changes in your vision; if you need to wear sunglasses indoors; or if the photophobia is accompanied by fever, headaches, blurry vision or red eyes, as there may be a concern for meningitis.

Summing up, here’s what you need to know: People with lighter-colored eyes tend to be more sensitive to bright light, as are those taking certain medications (doxycycline, tetracycline, furosemide), so speak to your pharmacist or physician about medications that may cause photophobia. Dry eyes may cause your eyes to feel sore. Even though they are dry, the feeling of being watery (especially when exposed to bright light) may occur due to poorly spreading tears, or less of them.

When it comes to photophobia accompanied by eye soreness or pain, there are common eye concerns to consider. These include but aren’t limited to:

• uveitis (inflammation of the inner portion of the eye)
• iritis
• conjunctivitis (inflammation of the conjunctiva, which is the thin, clear membrane over the white part of the eye; the conjunctiva also lines the eyelids)
• contact-lens irritation or complication
• sunburn (yes, eyes can experience sun damage)
• refractive surgery
• migraines
• retinal detachment
• Sjogren’s Syndrome (inflammatory autoimmune disorder)
• burns to the eye (welder’s flash)
• a stye or chalazion (these can create eye pain and sensitivity as they grow)
• corneal ulcer
• a foreign body in the eye or irritation.

The symptom of light sensitivity may be your eyes’ way of buying time to heal from one of the conditions causing the eye soreness. Given your concern and combination of eye complaints, it is important to visit your family physician or eye-care specialist. It’s better to catch a problem early and to be reassured than to be shortsighted and let it fester.

Read More About Eye Care on MSN Health & Fitness:

• 10 Tips to Protect Your Eyes
• From 20/80 to 20/20
• Talk About It: Eye Problems

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Robert Danoff, D.O., M.S., is a family physician and program director of The Family Practice Residency, as well as the combined Family Practice/Emergency Medicine Residency programs at Frankford Hospitals, Jefferson Health System, Philadelphia, Pa. He is the medical correspondent for CN8, The Comcast Network, a regular contributor to Discovery Health Online and a contributing writer to The New York Times Special Features. (Read his full bio.)