Understanding photophobia in mTBI patients

Photophobia or photosensitivity, is one of the more common conditions associated with a traumatic brain injury, experienced by approximately 50% of patients.

Understanding photophobia in mTBI patients in Bellflower

One of the most common symptoms reported after a head injury is photophobia or light sensitivity. This is experienced both by those who have had a serious head injury (TBI or traumatic brain injury) as well as a mild head injury (mTBI). 

Mild TBI (mTBI), which is typically defined by Glasgow Coma Scale score ≥ 13, accounts for the vast majority of all TBIs, particularly in the setting of sports-related injuries. The Glasgow Coma Score is a method for assessing the patient's extent of consciousness after a traumatic brain injury.

At our specialty eye care center we provide advanced care for patients who experience light sensitivity following a stroke, concussion or neurological condition. We are proud to provide cutting edge neuro optometric rehabilitation services to patients from all over California, and we are proud to be a leading provider of neuro-optometric rehabilitation services for patients from Bellflower, Long Beach, Lakewood, and Los Angeles.

Amplify Eyecare of Greater Long Beach

What are the most common symptoms and conditions you may experience following a mTBI?

A mTBI can result in a variety of visual complications. These are some of the most common visual-related conditions and symptoms:

  • Oculomotor dysfunction
  • Convergence insufficiency
  • Accommodative dysfunction
  • Dry eye
  • Photophobia
  • Visuo-spatial disorientation
  • Dizziness
  • Headache
  • Sleep disorders
  • Photophobia, or photosensitivity, is one of the more common conditions associated with TBI, experienced by approximately 50% of patients.
  • The reduced peripheral field (also known as collapsed fields) is another common mTBI symptom.

The conditions described above are in some way related to one another. There is a link between convergence problems and accommodative problems, for example. Another example is headaches and photophobia. Post Traumatic Vision Syndrome was described by William V. Padula, OD, as a cluster of vision and spatial disorders that affect people who have suffered a neurological event, such as a traumatic brain injury, a cerebral vascular accident, multiple sclerosis, or another neurological disorder.

If you are experiencing any of the above symptoms and conditions following a traumatic brain injury, you don't have to suffer any longer. It is possible to alleviate these symptoms with a customized neuro-optometric rehabilitation plan and continue to do your everyday tasks without difficulty and sensitivity to light. To schedule a neuro-optometric evaluation, please call (562) 925-6591.

How does a TBI affect your visual ability?

Often, when the visual system isn't functioning appropriately after a neurological/traumatic injury, we see a high level of exophoria (one eye drifting out) or exotropia (eye misalignment where one eye deviates outwards). Due to this additional effort, the visual system is stressed and activates the proprioceptive fibers in the extraocular muscles, which transmit signals to the trigeminal ganglion indicating the added effort. Nerve signals sent to the trigeminal ganglion activates pain signals through the thalamus and up to the cerebral cortex. Patients may experience headaches, light sensitivity, or dizziness.

How does a TBI affect your visual ability?
What is the connection between light sensitivity and traumatic brain injuries?

What is the connection between light sensitivity and traumatic brain injuries?

Photophobia is closely linked to pain sensation. It is the trigeminal nerve and its nuclei that are responsible for sensations of pain in the head. Several parts of the eye are densely innervated with trigeminal fibers and sensitive to pain, including the conjunctiva, cornea, sclera, and uvea (iris, ciliary body, and choroid). Photophobia is usually caused by painful stimuli to these areas (e.g. corneal abrasion, iritis, uveitis).

What is the connection between light sensitivity and traumatic brain injuries?

What is the mechanism that triggers light sensitivity in TBI?

On a pathophysiological level, let's examine some of the more common mechanisms. The retina contains photosensitive cells known as rods, cones, and intrinsic photosensitive retinal ganglion cells (ipRGCs). In the human retina, rods and cones are the predominant photosensitive cells. Melanopsin is found in the intrinsic photosensitive retinal ganglion cells. These cells specifically detect luminance levels, but they do not support vision. The ipRGC sends axons to the suprachiasmatic nucleus of the hypothalamus, and these axons control circadian rhythms. In addition, the ipRGC cells also send axons to the Edinger-Westphal nucleus to control the pupil light reflex. In the human retina, there are only 3,000 of these cells, representing .2% of all RGCs. These cells are photoreceptive, with maximum sensitivity to blue light within the 460-480 nm range. A patient with a traumatic brain injury may have a poorly regulated melanopsin-signaling system when exposed to light.

