Why do eye sockets hurt. What causes eye socket pain. How to choose between an optometrist, ophthalmologist, and optician. What are the differences between eye care professionals. How to treat eye pain and ocular symptoms.

Understanding Eye Socket Pain: Causes and Symptoms

Eye socket pain, medically known as orbital pain, can be a distressing experience. It’s essential to understand the potential causes and recognize the symptoms to seek appropriate treatment. But what exactly causes eye socket pain?

Eye socket pain can stem from various sources, including:

• Sinus infections
• Tension headaches
• Migraines
• Orbital cellulitis
• Optic neuritis
• Trauma or injury to the eye area

Symptoms accompanying eye socket pain may include:

• Tenderness around the eye
• Swelling or redness
• Difficulty moving the eye
• Blurred or double vision
• Sensitivity to light

Is eye socket pain always a serious condition? Not necessarily, but it’s crucial to consult an eye care professional if the pain persists or is accompanied by other concerning symptoms.

Optometrist, Ophthalmologist, and Optician: Decoding the Differences

When seeking eye care, it’s important to understand the roles of different professionals in the field. Let’s explore the distinctions between optometrists, ophthalmologists, and opticians.

Optometrist: Primary Eye Care Provider

An optometrist is a primary eye care provider who focuses on vision care and eye health services. What education do optometrists receive?

• Bachelor’s degree
• 4-year Doctor of Optometry (OD) program
• Optional additional clinical training or specialty fellowship

Optometrists are qualified to:

• Perform comprehensive eye exams
• Prescribe and fit corrective lenses
• Diagnose and treat certain eye conditions
• Provide pre- and post-operative care for eye surgery patients

Ophthalmologist: Medical and Surgical Eye Specialist

An ophthalmologist is a medical doctor specializing in eye and vision care. How extensive is an ophthalmologist’s training?

• 4-year undergraduate degree
• 4-year medical school
• 1-year internship
• 3-year residency in ophthalmology
• Optional 1-2 year fellowship for subspecialization

Ophthalmologists are equipped to:

• Perform eye exams
• Diagnose and treat all eye diseases
• Perform eye surgeries
• Prescribe medications
• Conduct scientific research on eye diseases and vision disorders

Optician: Eyewear Specialist

An optician is a technical practitioner who specializes in fitting eyeglasses, contact lenses, and other vision-correcting devices. What training do opticians undergo?

• 1-2 year degree, certificate, or diploma program
• On-the-job training

Opticians are responsible for:

• Filling prescriptions from optometrists and ophthalmologists
• Helping customers choose appropriate frames and lenses
• Adjusting and repairing eyewear
• Taking facial measurements for proper fit
• Ordering and verifying the accuracy of eyewear products

Choosing the Right Eye Care Professional for Your Needs

Selecting the appropriate eye care professional depends on your specific needs and concerns. How can you make the best choice?

• For routine eye exams and vision correction, an optometrist is usually sufficient.
• If you have a complex eye condition or need surgery, an ophthalmologist would be more appropriate.
• For eyewear fitting and adjustments, an optician can assist you.

Consider these factors when choosing an eye care professional:

• Recommendations from your primary care physician or trusted friends and family
• The professional’s experience and expertise in treating your specific condition
• Your comfort level and trust in the practitioner
• Insurance coverage and accessibility of the practice

Common Eye Conditions and Their Treatments

Understanding common eye conditions can help you recognize when to seek professional help. What are some prevalent eye issues and their treatments?

Acute Iritis

Acute iritis is an inflammatory condition affecting the iris and surrounding structures. What are the symptoms of acute iritis?

• Eye pain
• Light sensitivity
• Pain with focusing
• Blurred vision
• Eye redness
• Floaters

Treatment for acute iritis typically involves:

• Ocular steroid eye drops
• Oral steroids in severe cases
• Dilating eye drops to reduce pain and prevent complications

Dry Eye Syndrome

Dry eye syndrome occurs when the eyes don’t produce enough tears or the tears evaporate too quickly. What are the symptoms of dry eye syndrome?

• Gritty or burning sensation in the eyes
• Redness
• Blurred vision
• Light sensitivity
• Excessive tearing (as a reflex)

Treatment options for dry eye syndrome include:

• Artificial tears and lubricating eye drops
• Prescription medications to increase tear production
• Punctal plugs to prevent tear drainage
• Lifestyle changes and environmental modifications

When to Seek Immediate Medical Attention for Eye Problems

While many eye conditions can be managed with routine care, some situations require urgent medical attention. When should you seek immediate help for eye problems?

