Chances are, at least one out of every five patients you will see today experiences migraine. Many are also light sensitive. Light sensitivity, also known as photophobia, is one of the most common symptoms experienced by people with migraine – as many as 80%-90% of those with migraine also have light sensitivity1.
It is so common, in fact, that The International Classification of Headache Disorders considers light sensitivity by itself as one of the criteria for diagnosing migraine headaches2. And it can occur both during active migraine attacks as well as between attacks when headache pain may not even be present3.
Bottom line: light sensitivity can cause disability in patients with migraine, and it needs to be treated as an independent symptom. And you, as an eye care professional, can help.
Why Does Light Sensitivity Occur?
Light sensitivity in migraine relates directly to certain cells in the back of the retina known as photoreceptors. There are several different types of these cells including those known as intrinsically photosensitive retinal ganglion cells (IPRGC). In this group are cells containing the photopigment melanopsin, and they appear to be the mediators of light sensitivity.
This particular cell type appears to be sensitive to blue light and amber light, peaking in the 450nm-500nm and 570nm-600nm ranges of the light spectrum. Signals from these cells, when activated, appear to converge on certain areas in the brain known as thalamic trigeminovascular neurons which then transmit pain signals from the dura to the cortex of the brain during a migraine attack4.
Screening for Light Sensitivity
So how is light sensitivity diagnosed? You could just ask the patient if they are bothered by light, but a simple yes or no to that question may not be enough. Sometimes light sensitivity isn’t that obvious. You will get more detailed and precise information if you integrate a questionnaire into your practice, such as the one below:5
- Do you notice yourself wearing sunglasses more frequently than people around you?
- Would you describe yourself as being extra sensitive to light?
- Do you find yourself moving to a dark room when experiencing a headache?
- Are you especially bothered by harsh lighting, tv or computer screens?
- Does harsh light or headache take you away from spending time with family, friends or work?
Light Sensitivity: Managing Light
So how can you help your patients? Light sensitivity can be avoided in different ways and the most obvious, of course, is to prevent light from reaching the cells at the back of the eye in the first place. This is why so many patients go directly to a dark room when migraine symptoms begin.
But there is another option: offering Avulux Migraine & Light Sensitivity Lenses.
Avulux is a precision optical filter that can absorb light at both the 450nm-500nm and 570nm-600nm wavelengths, preventing ganglion cells like the ones secreting melanopsin from being activated. This has the advantage of eliminating the offending light at its origin, but also being a non-invasive light management option that has no side effects or adverse reactions associated with it.
Tools for Managing Light Sensitivity
While light sensitivity has a huge impact amongst people with migraine, and is often the most debilitating symptom for them, there are effective light management tools in the market today – including Avulux Migraine & Light Sensitivity lenses, which are the only clinically proven lenses that precisely filter light to help people living with migraine.
References
1 Laurell L Artto V Bendsten et al Premonitory symptoms in migraine: A cross-sectional study in 2714 persons. Cephalgia 2016 Sep;36(10):951-9
2 The International Classification of Headache Disorders, 3rd edition. Cephalgia, 2013, 33(9): 629-808
3 Drummond PD, Woodhouse A. Painful stimulation of the forehead increases photophobia in migraine sufferers. Cephalalgia. 1993;13:321–324.
4 Hattar S, Lucas RJ, N, Thompson S, Douglas RH, Hankins MW, et al. Melanopsin and rod-cone photoreceptive systems account for all major accessory visual functions in mice. Nature 2003. ; 424 : 76 – 81
5 Evans RW, Seifert T, Kailasam J, et al. The use of questions to determine the presence of photophobia and phonophobia during migraine. Headache. 2008;48(3):395–7.