Why Are My Eyes More Sensitive to Light After Using Eye Drops?

The halos around streetlights appear larger when viewed with the eyes?

Hello Doctor, in recent years, my health check-ups have indicated that I have elevated intraocular pressure (around 21-23).
Initially, I didn't pay much attention to it because my cornea is relatively thick (about 600 microns).
I have also noticed mild floaters and dry eye symptoms.
In October of this year, I decided to undergo a thorough examination for precautionary reasons, including visual field testing and fundus photography.
The doctor said the fundus photography was normal, but there were slight impacts observed in the visual field.
I was advised to start using the eye drop medication Xalatan, twice a day (I usually apply it around 9-10 AM and 10-11 PM).
Currently, after two months of use, the intraocular pressure in one eye has decreased to 17, while the other eye is around 20.
However, recently I have noticed that my eyes are more sensitive to light, the floaters have become more pronounced, and the halos around streetlights have increased significantly.
I'm unsure why this is happening; it feels like my eyes are getting worse after using the drops.
I wonder if this could be a side effect or if there are other issues that need to be checked.
Thank you!

Cheng, 20~29 year old female. Ask Date: 2021/01/09

Dr. He Jianxian reply Ophthalmology

Basically, the enlargement of the halo is likely unrelated to the eye drops you suspect for glaucoma; it should not be a side effect of the medication.
If you have concerns, it is advisable to discuss them with the prescribing physician.
Director He Jian-xian, Ophthalmology Department, Nantou Hospital.

Reply Date: 2021/01/09

More Info

It sounds like you are experiencing increased light sensitivity and other visual disturbances after starting your eye drops, specifically Xalatan (latanoprost), which is commonly prescribed to lower intraocular pressure in patients with glaucoma or ocular hypertension. Let's break down your concerns and provide some insights into why this might be happening.

Increased Light Sensitivity
1. Mechanism of Action: Latanoprost works by increasing the outflow of aqueous humor, which helps to lower intraocular pressure. However, one of the side effects can be changes in the eye's sensitivity to light. This is because the medication can alter the structure of the iris and the pupil's response to light, leading to increased sensitivity.

2. Pupil Dilation: Some eye drops can cause the pupils to dilate or react differently to light. If your pupils are more dilated than usual, they may allow more light to enter the eye, making bright lights appear more intense and uncomfortable.

3. Dry Eye Symptoms: Since you mentioned having dry eye syndrome, this condition can exacerbate light sensitivity. Dry eyes can lead to discomfort and increased sensitivity to light, especially after using certain medications. If your eyes are not adequately lubricated, they may react more strongly to bright lights.

Visual Disturbances
1. Increased Floaters: You noted that your floaters have become more pronounced. Floaters are often a result of changes in the vitreous gel inside the eye, and while they can be a normal part of aging, they can also be exacerbated by changes in eye pressure or inflammation. If you are noticing a significant increase in floaters, it is essential to discuss this with your eye doctor, as it could indicate a more serious issue, such as retinal detachment.

2. Halos Around Lights: The halos you see around streetlights can be related to several factors, including dry eyes, corneal changes, or even the effects of the eye drops. If your cornea is not smooth due to dryness or other factors, light can scatter more, creating halos. Additionally, if your pupil size is altered, it can also contribute to this phenomenon.

Recommendations
1. Follow-Up with Your Eye Doctor: Given your history of elevated eye pressure, glaucoma, and the recent changes in your symptoms, it is crucial to have a follow-up appointment with your eye doctor. They can assess whether the eye drops are the right choice for you or if adjustments need to be made.

2. Discuss Side Effects: Bring up your concerns about increased light sensitivity and visual disturbances with your doctor. They may consider switching you to a different medication or adjusting the dosage.

3. Manage Dry Eyes: Since you have dry eye syndrome, consider using preservative-free artificial tears to help lubricate your eyes. This can alleviate some discomfort and may help with light sensitivity.

4. Monitor Symptoms: Keep a diary of your symptoms, noting when they occur and their severity. This information can be valuable for your doctor in determining the best course of action.

5. Protect Your Eyes: When outdoors or in bright environments, wearing sunglasses can help reduce light sensitivity. Look for sunglasses that block 100% of UVA and UVB rays.

In conclusion, while it is common to experience some side effects when starting new eye medications, it is essential to communicate any significant changes in your symptoms to your healthcare provider. They can help determine the cause of your increased light sensitivity and visual disturbances and adjust your treatment plan accordingly.

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