• Sudden loss of vision
• Severe eye pain
• Chemical exposure to the eye
• Eye injury or trauma
• Sudden onset of flashing lights or floaters
• Sudden appearance of halos around lights

In these cases, it’s crucial to visit an emergency room or contact an ophthalmologist immediately to prevent potential vision loss or further complications.

Maintaining Optimal Eye Health: Prevention and Care

Preserving your eye health is essential for overall well-being and quality of life. How can you maintain optimal eye health?

• Schedule regular eye exams, even if you don’t wear glasses or contacts
• Protect your eyes from UV rays by wearing sunglasses outdoors
• Eat a balanced diet rich in vitamins A, C, and E, as well as omega-3 fatty acids
• Stay hydrated to prevent dry eyes
• Practice good hygiene, especially if you wear contact lenses
• Take frequent breaks when using digital devices to reduce eye strain
• Quit smoking or avoid secondhand smoke
• Control chronic conditions like diabetes and hypertension, which can affect eye health

By following these preventive measures and seeking appropriate care when needed, you can significantly reduce your risk of developing eye problems and maintain healthy vision throughout your life.

The Future of Eye Care: Emerging Technologies and Treatments

The field of eye care is constantly evolving, with new technologies and treatments emerging to improve diagnosis, prevention, and management of eye conditions. What are some exciting developments in eye care?

Artificial Intelligence in Eye Care

AI is revolutionizing eye care by enhancing diagnostic accuracy and efficiency. How is AI being used in eye care?

• Automated analysis of retinal images for early detection of diseases like diabetic retinopathy
• Predictive modeling for progression of conditions like glaucoma
• Personalized treatment recommendations based on vast datasets

Gene Therapy for Eye Disorders

Gene therapy holds promise for treating previously incurable inherited eye disorders. What potential does gene therapy offer?

• Correcting genetic mutations responsible for retinal diseases
• Potentially restoring vision in patients with certain forms of blindness
• Slowing or halting the progression of degenerative eye conditions

Stem Cell Therapy

Stem cell research is opening new avenues for treating various eye conditions. How might stem cell therapy benefit eye health?

• Regenerating damaged retinal cells
• Repairing or replacing damaged corneal tissue
• Potentially treating age-related macular degeneration

Advanced Imaging Technologies

Cutting-edge imaging techniques are improving our ability to visualize and understand eye structures. What new imaging technologies are emerging?

• Adaptive optics for high-resolution imaging of individual retinal cells
• OCT angiography for non-invasive visualization of retinal blood flow
• Hyperspectral imaging for early detection of eye diseases

These advancements in eye care technology and treatments offer hope for improved outcomes and quality of life for patients with various eye conditions. As research progresses, we can expect even more innovative solutions to emerge in the field of eye care.

In conclusion, understanding the roles of different eye care professionals, recognizing common eye conditions, and staying informed about emerging technologies can help you make informed decisions about your eye health. Whether you’re dealing with eye socket pain or simply maintaining your vision, remember that regular check-ups and prompt attention to eye concerns are key to preserving your precious sense of sight.

Optometrist vs Ophthalmologist vs Optician

There are two main types of eye doctors: ophthalmologists and optometrists. Confused about which is which and who does what? Here’s a look at how they’re different. Keep in mind that these professionals can work together and that a team approach can be the best option for eye care. 

Ophthalmologist: Medical and Surgical Eye Care

They went to medical school. After that, they had a 1-year internship and a residency of 3 years. That’s sometimes followed by a 1 to 2 years fellowship. 

They offer complete eye care services:

Optometrist (OD): Vision Care and Eye Care Services

Optometrists take care of primary health care for the eye. After college, they spent 4 years in a professional program and got a doctor of optometry degree. Some optometrists get additional clinical training or complete a specialty fellowship after optometry school. They focus on regular vision care and they:

Optometrists and ophthalmologists often work together to take care of you.

Optician: Eyeglasses and Contact Lenses

Opticians aren’t eye doctors and can’t give eye exams. They get a 1- or 2-year degree, certificate, or diploma. They fill the prescription your eye doctor gives you. They also:

• Check lens prescriptions
• Provide, adjust, and repair glasses, frames, and contact lenses
• Take facial measurements
• Help decide which type of lenses and frames will work best
• Order and check products, including contacts and eyeglass lenses

How to Choose an Eye Doctor

One type isn’t automatically better than the other. The right choice depends on your needs. The best eye doctor for you should be:

• Recommended by your doctor, friends, or family
• Someone you like and trust

A good rule of thumb would be:

