Cephalalgia. 2026 Apr;46(4):3331024261439257. doi: 10.1177/03331024261439257. Epub 2026 Apr 15.
ABSTRACT
BackgroundPhotophobia is experienced by most individuals with migraine, and it is frequently the most bothersome symptom other than headache. Light is not perceived uniformly; spectral composition and intensity influence discomfort and can exacerbate symptoms. While monochromatic green light shows therapeutic potential, it appears visually unnatural and is impractical for daily use. This study aimed to determine whether spectrally tailored white light, more visually acceptable in everyday environments, reduces light sensitivity among those with migraine.MethodsTwenty adults (18-44 years) with episodic migraine completed two research sessions: one during an acute migraine attack and one between migraine attacks. Participants were exposed to four spectrally distinct white light conditions (red-, green-, cyan-, and blue-enriched) in a randomized order delivered at ten intensity levels (50-590 lux). After each exposure, visual discomfort was rated on a 0-10 scale. Pupil size was measured using a pupillometer. Repeated-measures ANOVAs examined the effects of light spectrum, intensity, and migraine state on visual discomfort and pupil response.ResultsMigraine attack status significantly increased visual discomfort (F(1,19) = 25.84, p < .001, η2 = .576). White light spectrum (F(3,57) = 12.47, p < .001, η2 = .396) and light intensity (F(9171) = 124.30, p < .001, η2 = .867) were associated with intensity of visual discomfort. Post-hoc analyses indicated that visual discomfort increased with increasing light intensity, especially at higher light intensities. Among all tested spectra, green-enriched white light resulted in the least visual discomfort; blue-, red-, and cyan-enriched white light produced significantly higher discomfort (all p < .001). Pupil size varied by spectrum (F(3,57) = 14.13, p < .001, η2 = .426), with green-enriched white light producing the largest pupil size.ConclusionSpectral composition, light intensity, and migraine state jointly influence both subjective and physiological responses to light. Across lighting spectra, lower light intensity was consistently associated with reduced visual discomfort, indicating greater visual comfort at lower intensities. These results identify green-enriched white light at lower intensities as a visually acceptable, migraine-conscious lighting option with potential for real-world application.
PMID:41983992 | DOI:10.1177/03331024261439257
