HEADACHES AS SYMPTOMS OF OTHER MEDICAL CONDITIONS: DISEASE OF THE EYES

Pain from disease in or around the eyes may be referred to other regions of the head or face. Conversely, pain from another area of the head may be felt in the eye area. People seeking relief for headaches often first explore the need for glasses or a change in lenses before seeking a more thorough medical evaluation.
Before discussing diseases of the eyes and the headaches that they can cause, the roles of ophthalmologist, optometrist, and optician should be clarified, since people seeking help for problems with their sight or eyes may not understand the differences among these specialties. An ophthalmologist is a physician who has graduated from medical school and has specialized in diseases of the eyes and related structures. An ophthalmologist diagnoses and treats conditions of the eyes, and, when necessary, performs surgery. He/she also evaluates the need for lenses. An optometrist is not a doctor of medicine and is primarily concerned with evaluating and measuring the need for glasses. The optometrist makes lenses and dispenses them. The optometrist can also examine the eyes for certain diseases and then refer the patient to an ophthalmologist for treatment. An optician fills prescriptions for lenses and dispenses and repairs frames. All three professionals play an important and complementary role in the care of the eyes.
We believe that the vast majority of people with chronic head pain around the forehead or eye area have migraine or muscle contraction headaches. But, because a disease of the eyes may be to blame, it is appropriate that a thorough examination of the eye structures be carried out. Although optometrists are well trained for what they do, a thorough evaluation for certain diseases of the eyes is best performed by an ophthalmologist, whose training also includes disorders of the brain, some of which can cause headaches.
Eyestrain can cause headaches. This is particularly common following long periods of reading in poor light. Eyestrain is most common when there is a subtle or more noticeable weakness and imbalance of the eye movement muscles or ability to focus. Glaring and bright light may also produce discomfort. Fluorescent lighting may create an unnoticed flickering in lighting intensity, and headaches can be the result of this.
The pain of eyestrain is usually located around the eyes and forehead, frequently improving after reading is discontinued and the eyes are rested. Improving lighting conditions or obtaining
eyeglasses or a new prescription will often be of some relief.
While poor focusing ability can cause headaches, many more people believe that they need glasses in order to stop their headaches than is actually the case. Many patients report that when the glasses are acquired and used, no improvement in the headaches is noticed.
We believe that it is unlikely that your headaches will benefit from wearing glasses if you have headaches at times other than just when reading and if you do not experience focusing problems. To prevent the needless purchase of expensive eyeglasses, we suggest that you get two independent opinions and ask each doctor to give you the recommended lens prescription after the examination. Compare from one doctor to the next.

Glaucoma is a serious disease of the eyes that is capable of causing headaches as well as blindness. Sometimes the disease remains silent until damage is done. Glaucoma may strike the young as well as the old. The symptoms associated with glaucoma are due to impaired drainage of fluid from the eyes. The reduced drainage causes pressure within the eyes, and it is this increased pressure that leads to damage if the condition is not corrected.
Pain from glaucoma may be severe or mild. It is felt in or around one or both eyes or forehead, and nausea and vomiting may be present. Many individuals suffering from glaucoma see colored halos around lighted objects or experience a mistiness of vision.
A test for glaucoma can be performed simply and painlessly in a doctor’s office by using a device that measures the pressure within the eyes. All adults should have a yearly test for the disease.
Depending upon the severity and type of glaucoma, the condition can be treated with medication or by surgery.
Individuals with certain types of glaucoma must avoid those drugs known to worsen the disorder. Among these are antihistamines, some bowel relaxants, the tricyclic antidepressants, some anti-nauseants, certain tranquilizers, and some drugs used in Parkinson’s disease.
Over-the-counter pain or headache preparations may contain these or similar agents and should be avoided until you consult your doctor. It is particularly important for you to have your eyes checked for glaucoma if you must take one of these drugs for prolonged periods.
Tumors and infections of the eyes may also cause headaches. These and other diseases of the eyes, however, are infrequent causes of recurring head pain. Again, it should be emphasized that anyone experiencing headache of uncertain cause should be evaluated for glaucoma as well as for other serious illnesses of the eyes.

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