If a sunny day or the lights in your office building give you eye pain and a throbbing headache that sends you searching for the nearest dark room, you may have migraine.

“It’s extremely common for people to have light sensitivity and eye pain in migraine,” says Deborah Friedman, MD, MPH, a neuro-ophthalmologist and headache medicine specialist in Dallas, Texas. “Light sensitivity, known as photophobia, occurs more frequently than many other migraine symptoms, including nausea, vomiting, sensitivity to sound, or sensitivity to odor.

Here are answers to some common questions about light sensitivity and eye pain in migraine.

1. What Is Light Sensitivity, or Photophobia?

Photophobia is when light that would not ordinarily be bothersome causes discomfort or pain in the eyes. It is a common symptom of migraine.

“Light sensitivity not only causes eye pain and aversion to light, it can make a headache worse,” says Dr. Friedman.

2. What Causes Light Sensitivity in Migraine?

Sensitivity to light during a migraine attack is thought to be related to the pathway between special cells in your eyes called intrinsically photosensitive retinal ganglion cells (ipRGCs) and the thalamus, a part of your brain that senses pain.Different from rod and cone cells, which process visual information and enable you to see, ipRGCs are involved in nonvisual responses to light, such as the sleep-wake cycle.

3. When During a Migraine Attack Does Photophobia Typically Occur?

Light sensitivity can begin in a migraine attack even before the head pain starts, says Friedman. “I’ve had patients tell me that photophobia can be one of their very first symptoms of migraine. All of a sudden, light becomes too bright, and it starts to bother them. Many people notice that noise also becomes too loud — they start hearing things they wouldn’t normally be able to hear very well,” she says.

Even if it doesn’t occur first, the photophobia usually starts by the time headache pain begins, says Friedman. “For most people, light sensitivity and eye pain persist for the duration of the headache, and some people even have residual photophobia after the head pain ends,” she says.

4. Can Bright Light Trigger a Migraine Attack?

It’s not uncommon for bright light or excessive light to bring on a migraine attack, says Friedman. “People will say that going out on a bright, sunny day or seeing the glare reflected off snow or water can sometimes trigger an attack,” she says.

Many types of light can trigger a migraine attack, including flickering light, bright or reflected sunlight, high-contrast light, and glare, such as from a computer screen. Fluorescent lights are also a common trigger.

5. Why Does Light Sensitivity Sometimes Become Chronic?

It’s not clear why light sensitivity can become chronic, says Friedman. “There are people who get light sensitivity with migraine, and eventually they’re just more light-sensitive all the time,” she says.

“We do know that in the general population (not just those who have migraine), people with blue eyes or light-colored irises tend to be more light-sensitive,” she says.

While the exact mechanism of light sensitivity in migraine is unclear, it may be related to the reason people develop chronic migraine, Friedman says. “It seems to be caused by what we call central sensitization that occurs in the brain,” she says.

Central sensitization is a condition of the central nervous system that can occur in people with chronic pain conditions. It happens when the system that mediates pain enters a persistent state of high reactivity. This lowers the threshold for pain, meaning 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 produce discomfort. Even with dimmed or less bright light, some people can experience the same response that they get with migraine,” she says.

6. What’s the Best Treatment for Light Sensitivity and Eye Pain in Migraine?

“Unfortunately, there’s no magic pill that you can take that’s going to take your photophobia away. Most people who experience photophobia during a migraine attack go into a dark room,” says Friedman.

Medications used to treat acute attacks often work to treat the photophobia, because the symptom is part of the migraine process, she adds.

While no medications target photophobia specifically, finding an effective treatment for migraine attacks could reduce your sensitivity to light. Acute migraine medications include triptans, gepants, ergotamine, nonsteroidal anti-inflammatory drugs (NSAIDs), and combination pain relievers.

Triptans

Triptans narrow your blood vessels by acting on serotonin receptors in your brain and nerve endings to decrease pain and inflammation. They are a first-line treatment for acute migraine attacks.Triptans are available as pills, nasal sprays and powders, and subcutaneous injections:

• almotriptan (Axert)

• eletriptan (Relpax)

• frovatriptan (Frova)

• naratriptan (Amerge)

• rizatriptan (Maxalt)

• sumatriptan (Imitrex, Onzetra)

• zolmitriptan (Zomig)

Gepants (CGRP Antagonists)

Gepants block calcitonin gene-related peptide (CGRP), a protein found in higher levels during a migraine attack. CGRP causes inflammation and blood vessel swelling, and also sends pain signals to the brain. Gepants are available as oral tablets and nasal sprays:

• rimegepant (Nurtec)

• ubrogepant (Ubrelvy)

• atogepant (Qulipta)

• zavegepant (Zavzpret)

Ergot Alkaloids

Ergot alkaloids act on serotonin and dopamine receptors in your brain, and help reduce inflammation by inhibiting CGRP. They may be less effective than other types of migraine medications.

