Referred Ocular Pain or Referred Headaches

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Greetings to all and sundry,

We are getting closer to the end of January and the middle of this week already, and time seem to be flying a bit faster now, I am happy about it though, I don't know for you but I think we have had enough of January so it ought to go and let the other months come.

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Anyway, how are you doing today? I hope you are having a good time both at work and at home? Today we had our first rain for the year in my area and it was beautiful, the smell of sand getting wet filled the atmosphere and I even went in the rain for a while to get myself soaked. The dry season would be coming to an end shortly from the look of things.

Anyway, let's get back to business, I am certain that you are here to read about health and not my life's story, so as I am always about, today I would be discussing one of the common complaints that one would hear in the eye clinic or hospital and what could possibly be causing these and perhaps what we can do for ourselves. I hope you enjoy the read.


Introduction


The eye is one of the most reactive organs when it comes to changes within the human body and with other organ systems, your eyes pick up even the tiniest details easily and would manifest this such that an expert who knows what they are looking forward can easily find it.

The eye has been a great tool for the diagnosis of many conditions within the human body some examples have been jaundice, hypertension, diabetes, STDs, etc. You are probably wondering how this is even possible right? Don't worry stay continue to stay with me every day and I would get to talk about all these with time.

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For our discussion today though I would be talking about some of the things that tend to happen in the human body or the organ system that reflect on the eye resulting in painful sensations in and around the eye. When pain is found in the eye and it's originating from a different source other than the eye we call it referred pain.

In the same vein, the eye could also bring about some effects which would not necessarily manifest in the eye itself. The most common and the perfect example of this would be the experience of headaches by lots of patients, I think in one of my previous writeups I even mentioned how some eye conditions could end up being misdiagnosed as migraine? Yh, headaches relating to the eye can be quite common.


Referred Ocular Pain


So what are some of the things that could result in one feeling pains in and around the eye? The most common one that I am certain most of my readers could relate to is the painful sensation in and around the eye when their systemic pressure shoots up. Hypertensive patients tend to suffer from this a lot and most often calming the pressure down can relieve the pain.

But this is not limited to hypertensive patients though, have you ever experienced pain in the eye after staying up for so long or after some consecutive days of not getting good sleep? When when we are not able to rest well our system goes into overdrive and one of the things that happen is an acute rise in systemic pressure which directly or indirectly results in painful sensations in the eye as well as headaches.

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Whiles, we are still on the topic of pressure I should mention that when your eyes pressure rises acutely too you are bound to experience pains in and around the eye. It could be throbbing pain or prickly pain, either way, it is quite uncomfortable and it could make light tolerance quite difficult.

Another source of ocular pain we could look at is issues relating to the head generally or the brain. Now when there is a tumor in the brain it would inevitably reflect in the eye and one of the common symptoms it presents with is pain, When the intracranial pressure rises you may experience pain in the eye and you experience electrical impulse outbursts like what happens in migraine patients you would also experience pain in the eye alongside the unbearable headaches that come with being a migraine patient.


Referred Headaches


Looking the other way around, some conditions or issues stem from the eye that inevitably results in headaches and can be quite discomforting and some people are not able to perform their daily duties accordingly. A lot of times these issues come with photophobia which means working in the sun worsens things.

The most common one that I would be talking about is the asthenopia that comes with being a hyperope which is one of the refractive error conditions. With this condition, the eye uses more power than it ought to enable the individuals to see quite well at far and this stress inevitably goes back to the head and the brain, and the pressure build-up results in headaches.

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In very high hyperopes it can be extremely discomforting and may need to have things sorted out for them as soon as possible for them to have a good quality of life. Another example is an acute rise in Intraocular pressure as in the case of acute closure glaucoma, trauma to the eye, and some cases of uveitis.

In acute close-angle glaucoma, there are instances where things get bad so fast patients feel dizzy and nauseous and could even collapse. The cases of trauma are quite expected as most often than not the trauma not only gets to the eye but other parts of the head which could also be a reason for the head and in the case of uveitis, well inflammations would do that to you, the pain and head are inevitable.


Conclusion


But in all this the purpose of our learning is not so you can diagnose yourself and say your headache or pain is probably from this or that but rather so you can understand the diagnosis your Optometrist presents you and the education or explanations he tries to give you because I would basically be adding up to that.

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by @nattybongo

Thus why I always say that when I doubt consult a professional, never keep things to yourself, do not diagnose yourself and even worse do not do self-treatment without proper diagnosis and management procedure. Avoid over-the-counter medication, prioritize your sight and your health and please stay safe. It is a pleasure serving you once again and I wish you a fruitful week.


Further Reading

Moshirfar, M., Benstead, E. E., Sorrentino, P. M., & Tripathy, K. (2022). Ocular Neuropathic Pain. In StatPearls. StatPearls Publishing..

Ringeisen, A. L., Harrison, A. R., & Lee, M. S. (2011). Ocular and orbital pain for the headache specialist. Current neurology and neuroscience reports, 11(2), 156–163. https://doi.org/10.1007/s11910-010-0167-6.

Waldman, C. W., Waldman, S. D., & Waldman, R. A. (2014). A practical approach to ocular pain for the non-ophthalmologist. Pain management, 4(6), 413–426. https://doi.org/10.2217/pmt.14.38.

Shibata, M., & Suzuki, N. (2013). Nihon into. Japanese journal of clinical medicine, 71(12), 2135–2140..



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5 comments
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Some years ago, when I was in my third year of medical school, I was fascinated by how much could be known through the eye. The first time I got to see the back of the eye was magical. From then on I started to go deeper into this, and when I learned that it was important to analyze the fundus in people with hypertension, I found much more sense to this test.

My mom is hypertensive, and the fundus exam is something I do with some frequency. Being able to see inside the eye is exciting.
And it is real, when for some reason her blood pressure goes up a lot, the pain is not only in the back of her neck but in her eye, and she gets red eyes. We just have to know how to observe, and we will know much more about the patients.

Thank you for this great information.

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I am happy to know you perform funduscopy for your mum nd every now and then, it can really give us so much information about a person’s ocular health as well as systemic health.

I do remember how it felt the first time got to see the fundus too, it was truly magical and exciting, haha, thanks for the reminiscence Doc

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Is this referred headache different from how migraine works

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True migraine diagnosis would give you an ocular pain which is considered referred because it doesn’t stem from the eye whereas eye conditions giving headaches would result in a referred heachache. I hope you get it?

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