Headaches are one of the most common afflictions that affect millions of people. Headaches are rarely serious and most are caused by tension. The eyes are rarely the cause of headaches, however the eye is often part of the symptoms of headache. Increasingly, computers have become one of the leading causes of eyestrain and ocular headache. Computer Vision Syndrome (CVS) is a new term used to describe this type of headache. Some of the more common types of headaches are described below.
Tension Headaches are by far the most common type of headaches. The pain is usually caused by the pulling or strain of the muscles in the neck and back to the head. Even though the cause is the muscles in the back, the pain is usually “referred” forward up to the front of the head and down into the eye region. Fortunately, these headaches are usually relieved by over the counter headache pills and by reducing the tension. Tension can come from many causes including long work hours, close visual tasks such as reading or computer use, everyday stress, working or even sleeping in unusual positions, and so many other sources.
Migraine Headaches are another common type of headache. Migraines can range from mild discomfort to almost debilitating pain. They are caused by spasm of blood vessels in the brain. They often tend to run in families. Since the optic nerve visual pathways in the brain are often next to the blood vessel causing the migraine, some people experience a visual aura before the migraine starts. This aura is characterized by seeing shimmering zigzag lines, heat wave like allusions, flashing colored lights, and even a temporary loss of the central vision. These auras typically last between 10 to 30 minutes. It is possible to get a "migraine visual aura" and not have a headache! Fortunately, there are many effective treatments for migraine headaches including Botox injections.
Sinus Headaches are also quite common. They usually cause a deep dull pain in the eyes and can be very painful. It must be stressed that it is not the eyes causing the pain even though the pain is in the eye. Sinus headache require medical workup usually including either a CAT scan or MRI. There are excellent treatments for sinus headaches.
Allergic Headaches are associated with systemic allergies. They may occur without having other allergy symptoms. Often the sinuses are involved with this type of headache. A complete allergy workup is necessary usually involving skin tests and a CAT scan.
Computer Vision Syndrome is one the fastest growing causes of headaches as more and more people are using computers or playing video games. Video display monitors do not have "laser" sharp print and they are luminescent. They require head and body posturing that is not always comfortable, and for those people that need bifocals, the posturing is very unnatural. When we do close visual tasks, we tend not to blink as much which in turn can dry our eyes out thus enhancing eyestrain. Some of the symptoms of CVS can be headache, eyestrain, neck and back ache, irritated eyes, red eyes, eye fatigue, and dry eye syndrome.
Disease, either in the eye or elsewhere in the body, is the least most common cause of headache. These type headaches are often associated with other symptoms depending on what the disease process is. Some of the ocular symptoms can be blurred vision, halos and glare around lights, sensitivity to light (photophobia), and intense pain in the eye. Narrow or closed angle glaucoma is vary rare but can give all the above mentioned symptoms. Brain tumors, certain types of cancer, multiple sclerosis, are just a few of the many systemic diseases that can cause headache or pain in or around the eye.
Even though the eyes are rarely the cause of headaches, an ophthalmologist is a very important part of the workup and diagnosis of headaches. An ophthalmologist’s medical training is essential in the workup of headaches as well as associated medical disease. It is estimated the approximately 1/3 of all disease may potentially be diagnosed, sometimes way before they are know elsewhere in the body, during a complete eye exam by an ophthalmologist.
Routine eye care is recommended every 2 years under the age of 60 and annually thereafter. If you have any headache that does not respond quickly to over the counter medication, if the headache is recurrent, out of the ordinary, or sever, if it is only on one side of the head, if it’s accompanied by fever or a stiff neck, or if a headache wakes you up from sleep, you should seek medical help immediately.