Eye-related headaches: the cause and effect

Headaches are no fun and are often debilitating and unnerving.  Many of us have experienced at least one episode of a headache in our life time.  Some of us unfortunately experience weekly if not daily headaches.  This just shouldn’t be.  Some headaches come and go while others seem to get worse and worse.  A knee jerk reaction in all of us is to reach for that bottle of headache pain reliever that we conveniently store in our home medicine cabinet.  While this may temporarily relieve whatever headache type we may be feeling, this may not always be the best treatment choice.

Courtesy of Brandon Koger on Flickr

Courtesy of Brandon Koger on Flickr

Did you know that the root cause of many headaches stem from eye-related conditions?  Doctors of optometry routinely address headache concerns, evaluate for eye-related causes of headaches, and prescribe an appropriate course of treatment or further necessary testing.

How can you ready yourself for an appointment with your optometrist?  Be prepared to answer the following 10 questions that your optometrist will likely ask of you regarding your headache.

  1. When did your headaches begin?
  2. How often do you get these headaches?
  3. How long do they last?
  4. Where specifically is the headache?
  5. Describe the nature of the headache?
  6. How intense is the headache on a scale of 1 to 10?
  7. Is there anything you do to make the headache worse?
  8. Is there anything you do to make the headache better?
  9. What medications are you currently taking?
  10. Do you have a family member that also suffers from headaches?

Your optometrist will perform a battery of selected in office tests to determine if your headache may be caused by an eye-related source or from some other bodily origin.  Common eye-related headache conditions that your doctor of optometry may consider include but not limited to:

● Uncorrected or undercorrected hyperopia (farsightedness)

● Uncorrected or undercorrected presbyopia

● Accommodative spasm or dysfunction (focusing problems)

● Vergence disorders (eye teaming problems)

● Uveitis (inflammation of the eye)

● Intermittent angle closure glaucoma (acute raise in eye pressure)

Cause and Effect

Uncorrected or undercorrected hyperopia or presbyopia, and accommodative disorders all put an undue amount of stress on the overall focusing system of the eye causing the patient to experience blurry vision and headaches .  When the two eyes do not work in concert in the case of vergence disorders, it wreaks havoc with the muscles in each eye and in how vision is ultimately perceived and processed.  This can also provoke a headache to come on.  If an eye becomes inflamed in uveitis, specific muscles in the eye goes into spasm creating light sensitivity, tearing, eye pain, browache, and headaches.  And last, when the drainage system of the eye intermittently impends the flow of fluids out of the eye with that of intermittent angle closure glaucoma, the eye pressure may acutely spiral up triggering a subsequent browache and headache.

If your optometrist determines that your current headache is not eye related, he or she will recommended that you seek further evaluation and care from your primary care physician if the patient has/is…

● Sudden, abrupt, or split-Second

● New headache sufferer without a previous history

● Progressive headache especially in individuals over 50 years of age

● Long standing headaches sufferer, but the headaches have evolved in its frequency, severity, or nature

Or if the headache is accompanied by…

● Fever, weight loss, night sweats

● Other concurrent health conditions such as cancer and HIV

● Neurologic symptoms such as confusion, impaired alertness / consciousness

A doctor’s order:  Don’t go another day with a nagging headache. Go see your optometrist to get relief, today!

~Judy Tong, OD, FAAO
California Optometric Association

Vision therapy to improve academic & athletic performance


Vision therapy (VT) is a high effective type of physical and perceptual therapy that works on improving eye muscle control and coordination, eye-hand and eye-body coordination, as well as visual processing/understanding and visual cognitive skills.

Seeing takes place in the brain instead of the eyes. The eyes are the instruments which transmit visual images to the brain. The brain then processes and integrates visual information with other systems such as the vestibular system to affect balance and spatial localization, as well as affecting understanding of what is seen or read. VT uses neuroplasticity to improve visual functioning and the activities that require vision.

When most people think of good vision, they think of seeing clearly– that is, having 20/20 vision. While seeing clearly is important, it is only one aspect of vision.

Having good vision involves much more than seeing 20/20. Being a good reader, a good driver, or a good athlete requires mastering a complex set of vision skills, such as eye tracking, eye teaming, visual perception and visual memory. Unfortunately, many children and adults have problems with these types of visual skills. Although they may see 20/20, they do not have good vision. They may have trouble reading or working on a computer. They may have difficulty driving or excelling in sports.

It is estimated that as many as 20 percent of people may suffer from these types of problems. Please click here to see if you may have a treatable vision problem that is interfering with your work, reading or sports performance.

