Light-sensitive eyes with headache: what to know

Bright light may intensify a headache when the nervous system is sensitised, including during a migraine-like episode. Tired eyes, prolonged screen use, poor sleep, or an uncorrected vision problem can also make light uncomfortable. Nasal blockage and facial pressure may occur with Allergic Rhinitis, Chronic Sinusitis, or a Common Cold. Fever and respiratory symptoms can accompany COVID-19. Dehydration or heat exposure may worsen headache and light sensitivity. An eye that is very red or painful needs a direct examination because the cause may be local to the eye.

Move to a quiet, dim room and reduce screen brightness without sitting in total darkness for a prolonged period. Rest, drink fluids, and use a cool cloth over closed eyes. Avoid driving while vision is uncomfortable or altered. Note the start time, triggers, associated nausea, fever, nasal symptoms, and any visual changes. If heat, poor fluid intake, or heavy exertion preceded the episode, cool down and rehydrate; symptoms that do not settle should be assessed. Do not use another person’s eye drops.

Call for emergency help for a sudden, severe headache, loss of vision, confusion, fainting, weakness, trouble speaking, seizure, repeated vomiting, or a stiff neck with fever. Seek same-day eye or medical assessment for a painful red eye, halos around lights, a new unequal pupil, injury, or light sensitivity that is severe or worsening. Arrange review for repeated episodes, a first unusually intense episode, or symptoms that continue despite rest and fluids.

Does the pattern fit migraine, an eye problem, infection, sinus symptoms, or dehydration? Do I need an eye examination? Which features would require emergency help if they recur?