• For primary eye care, you may wish to start with an Optometrist. From there, they may refer you to an Ophthalmologist if needed
• If you think you need eye surgery for cataracts, glaucoma or another eye disease, an ophthalmologist with the appropriate specialty would be a good place to start

Eye Pain Treatment

Ocular Symptoms and Conditions: Eye Pain and Light Sensitivity

Ocular pain can originate from many different places: from the eye itself, from the orbit (the bony eye socket), from around the orbit, and even referred from remote areas of the head and neck. Almost any eye problem that causes some discomfort can also cause eye pain, if the condition is bad enough. (For example, a dry eye problem usually causes a gritty eye sensation. But severe dry eye will cause eye pain.) This page discusses four conditions that are known to cause severe eye pain. Many of the conditions causing severe eye pain are associated with underlying medical conditions.

Other conditions capable of causing eye pain that are discussed on other pages of this Symptom and Diagnosis section are listed below with possible distinguishing features.

Conditions Discussed on this Page:

——————————————————————————–

Acute Iritis

Iritis usually refers to a group of ocular inflammatory diseases affecting the iris, ciliary body, and choroid. This is the “uveal tract”, and another term for iritis is “uveitis”. In acute iritis, the structures near the front of the eye become inflamed. This inflammation is similar to arthritis, except that in arthritis a joint is inflamed. Inflammation affecting the iris and ciliary body usually lead to symptoms of eye pain, sensitivity to light, pain with focusing, blurred vision, eye redness, and sometimes floaters. These symptoms occur because the iris and ciliary body both contain muscles which act to control the pupil size and focusing. Anything causing these muscles to work will cause pain. One or both eyes can be affected.

There are several symptoms of iritis which are fairly specific to it. One is “contralateral photosensitivity”. This means that the eye with iritis will feel pain even if light is shined into the OTHER eye only. Furthermore, the eye redness in iritis is usually a “flush” of redness in a ring around the cornea.

The ophthalmologist can diagnose iritis because inflammatory cells can actually be seen floating in the aqueous humor, which the clear fluid in the front part of the eye. Treatment is with ocular steroids, usually in the form of eye drops. It is important to shake most steroid eyedrop bottles well, since the medication can often settle and become concentrated in the bottom of the bottle. It is also important not to stop these eye drops suddenly without “tapering off” of the medication. A sudden stoppage of the medication when there is still low-grade (but asymptomatic) iritis can result in a severe flare up of the disease. Thus follow-up visits are important. Oral steroids and other medications (such as dilating eye drops) are sometimes used as well for treatment of iritis.

Iritis can be associated with several medical conditions. Cases of recurrent iritis, especially severe iritis, and iritis involving both eyes may indicate reason to search for an underlying medical condition. Sarcoidosis is a commonly found cause of iritis in adults, more frequently in women. Arthritic conditions such as ankylosing spondylitis (a back arthritis) and Reactive Arthritis may be found. These tend to be more common in men than women. Some infectious diseases such as syphilis, herpes, and toxoplasmosis can cause iritis. Iritis can be associated with inflammatory bowel disease and with arthritis associated with psoriasis.

Corneal Ulcer (infection)

A corneal ulcer (or ulcerative keratitis) can cause severe eye pain. A corneal infection occurs when bacteria or fungus are able to gain entry to the cornea through a scratch or breakdown in the corneal surface. With the use of extended wear disposable contact lenses, corneal ulcers have become more and more common. Symptoms include eye pain, redness, tearing, foreign body sensation, sensitivity to light, and blurred vision. In some contact lens users, the cornea may become somewhat insensitive to pain, and only symptoms of redness and irritation may appear.

A corneal ulcer is a serious, vision threatening problem. Some bacteria can be extremely aggressive, and the cornea can actually perforate (leading to endophthalmitis, or infection within the eye.) Treatment may include culturing of the corneal infection, and antibiotic eye drops are used very frequently (sometimes every 1/2 hour.) The eye may need to be re-examined on a daily basis to insure that the treatment is being successful. Contact lenses should not be used during this time.

Acute Glaucoma

Most people with glaucoma have “open-angle glaucoma”. This type of glaucoma causes no symptoms except for a gradual loss of vision. Acute angle-closure glaucoma is a rare, but severe form of glaucoma.

In this condition the eye pressure becomes extremely high rapidly. This can lead to symptoms of eye pain, redness, tearing, seeing rainbows around lights, blurred or lost vision (black-out), nausea, and vomiting. Treatment to break the attack of glaucoma includes eye drops to lower the pressure, and often oral medication as well. In some cases, IV medication has to be used. A laser surgical procedure can often break the attack and prevent future attacks.