Ergotamine, a type of ergot alkaloid medication, is typically combined with caffeine to increase its effectiveness.

Ergot alkaloids are available as oral tablets, nasal sprays, rectal suppositories, and injections:

• dihydroergotamine (Migranal, Trudhesa)

• ergotamine (Ergomar, Migergot)

Nonsteroidal Anti-Inflammatory Drugs

NSAIDs help reduce pain and inflammation during a migraine attack. They are sometimes used with triptans or other migraine medications.

Common NSAIDs for migraine include the following:

• ibuprofen (Advil, Motrin)

• naproxen (Aleve, Anaprox)

• diclofenac (Cambia, Voltaren)

• aspirin

• ketorolac (Toradol)

• celecoxib (Elyxyb)

Combination Pain Relievers

Pain relievers such as naproxen, acetaminophen, and aspirin are also combined with other migraine medications and ingredients to increase their effectiveness and reduce side effects like nausea, vomiting, and sensitivity to light.

Combination pain relief medications for acute migraine attacks include the following:

• acetaminophen, butalbital, and caffeine (Fioricet, Esgic, Zebutal)

• acetaminophen, aspirin, and caffeine (Excedrin)

• sumatriptan and naproxen (Treximet)

• meloxicam and rizatriptan (Symbravo)

7. What Else Can Help With Light Sensitivity?

Beyond working with your doctor to manage migraine symptoms, Friedman suggests the following tools and strategies to help manage light sensitivity:

• Sunglasses “It can be helpful to wear sunglasses, but not super-dark glasses,” says Friedman. “We recommend an amber tint. Darker tints can make it harder for the eyes to readjust when you aren’t wearing them.”

• FL-41 Glasses These glasses have a rose-colored tint that blocks blue wavelengths of light, which seem to be the most bothersome to people, explains Friedman. “You can buy these glasses on the internet, or if you have prescription glasses, you can get the lenses tinted,” she says. "If FL-41 glasses don’t seem to help you, some people find that using glasses with a light yellow tint works for them while indoors."

• Anti-Glare Computer Screens or Filters These reduce glare and reflections on your computer monitor, which can be helpful, especially if you use your computer a lot.

• Less Screen Time If possible, limit the amount of time that you spend looking at a screen.

• Blue-Light-Blocking Glasses Glasses marketed as blocking blue light can be helpful, though their efficacy varies from brand to brand, says Friedman. “It’s not clear to me what coating is used to block the blue light and whether it’s standard throughout the industry,” she adds. They may work for you, but you may need to try a few pairs to find the right glasses.

• Green Light Studies show that using green light instead of incandescent light or fluorescent light can be very helpful, says Friedman. “Green seems to be the least unpleasant wavelength of light; people with photophobia can often tolerate this better than they can tolerate anything else.”

8. What Are the Drawbacks to Staying Inside, in the Dark, Most of the Time?

If you stay in a really dark room for a long period and then try to walk out into the sun, it’s painful, says Friedman.

“When you try to come out into the light, it just gets harder and harder to do that. It creates a situation where a person almost has to become a hermit, because they can’t stand any light,” she says.

There has to be a balance between trying to reduce some of the ambient light, particularly blue wavelengths, and spending time in the dark, she adds.

9. How Can a Person With Migraine Become More Tolerant of Light?

Typically, for people who have been living in the dark, doctors will try to move them into the light gradually, says Friedman. “If someone is using glasses, we gradually lighten the tint while turning up the lights,” she says.

In addition to increasing your light tolerance and utilizing tools to minimize its negative impacts, it’s important to get your migraine attacks under control, says Friedman.

10. Who Should You See for Photophobia Treatment?

“Photophobia isn’t easy to treat; it’s a problem that many neurologists and ophthalmologists don’t really feel comfortable treating. If your provider isn’t comfortable treating you, you might ask them to refer you to a neuro-ophthalmologist,” says Friedman.

11. When Should You Seek Out an Ophthalmologist?

You should see a specialist if you have a lot of eye discomfort that doesn't just occur with exposure to light, such as itching, burning, tearing, redness, or a foreign body sensation (a feeling of something in your eye), says Friedman.

"If people have light sensitivity that isn’t associated with their migraine attacks, that would also be a reason to visit an ophthalmologist," she says. “You want to make sure you don’t have dry eye or another retinal disease that can cause sensitivity to light.”