Does visual field loss occur in patients with light sensitivity?

In patients with photosensitivity, visual fields are important. It was noted by Christine T. Langerhorst and Avinoam B. Safran that there were generalized constrictions in the visual field. While the authors attributed it to an attention disorder, Jackowski attributed it to loss of rod-mediated activity related to dark adaptation. All patients reporting photosensitivity had visual field losses within the central 30 degrees when Jackowski used frequency doubling technology (FDT). Rods affect magnocellular loss, which affects the FDT. These patients reported collapsing visual fields during testing. Kinetic fields, such as Octopus or Goldmann, can also be used to map the visual field constriction. It was found that the FDT and kinetic fields show a strong correlation with visual field constriction.

How does a TBI affect your visual ability?
What is the connection between light sensitivity and traumatic brain injuries?

How is light sensitivity treated and managed in patients with mTBI?

The degree of light sensitivity caused by mTBI varies from mild to severe. The most severe cases might require patients to wear sunglasses constantly, even indoors. They may be sensitive to fluorescent lighting as well as digital devices, which emit a lot of blue light. With the introduction of filters and vision rehabilitation, light sensitivity can be improved even when it is severe and of long duration. 

The goal is to relieve symptoms with specific filters and to take the patient off the use of sunglasses indoors. Photosensitivity is associated with visual fatigue. It often occurs in conjunction with binocular vision problems, and is not a standalone condition. Binasal occlusion is used to reduce binocular stress in patients with mTBI. Through binasals, the system becomes less hyper-focused, which reduces sensitivity to light. Additionally, blue filters may reduce symptoms of indoor light sensitivity. Polaroid, blue-blocking filters, and FL-41 filters can be used outdoors to tone down the brightness.

Photophobia is a complex subject. Research in the future will provide us with a deeper understanding of photophobia in mTBI patients and allow us to provide better treatment for them.

Common Questions

In some cases, photophobia may be temporary and resolve on its own or with treatment. In other cases, it may be a long-term or permanent condition. Since there are a variety of causes for light sensitivity it is very important to schedule a neuro optometric evaluation to fully understand what is causing your symptoms.
Some people find relief from photophobia with home remedies such as using artificial tears, wearing sunglasses or a hat to block out bright light, or taking breaks from screens and other sources of artificial light. However in most cases these home remedies are not adequate to solve the issue. When you schedule a neuro optometric evaluation we spend time assessing the root cause of your light sensitivity as well as discussing the various treatment options such as binasal glasses and specialized filters. It is important to note that home remedies are generally not effective for everyone and are not a substitute for proper medical treatment by an eye doctor.
If you are experiencing photophobia and it is severe, persistent, or causing discomfort, it is important to see a neuro optometrist. You should also see a neuro optometrist if you are experiencing other symptoms that may be related to an underlying condition, such as eye pain or changes in vision. In many cases light sensitivity can be remedied by using filtered lenses or binasal glasses, these is a fairly simple solution and does not require a major investment, we highly recommend scheduling a neuro optometric evaluation to treat your light sensitivity.
Understanding photophobia in mTBI patients
Dr. Ikeda cartoon

Schedule a neuro optometric evaluation near you

If you or a loved one has suffered a traumatic brain injury and has been suffering from light sensitivity or any of the above listed visual conditions, please schedule a neuro-optometric evaluation with Dr. Ikeda.

Dr. Ikeda, FCOVD, DPNAP, is a leading optometrist in the field of neuro optometric rehabilitation and developmental optometry. He has made profound contributions to the field over the years and uses these expertise to provide the highest quality of eye care to his patients. He was Past-President of the Optometric Extension Program Foundation (OEPF) and of the Neuro-Optometric Rehabilitation Association (NORA). He received the “Founding Fathers Medal” for his continued service to NORA and he was recognized as “Physician of the Year” by the Rehabilitation Nurses Society. He is a clinical associate professor of the Western University of Health Sciences College of Optometry and was inducted as a Distinguished Practitioner into the National Academies of Practice (Optometry Academy).