For more information on glaucoma and acute angle-closure glaucoma, see the section on Glaucoma.

Scleritis

Scleritis is a fairly rare disorder involving inflammation of the wall of the eye (the sclera). It is often associated with serious medical problems, usually auto-immune or vascular problems (rheumatoid arthritis, polyarteritis nodosa, lupus). In scleritis, symptoms of severe, “boring” eye pain occur. The white part of the eye may appear red, swollen, and there may be a nodule present which is painful to touch. Scleritis can be associated with iritis, and in some cases with swelling under the retina leading to visual loss. Treatment is usually with oral medication, and eyedrop medication as needed. Treatment of the underlying medical problem may be necessary.

Endophthalmitis

Endophthalmitis is a serious infection within the eye usually involving the anterior and posterior segments of the eye.  The infection is usually bacterial, but cases of fungal and parasitic infections can occur.  Most cases occur postoperatively after any type of intraocular surgery including cataract and glaucoma surgery.  Penetrating trauma and intraocular foreign bodies also carry a high risk of intraocular infection.  Endogenous endophthalmitis occurs when bacteria present within the blood break into the eye and start and infection.  This can occur with contaminated central lines and dialysis shunts, for example.   Rarely, endophthalmitis can result from a perforating cornea ulcer where the infection then spreads into the eye.

Symptoms of endophthalmitis include progressively increasing severe eye pain and profoundly decreasing of vision over a short period of time (hours or days).  The pain can be incapacitating and usually results in emergency management at any time of the day or night.  The eye is usually severely red and the lids may be swollen.  In surgical causes of endophthalmitis, the infection usually begins between a few days and 1 week after surgery.  Traumatic endophthalmitis may have a more rapid onset.  There are cases of more slowly progressing, chronic endophthalmitis that may not cause pain or severe loss of vision.

Management of acute endophthalmitis requires a rapid diagnosis and appropriate treatment or referral.  Most cases of endophthalmitis are managed by vitreoretinal specialists who will take a sample of fluid from the eye for culture and inject antibiotics or antifungal agents into the eye on an emergent basis.   In cases of light perception vision only, vitrectomy is recommended in addition to culture and antibiotic injection.  Cases of endophthalmitis can lead to a complete loss of vision and even the eye if not treated rapidly.  However, it is possible to retain good vision if treatment is timely and successful.

Other Conditions causing eye pain or light sensitivity found on other pages:

A link to each condition is listed along with other hallmark features of the condition.

• Cellulitis (infection) of eyelid skin – eyelid swelling, tenderness.
• Cellulitis (infection) of the orbit – eye pain, protrusion, double vision, redness.
• Corneal problems such as dry eye, corneal abrasion, corneal foreign body, and retained foreign body under the eyelid.
• Dacryocystitis – infection of the tear drainage system leading to pain and tearing.
• Ectropion (out-turning) of eyelid – scratchy sensation, pain, tearing.
• Entropion (in-turning) of eyelid – scratchy sensation, pain, tearing and discharge.
• Headache may be interpreted as eye pain.
• Optic neuritis – may lead to pain with eye movement.
• Thyroid related eye disease – scratchy sensation, double or blurred vision, protruding eyes.
• Trichiasis (in-turning of eyelashes) – scratchy sensation, pain, tearing.

Do I Need To Have My Eyes Checked If My Head Hurts?

By: Deborah I. Friedman, MD, MPH

A red eye typically warrants immediate eye examination—at least the first time. Eye pain or headache with a normal external appearing eye nearly always has another answer than the eye itself when anyone seeks medical attention. The eyes deserve an exam to evaluate the nerves in the eyes and the optic discs when headache or eye pain is present. This is to eliminate increased pressure in the head and/or eye as a cause.

Many people will begin their quest for trying to find the cause for their headaches by seeking medical care with the ophthalmologist or optometrist. In fact, most eye pain does not result from an eye problem. Pain in and around the eye usually reflects referred pain from headache. “Referred” pain is pain that radiates from its originating location to another site. There are a few eye conditions that are important to consider.

What is eye strain?

“Eye strain” can produce eye discomfort and headaches, although it is uncommon and overrated as a cause of headache, especially headache associated with any function limiting activity. Eye strain is caused by improper focusing (nearsighted, farsighted or astigmatism), or when the two eyes are not properly aligned. Children under school age rarely complain of headaches from eyestrain. The typical headache of eyestrain starts after using the eyes, especially for extended periods of time, such as long periods of time using the computer, reading, or even sewing. Any number of tasks that require you to use your eyes for a long time may lead to a headache. For these individuals, it is important to make sure that, if needed, they have the appropriate prescription of eyeglasses. If the discomfort is caused by eyestrain, then it will be relieved with lenses or by correcting the alignment of the eyes.

