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
http://www.coavision.org

Dry Eye Disease

If you ever have stinging, burning, gritty or sandy sensation, excessive tearing or itchy eyes, you may have symptoms of dry eye disease.

Dry eye disease is a condition where you don’t have enough tears or have poor quality tears to lubricate and nourish the eye. Tears maintain the health of the front surface of the eye and provide good vision. Dry eye disease is a common and often chronic problem, particularly in older adults. Advanced dry eyes may damage the front surface of the eye and impair vision.

The front surface of the eye is called the cornea. With each blink of the eyelids, tears are spread across the front surface of the eye. Tears are produced by several glands in and around the eyes. The tear film is composed of nutrients, electrolytes, proteins and lubricants. Tears provide lubrication, reduce the risk of eye infection, clear the eye of foreign matter, and keep the surface of the eyes intact and clear. Tears drain from the eyes into small drainage ducts called puncta in the corners of the eyelids, which drain in the back of the nose.

Courtesy of Clearly Ambiguous on Flickr

Courtesy of Clearly Ambiguous on Flickr

If there are any irregularities in the tear film, symptoms of dry eye may manifest. Dry eye disease may limit daily activities including reading, driving, working on the computer or wearing contact lenses.

Many different factors cause dry eye. These are some of the most common:

1) Hormones: Dry eye disease is more common in people 50 years old or older. Hormonal changes that are common in women experiencing menopause can cause dry eye.

2) Systemic diseases: Other systemic diseases including diabetes, glaucoma, Sjogren’s syndrome, lupus and rheumatoid arthritis can exacerbate the symptoms of dry eye.

3) Medications: Medications including antihistamines, hormonal replacement therapy and androgen therapy may contribute to dry eyes.

4) The environment: Environmental factors such as pollen or allergies, working on the computer or contact lens wear can make dry eyes worse.

Dry eye disease is diagnosed by patient history. In diagnosing dry eye disease, your doctor of optometry will evaluate the symptoms, general health problems, medications or environmental factors that contribute to dry eye disease. Your doctor will perform an external examination of the eyes including the eyelid structure and blink dynamics. Your doctor will evaluate the eyelids, cornea and conjunctiva is performed using bright light and magnification. Measurement of the quantity and quality of tears is assessed for any abnormalities. From this information, your doctor of optometry can determine if you have dry eyes and advise you on treatment options.

Treatments for dry eyes include:

  • over the counter artificial tears,
  • punctal plugs (small plastic pieces that close the ducts that drain tears out of the eyes),
  • eyelid hygiene,
  • dietary supplementation,
  • or a prescription eyedrop called Restasis (cyclosporine 0.05%).

If you experience any of theses symptoms, contact your doctor of optometry and ask for a dry eye evaluation.

~ Melissa Barnett, OD, FAAO