I've had low-grade light sensitivity with moments of relief for no apparent reason, and times when things get worse. The only trigger that pretty consistently (but not always) makes photophobia worse is drinking coffee, decaf or regular. I also suffer from hippus, or fluctuations in the pupil when exposed to light, which sometimes includes pupils that dilate rather than constrict when exposed to light too long. I happen to have low aldosterone (with low renin, i.e., secondary hypoaldosteronism, or the much cooler sounding hyporeninemic hypoaldosteronism), which is important in regulating the balance of sodium and potassium, and have been drinking water with unrefined sea salt but without apparent (maybe slight) relief when photophobia is present. Interestingly, the pupil fluctuations started about a year and a half ago after trying a whopping dose of methyl vitamins in a supplement concocted by my previous doctor. I've been tested for serum and plasma (RBC) potassium, and have middling serum levels but levels touching the top of the range for plasma/RBC, which with middling sodium could fit with low aldosterone, except I don't have the typical symptoms of low aldosterone such as constant urination or hearing problems. I'm trying to figure out the mechanism by which photophobia occurs. It seems to correlate tightly with hippus/mydriasis problems, i.e., I'm usually sensitive to light when my pupils are noticeably dilating when they shouldn't be and/or fluctuating when exposed to light. The question is whether it's a matter of low aldosterone and the electrolyte imbalances it causes, or if it's related to sympathetic overarousal, which definitely fits my other symptoms, such as the inability to nap, occasional insomnia, occasional abnormal anxiety symptoms (like sticky saliva, sometimes actual nervousness or excessive energy, libido and sexual problems, etc.), poor stress tolerance, and so on. This would make sense, as pupillary dilation is governed by the sympathetic response, i.e., norepinephrine, whereas contraction is governed by the parasympathetic response. I do know that when I've been stressed in the past by having too little (or no) sleep that my pupillary fluctuations ramp up even worse, so that seems to indicate (for me) a norepinephrine/sympathetic problem. My current doc has me on multiple antiinflammatory supplements, suspecting that chronic inflammation is creating positive feedback with norepinephrine, leading to hippus, mydriasis, and my other non-ocular symptoms. So far these supplements (fish oil, astaxanthin, vitamin K complex, etc.) haven't helped. I also tried up to 30 mg of hydrocortisone (which is in negative feedback with CRH and norepinephrine and so should lower both) but without any noticeable benefit. Anyone have any experience with light sensitivity and how to manage it?