Recognizing headache that is NOT due to eye strain

Most headaches are not due to eye strain. Some are tension-type headaches that have little to do with vision. Headaches that are present on awakening or those that wake one from sleep also are not caused by eyestrain. Additionally, eyestrain headaches are not generally associated with nausea or vomiting. For the vast majority of people with headaches, making changes to their glasses, using prisms, doing eye exercises and other types of “vision therapy” are generally not useful. Instead, these people have what is called a primary headache disorder, and these headaches are not related to visual concerns at all. The two most common primary headache disorders are migraine and tension-type headache.

Recognizing headache that may be due to eye strain or an eye problem

Cornea-related concerns: The clear surface in the front of the eye (cornea) has a rich nerve supply and is very sensitive. Even a small speck of dirt in the eye produces intense pain. Likewise, anything that disrupts the front surface of the cornea can be painful. When the cornea is scratched or injured, there is extreme pain and redness of the eye. Degenerative disease of the cornea can also be painful. Infections of the eye produce eye pain, redness, swelling and light sensitivity.

A less obvious cause of corneal pain is dry eyes. The cornea requires constant lubrication with a film of tears released from glands near the eye. If the tear film is not adequate and the front of the cornea is exposed directly to the air, it is painful. Other symptoms of dry eyes include redness, itching, burning, excessive tearing (it’s a reflex response), fluctuating blurred vision (“Every time I go to the eye doctor they change my glasses—I now have 5 pairs and my vision still isn’t clear”), the sensation of having something in the eye, a gravel sensation in the eye, seeing multiple images out of one eye, and frequent blinking. The symptoms are worsened by activities requiring visual concentration (reading, watching television, using the computer, driving).

Dry eyes can be caused by medications (for example, diuretics, antihistamines, antidepressants), medical disorders (such as systemic lupus, Sjögren’s syndrome, thyroid-related eye disease) or in a dry environment (an arid climate, constant use of heating systems in the winter). Sometimes, there is no underlying cause. The treatment is lubrication—frequent use of artificial tears during the day and a lubricating ointment at bedtime. Do not use saline. Products that “get the red out” will make the condition worse.

Eye Inflammation: Inflammation in or around the eye can be painful. It is generally accompanied by redness and swelling of the eye and eyelids, pain with eye movement and extreme sensitivity to light. The eye doctor will be able to see evidence of inflammation by looking into the eye using a microscope (slit lamp). Tumors inside the eye are often not painful, but a tumor behind the eye can cause pain. The pain is most often constant and the tumor will cause the eye to bulge forward. A tumor may also cause visual loss or problems with peripheral vision.

Glaucoma: The type of glaucoma that most people get (open angle glaucoma) is painless. However, an acute attack of angle closure glaucoma produces eye pain, blurred vision, and a bulging, firm, red eye. A mild attack may just cause pain in and around the eye. The attack may be provoked by going from darkness to light (for example, when leaving a movie theatre, or when the dilating drops given by the eye doctor wear off). Urgent attention is needed to bring the eye pressure down to normal. A simple laser procedure will prevent future attacks.

Optic nerve conditions: The eye doctor will also be able to look inside the eyes and see your optic nerves. The optic nerves are part of the brain, and they become swollen if there is high pressure in the brain. A brain tumor may cause the optic nerves to swell or produce double vision. Pseudotumor cerebri (also called idiopathic intracranial hypertension) is a disorder that produces high pressure in the brain with no tumor. It generally affects young, overweight women, producing headaches that are concentrated in or behind the eyes. There may be episodes of temporary visual loss (lasting seconds), blurred vision, double vision or a whooshing sound in the ears. Anyone being evaluated for headaches by any physician should be examined with an instrument called an ophthalmoscope for optic nerve swelling.

Giant cell arteritis (also called Temporal arteritis): This headache disorder typically occurs in persons over age 65 and can lead to permanent blindness if it is undetected. There is no specific cause, but the underlying problem is inflammation of blood vessels that can block blood flow. Sometimes the first symptom of temporal arteritis is visual loss. It is usually sudden, painless and dramatic. Most often it occurs in one eye, but can rapidly affect the other eye if untreated. The other symptoms of giant cell arteritis are headaches, tenderness of the scalp, pain or weakness of the jaw while chewing, fever, weight loss, loss of appetite, new onset of joint or muscle soreness, night sweats, depression and feeling poorly overall. The arteries in the temples and forehead will sometimes look prominent and be tender to touch. The diagnosis is made by hearing the patient’s complaints, obtaining blood tests known as C-reactive protein, and erythrocyte sedimentation rate and a biopsy of the artery under the skin of the temple. It is treated with corticosteroids to stop the inflammation. Once it occurs, the visual loss usually doesn’t improve, so early detection and treatment are important.

