Photophobia or the ability for light to cause pain is a common complaint in the optometric exam chair. In fact, greater than 50% of patients with traumatic brain injury (TBI) and 80-90% of patients with chronic migraine present with complaints of photophobia and the prevalence of TBI and migraine is only increasing. Most commonly providers recommend sunglasses and light avoidance, however, recent studies have revealed that this treatment paradigm may be making patients worse. This course elaborates on the newly hypothesized pathophysiology of photophobia and different etiologies that need to be considered including – dry eye, migraine, TBI, medications, and other systemic and psychiatric disease. This course presents treatment paradigms for photophobia including filters, light re-adaptation, dry eye management and medications including occipital injections and botox, and how clinicians can know when to employ each option.