To schedule a neuro optometric evaluation, please call (562) 925-6591. Those who have suffered a traumatic brain injury and have been suffering from visual conditions visit our clinic from all over California, and we are proud to be a leading provider of neuro-optometric rehabilitation services for patients from Bellflower, Long Beach, Lakewood, and Los Angeles.

Related Articles


I haven't actually used the optometrist side, so my review is limited to the vision therapy offered.  This office was recommended by my occupational therapist for the treatment of my double vision following a stroke.

Claire A.

Love this location. I had a brain injury accident from day one one. All the team make you feel you still important and hope in the horizon after when the medical system fell you miserably. Dr. Ikeda very professional and very understanding about your issue. Two tombs up.

Jim K.

My husband and I were immediately impressed with Dr Ikeda. I was hit by a car while cycling which caused broken bones and three brain injuries. The brain injuries caused double vision. Dr. Ikeda examined my eyes and got me started on vision therapy with his occupational therapist who specializes in vision therapy.  She (Chris) is absolutely great.  I am impressed with the array of tools used to help recover my binocular vision.  I am doing things I never thought were possible (balance boards etc).  Chris pushes me and keeps me motivated. I really enjoy my sessions with her.  The office staff is always friendly and they have a wonderful appointment reminder tool that makes it easy to keep my calendar up to date. I am happy the rehab center at Little Co. of Mary recommended them!!

Teresa S.

The Vision Therapy is handled in a separate office through a different door from the shared waiting room. Chris, the vision therapist, has a wide and varied assortment of tools, equipment and resources to best evaluate and treat most vision issues. After just a few visits, my double vision became easier to control, using exercises developed during the therapy process. It was time well-spent.

Joe M.

I have been coming here since I can remember. I love it here. The staff is so amazing and nice. They explain everything they gonna do and never make you feel rushed. Dr. Ikeda has always been my doctor and I would never want another one. He is the doctor for my whole family and is always asking how everyone is doing. I am also so crazy about picking out my frames and have to try so many and each person who helps me take the time and lets me try them all on. I would never want to go anywhere else! I definitely would recommend this office to anyone looking for a great eye doctor.

Kayla W.

This is not for the eye exam but for the frames selection portion. I brought my prescription from Kaiser here with my VSP insurance. The reception staff was very polite and professional.  Manny helped me to pick out frames and explain my coverage.  Very helpful and patient not like the individual at the other place I rated here on Yelp.  I was running late and he still helped me and was not bothered at all.  I am so glad I came here ..........very pleased.

Very professional staff and pleasant.

Daniel G.
1 2 3



How Does Vision Therapy Improve Reading Ability?

According to the American Optometric Association, approximately 80% of what a child learns in school is acquired through vision, and […]

Read More

What Causes Bloodshot Eyes? Understanding the Causes and Treatments

Bloodshot eyes can be alarming, but they are not always a cause for concern. In this blog, we will discuss […]

Read More

Understanding Sensory Fusion: A Vital Test for Eye Health

Maintaining healthy vision is essential to live a fulfilling life. Our optometrist in provides advanced functional vision testing to ensure […]

Read More
see all blogs

Contact Us To Amplify Your EyeCare

Amplify EyeCare of Greater Long Beach Logo

Working Hours

Monday & Wednesday

Tuesday & Thursday

By appointment only

Friday & Sunday



16816 Clark Ave, Bellflower, CA 90706
(562) 867-8719
Website Accessibility Policy
Safety protocols page
privacy policy
Cancellation Policy
For Patients
Call Us
For Patients
Call Us
eyefile-adduserphone-handsetcalendar-fullarrow-uparrow-right linkedin facebook pinterest youtube rss twitter instagram facebook-blank rss-blank linkedin-blank pinterest youtube twitter instagram