In conclusion, most patients with headaches don’t have any related eye problems and do not need to see an eye doctor for them. Most headaches are due to a primary headache disorder, and are generally classified as migraine or tension-type headache. However, it is important to know that there are a few exceptions that warrant a visit to your doctor’s office for further evaluation. These other eye conditions should be apparent to your doctor and you may need to go to an ophthalmologist for further evaluation. A careful recounting of your symptoms and a complete eye exam will reveal any of the conditions discussed above.

Deborah I. Friedman, MD, MPH, Professor of Neurology & Neurotherapeutics, Professor of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, TX.

This article is a legacy contribution from the American Headache Society Committee for Headache Education (ACHE) and the Fred Sheftell, MD Education Center.

Updated May 2008 from Headache, the Newsletter of ACHE, Spring 2000, Volume 11, Issue 1.

Cornea Erosions | Eyesite

Cause of cornea erosions

Usually an injury to the cornea surface, such as a scratch from a baby’s fingernail, triggers the problem. Once disturbed, the delicate cells lining the cornea surface seem not to heal properly, causing a weakness that may recur – the erosions return is unpredictable, uninvited and unwelcome! Some patients have
a genetically-programmed disorder of the cornea surface called a ‘dystrophy’ for example ‘map-dot- fingerprint dystrophy’. In some people no cause is ever found.

Symptoms of a cornea erosion

The main symptom is eye pain which typically begins on waking in the morning. It can also begin at night during sleep. This is because the eyelids stick to the surface layer of the cornea when they are closed during sleep. When the patient wakes up in the morning (or during the night), the eyelids open suddenly and pull the abnormal surface layer away from the underlying cornea. This creates minute erosions or blisters that are painful. The pain usually lasts only a few minutes. However severe cases can be painful for long periods during the day. A bad blister may get infected although this is infrequent.

Treatment for cornea erosions

During a bad episode, I will prescribe antibiotic drops and – to make you comfortable – a therapeutic contact lens that stays on the eye acting as a bandage until you are better. I may also give you a supply of anaesthetic drops which are extremely effective for pain relief but must be used sparingly or they may slow healing.

Lets consider prevention – how can cornea erosions be prevented ? The initial and easiest treatment
is to apply a thick lubricating ointment to your eye last thing at night before sleep. Suitable ointments are Simple Eye Ointment and Lacrilube which in the UK may be bought from pharmacies without a doctors prescription. These do not contain medicated ingredients which might cause side effects. They are based on lanolin and simply coat the surface layer of the cornea, preventing the eyelids from sticking to it overnight. This stops the formation of painful blisters. The ointment must be applied every night for several weeks to allow the condition to settle. It can then stopped and re-instituted if the problem returns.

If ointment doesnt work other treatments are available. These are used in sequence from ‘simple and non-surgical’ contact lens wear to the ‘sophisticated and surgical’ technology of the excimer laser.
Some treatments are especially appropriate for particular patients- see below. An extended wear soft contact lens may be used as a ‘bandage’. It is worn day and night and not removed, protecting the cornea surface from eyelid rubbing until the erosion has healed. However it does not cure the underlying weakness which may return later. If you ordinarily wear contacts or need glasses to see, your prescription may be incorporated into the bandage lens and this approach may suit you.

The next step which is ‘surgical’ but relatively low-key is chemical debridement of the cornea surface. Here a chemical is applied to the cornea to remove the lining after which the chemical is re-applied to the now-denuded surface. The effect is to ‘roughen up’ the surface in a calculated way, so when the surface lining regrows – which takes about 3 days – it adheres more strongly than before and no longer forms erosions. The upside of this approach is that it is simple surgery with a low chance of causing complications – the only likely problem is ‘haze’, a fine scar of the area in contact with the chemical. This is uncommon, usually has no effect on vision and anyway passes after a few months. Haze is far too subtle to be visible. The downside of chemical surgery is that it hurts for 2-3 days after and isn’t always curative. It can be repeated if need be. This is a good treatment and usually works at either the first or subsequent attempts.