Vision therapy can treat many problems including:

  • Strabismus
  • Amblyopia
  • Visually-related learning problems
  • Visual Impairment after Brain Injury (such as stroke, craniotomy)
  • Double vision
  • Sports Vision – to enhance athletic performance through faster and more accurate visual motor skills
  • Computer Vision Syndrome (headaches, eyestrain, decreased productivity)

Here are the most frequently asked questions about VT:

1. How do I know that I may need VT?

A: There are many symptoms that indicate a need for VT. Some of the more common symptoms are: eyestrain associated with reading or computer use, not performing to potential at school or work, poor eye-hand coordination with sports or handwriting, double vision, print that appears to “move” on the page, and losing your place while reading.

Special tests will determine if your specific vision problems can be treated with VT.

If you have two or more of the following symptoms, you can benefit from VT. It takes energy to compensate for a vision problem, which results in discomfort and loss of productivity. Improving your visual skills can improve your academic, athletic and executive performance.

  • My eyes feel tired or uncomfortable while reading
  • Headaches while reading or studying
  • Reading or computer use makes me sleepy
  • I, or my child, is not performing to my potential in school or work
  • I have difficulty remembering what I have read
  • Frequent loss of concentration while reading
  • Words move, jump, or appear to “swim”
  • Double vision
  • I am a slow reader
  • “Pulling” sensation around eyes while reading
  • Words blur, or go in and out of focus
  • I often lose my place, or jump over letters & words
  • I often re-read the same line over and over
  • I do not like to read for pleasure
  • I have a short attention span while reading compared to other activities
  • I have poor eye-hand coordination while playing sports
  • I have poor depth perception
  • I learn better visually than verbally
  •  I get dizzy reading in the car
  • I have difficulty judging distances such as parallel parking or stopping a car
  • I have difficulty making visual judgments such as the depth of stairs, pouring coffee into a cup

2. What is involved with vision therapy?

A: A vision therapy program incorporates many different exercises that train deficient visual skills. Learning visual skills is like learning to play the piano, or a new sport. VT exercises are performed in our office under the supervision of a vision therapist. We also prescribe home therapy to reinforce and accelerate the development of newly learned skills.

The length of the VT program depends on the nature and severity of your vision problem.

3. What results can I expect?

A: You can expect your vision to improve significantly or completely if you stick to the program as prescribed by the doctor. The amount of your improvement depends on the type of vision problem(s) you have, how well you follow doctor’s orders and how regularly you practice your vision exercises.

4. Will my insurance cover vision therapy?

A: Few insurance plans cover VT, but it depends on your particular insurance coverage. The California Optometric Association has several doctors who specialize in vision therapy who would be happy to help you determine if you have any allowance for vision therapy.

5. What kind of vision problems can be treated with vision therapy?

VT can treat a variety of vision problems including:

  • Strabismus (eye turn)
  • Amblyopia (lazy eye)
  • Oculomotor dysfunction
  • Focusing problems
  • Double vision
  • Convergence insufficiency or excess

Visually-related learning problems

Visual motor or visual perceptual problems can interfere with the input and processing of visual information. This decreases a student’s performance on reading and writing tasks, which are highly dependent on visual skills (see symptom checklist below).

Visual motor problems can occur in these skills: tracking, eye teaming, or focusing.

Visual perceptual delays can occur in: visual-motor integration, visual memory or sequential memory, visual discrimination, visual figure ground, visual form constancy, or speed of visual processing.

Sports performance enhancement therapy


Photo courtesy of DeusXFlorida on Flickr.com

VT can be used to improve athletic performance through increasing visual accuracy, speed of visual reaction time, depth perception, tracking speed (to follow a target quickly), increasing the span of recognition, and improving eye-hand and eye-body coordination.

Enhancing Executive Performance

VT can be used to improve work productivity by increasing visual stamina, decreasing symptoms such as eyestrain or headaches associated with desk or computer work, improving speed of scanning and reading.

Visual Rehabilitation after Brain Injury

80 percent of the brain is related to visual function; therefore, after an injury to the brain (such as stroke, craniotomy, aneurysm or trauma) visual skills and activities dependent on visual skills (such as walking and driving) are often impaired. VT can be used to train the non-damaged part of the brain to do what the damaged part used to do.

Symptoms of brain injury-related visual impairment include double vision, poor judgment of distance while driving or reaching for objects, hemianopsia or loss of side vision, frequent loss of place while reading, skipping words, sensitivity to light, vertigo, fluctuating vision, bumping into objects, decreased depth perception, leaning to one side, and eyestrain.

Please refer to the section on Brain Injuries for more information.

6. Can Adults benefit from VT?

A: Vision therapy benefits adults. In fact, Dr. Brisco went through VT as an adult, and it has tremendously contributed to her improved reading speed and comprehension, as well as her tennis game!

Vision problems that were not corrected during childhood often persist through adulthood, thus interfering with efficiency and productivity on visual tasks. The majority of vision problems are treatable at any age, but it is better to catch problems early to maximize your potential during your academic and executive career.

~By Elise Brisco, OD, FCOVD, FAAO