Beyond migraine: A narrative review of photophobia's clinical spectrum

INTRODUCTION: Photophobia is a frequent and often disabling symptom encountered in a wide range of neurological and ophthalmological conditions. Particularly prevalent in migraine, but also observed in common eye diseases, photophobia reflects complex interactions between visual and nociceptive pathways. This review provides a comprehensive overview of the clinical features, pathophysiological mechanisms, diagnostic challenges, and therapeutic strategies of photophobia from both neurological and ophthalmological perspectives. MATERIAL AND METHODS: A narrative literature review was conducted using PubMed up to December 2025, focusing on studies addressing photophobia in neurological and ocular disorders, as well as experimental and translational research exploring its underlying mechanisms. RESULTS: Photophobia is frequently reported in migraine and traumatic brain injury, as well as in common ocular conditions such as dry eye disease and corneal pathology. Current evidence suggests that it involves altered interactions within visual-trigeminal pathways. Photophobia is also associated with impaired daily functioning and psychological distress, highlighting its clinical impact. Management primarily focuses on the underlying condition, while optical filtering strategies may provide additional relief in selected patients. DISCUSSION: Photophobia is a multifactorial symptom reflecting the convergence of ocular and central nervous system mechanisms. Improved understanding of the neural pathways involved may enhance diagnosis and support more targeted and individualized management strategies.