The most high-tech and surgical technology is a laser therapy called phototherapeutic keratectomy (PTK). This is done with an excimer laser – the same type of laser used to correct glasses dependance – sometimes combined with chemical debridement to increase the cure rate. The good news is that PTK may easily be combined with corrective eye laser treatment and so may appeal to you. However you should be aware that PTK hurts afterwards (it feels like a really bad erosion lasting a few days), there is a chance of haze (which may begin up to about a year later and be triggered by pregnancy or strong sunshine exposure – so wear your shades on the beach and the ski slopes!) and the success rate is probably no greater than chemical debridement alone.

Finally the good news – Eyesite surgeon Dr Simon Levy has looked after many patients with this disorder and has discharged most of them – cured!

Feeling Pressure In Your Eyes? Common Causes and Treatments

Dr. Jonathan Woolfson

Sometimes our patients will say, “I feel like there’s pressure in my eyes or pressure behind my eyes.” Have you ever felt like this?

Many patients have, and we can help.

Ocular hypertension– What you need to know

Do you know that approximately 4.5% to 9.4% of Americans (age 40 or older) experience ocular hypertension?

Ocular hypertension refers to the situation when a person feels pressure inside the eye. This intraocular pressure is higher than normal when patients describe pressure behind or inside of the eye.

If this condition is left untreated, the high eye pressure can cause glaucoma, as well as permanent vision loss. On the other hand, some patients may feel ocular hypertension without damaging their eyes or vision.

A comprehensive eye exam or a visual field test can determine your ocular pressure. There are no outward signs or symptoms that will indicate ocular hypertension. You must see your doctor.

? Why do patients feel pressure inside of the eyes?

Pressure inside of the eyes is part of a disease process called glaucoma. Glaucoma is when the pressure builds up in the eye and that causes gradual decline in the patient’s vision.

When patients have pressure in their eyes, it’s very rare that it would actually be pressure inside the eye. More typically that has to do with pressure around the eyes.

Let us explain.

The eyes are surrounded by a bony structure called the orbit, and surrounding the orbit is the sinuses. You have sinuses below your eyes and above your eyes. So when people feel pressure in their eyes, it is typically pressure in the sinuses surrounding the eyes.

? What causes eye pressure? What are the risks for elevated eye pressure?

The following list consists of factors that cause or are associated with ocular hypertension– they are virtually the same as the causes of glaucoma, as well.

• Excessive aqueous production: This is the clear fluid produced in the eye. With too much fluid production, a patient will feel pressure in the eye.
• Inadequate aqueous drainage: If the fluid drains slowly from the eye, this can cause increased eye pressure.
• Eye trauma
• Certain medications: Ocular hypertension is a side effect of certain medications (i.e. steroid eye drops, etc).
• Other eye conditions
• Race, age, and family history

? What should you do when you’re feeling pressure behind the eyes?

• An easy way to look into this problem is to see your doctor for diagnosis and treatment.
• Another way is to take a decongestant. If you have pressure in your eyes and you want to determine if it’s pressure around your eyes in your sinuses, a decongestant is a good way to resolve sinus pressure.

What should you do next? Seek treatment from qualified doctors.

! How to treat pressure inside or behind the eyes

In most cases it’s one or two eye drops a day to treat glaucoma and ocular hypertension. If eye drops are ineffective, we may recommend glaucoma surgery to treat high eye pressure.

If you are experiencing high pressure behind or inside your eyes, call Woolfson Eye Institute to schedule your appointment.

What are eye floaters? 5 eye problems you shouldn’t ignore

Considering it’s a marvel of design, the human eye doesn’t get a lot of respect. We wake up, we see (often with help of glasses or contacts) and move on with our lives. Most of us take our sight for granted, only visiting an eye specialist every year or two. There’s a good chance we’ll put off that checkup, too.

About half of the estimated 61 million adults in the United States who are at high risk for serious vision loss haven’t visited an ophthalmologist in the past 12 months, according to the Centers for Disease Control and Prevention.

Related

Here’s the problem: Eye exams not only gauge your vision, but can also provide vital information about your overall health. Many people may have other ailments, like high blood pressure, high cholesterol, infectious disease or even an autoimmune disorder, and may not know it until they get their eyes checked.

“The eyes may be the windows to the soul, but they can also tell us about a lot of systemic diseases, and the severity of those diseases,” explained Dr. Suber Huang, chief executive of Retina Center of Ohio in Cleveland and chair of the National Institutes of Health National Eye Health Education Program Steering Committee.

The message is straightforward: “Anything that is new in terms of a change in your vision could be potentially worrisome,” said Huang.

