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Why My Eyes Hurt so Badly by Sunlight?

It seems to be an obvious solution to people who are light sensitive- wear a pair of sunglasses. Many of us know two other optical solutions-- photochromic technology, which allows automatic transitions between light and dark; and polarized lenses, which eliminate horizontal reflected light. Here we are going to talk about some medical conditions that cause unusual photophobia.

Recently, I have a patient who reported sharp pain upon seeing sun light. He was diagnosed with Episcleritis, which occurred first in right eye and then left eye. Episcleritis usually has self limit course. It takes about 2-3 weeks to go away. However, it could reoccur. Luckily this patient doesn't have symptoms or signs of systemic immune diseases or posterior segment eye diseases. The treatment includes anti-inflammatory and Mydriatic (dilation) eye medications, which reduces eye pain and relaxes eye muscles.

Another patient has suffered from severe light sensitivity for several years. Sometimes she had to stay in a dark room to avoid eye pain. Due to the on and off nature of her condition, none of her eye doctors have been able to detect any eye diseases during routine eye exam, until one day she went to MEEI when it flared up during her interview. She was diagnosed with Thygeson’s superficial keratitis, a type of inflammatory corneal disease. With short term steroid eye medication, her light sensitivity quickly disappeared.

Similar magic happens to a 7 year old boy who has been very sensitive to light for several years. He needs to keep sun glasses on whenever go outside. His dad has raised the question about his son’s light sensitivity to several different eye doctors during routine eye exam. Since there was no pain or red eye, his son was reassured eyes were totally fine. At the encounter at my office, a few conjunctival papillae seen on both eyes make me suspect allergic conjunctivitis. With a full course of anti-allergy eye drops, he is not light sensitive any more. One day, his father was surprised to see his son looking at the sunlight direction without any squinting.

Sensitive to light also occurs to patients who experience traumatic brain injury. It will gradually resolve during vision rehabilitation.

In summary, any inflammation in the anterior part of the eye could result in over sensitivity to light. It can be difficult to be diagnosed if photophobia is the only visual complaint. Try to come for an urgent eye exam at the time you are suffering from light sensitivity. As an optometrist, I am dedicated to help you solve the mystery.

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