Here are just a few eye symptoms that should make you go see an eye doctor pronto.

About half of American adults who are at high risk for serious vision loss haven’t visited an ophthalmologist in at least a year.photoJakubStepan / Shutterstock

1. Flashes and floaters

Although most people have experienced floaters, those gnat-like or cobwebby squiggles that appear in your field of vision, a new onset of floaters, which may be accompanied by flashes of light (often described as a lightning streak in the peripheral vision), warrants a quick trip to an ophthalmologist.

You may be experiencing something benign called a posterior vitreous detachment (PVD.) Or you might be experiencing a retinal tear that could lead to a retinal detachment, which is potentially blinding if not fixed quickly.

A PVD is a process of aging (generally after age 50 for most of us and younger if you are near-sighted) in which the vitreous, a gel-like substance that fills your eye and is attached to the retina, begins to shrink and pull away from the retina.

It doesn’t hurt and some people may not even notice any symptoms, which can range from merely annoying to downright anxiety inducing, says Huang.

The bad news is that about 10 percent of people may experience a retinal tear if the vitreous gel separates from the retina with too much force. That tear, which needs to be taken care of ASAP, can generally be fixed right in your doctor’s office with a laser.

Although rare, some people may develop a full-blown retinal detachment, which is considered an emergency and requires surgery to avoid loss of sight. Retinal tears and detachments don’t hurt either.

If you are diagnosed with a PVD, your doctor will schedule a follow-up visit to make sure no tears have developed.

If floaters and flashes get worse, or if you lose your side vision (think of a curtain being pulled down), see a curtain moving across your field of vision or have a decrease in vision, your doctor will tell you not to wait for that follow-up appointment. Get in now. These are symptoms of tears and detachments.

The good news is the vast majority of people won’t have much trouble with a PVD, aside from learning how to live with floaters for a while, sometimes several months, maybe even longer. The brain will adapt and eventually they will float out of your line of sight.

If you experienced a PVD in one eye, chances are good you’ll get one in your other eye, too.

2. Red, teary eyes

Red, teary eyes aren’t always due to a long night out, especially if you wear contacts. You might have keratitis, an infection of the cornea that causes redness, pain, inflammation, discharge and a host of other miserable problems.

When caught early, it can be treated more easily. Wait too long and you could potentially lose your vision.

“I see this every day, people are happily wearing contact lenses, their eyes get irritated, and get more irritated, and by the time they come in, they can have some really bad infections,” said Dr. Randy J. Epstein, professor of medicine in the department of ophthalmology at Rush University Medical Center in Chicago.

If you are having problems like weepy, painful, irritated, light-sensitive, red eyes and you wear contacts, get in to see your doctor now.

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Another tip: Don’t sleep in your contacts — ever. “Sleeping in contacts can make a person more prone to infection or scar the cornea, so it’s never a good a good idea to sleep in them even if they are labeled extended wear,” said Epstein.

3. Double vision

Although it can be caused by some benign conditions, until proven otherwise, “double vision is never good,” noted Dr. Rebecca Taylor, a spokeswoman for the American Academy of Ophthalmology.

People can experience double vision in one or both eyes. If you have double vision in one eye, it can be due to a corneal problem. If you have double vision in both eyes, which is more common, it means your eyes aren’t working together in the right way. That could be due to a neurological issue, an autoimmune problem or other potentially serious issues.

If you have pain, weakness, slurred speech, along with double vision (or any vision change), go to an emergency department. “If the double vision is new or sudden, you need to be evaluated,” Taylor explained.

4. Pupils don’t look the same size

Anisocoria is the technical name for unequal pupil size. Some people who are otherwise healthy may have unequal pupils.

Generally, if you’re an adult and one of your pupils — that black dot right in the middle of your eye — becomes larger or smaller, and you haven’t used eye drops, call your doctor.

Unequal pupil size can be a sign of serious problems. “It could be nothing or it could be an aneurysm, a tumor, a brain infection or a sign of a stroke,” said Taylor. “The point is to get in so we can figure it out.”

5. Eye pain

Your eyes should never hurt, so any pain should be taken seriously.

Although eye pain may have a very obvious cause, such as injury, there are other problems that could be going on that range from benign to potentially blinding conditions like optic neuropathy or angle-closure glaucoma.

Be especially careful around fireworks. According to the U.S. Consumer Product Safety Commission, fireworks were involved in about 11,000 injuries treated in emergency departments in 2016.

Eye injuries caused by fireworks are almost always serious. “You can’t outrun a bottle rocket,” said Taylor, adding that injuries can include burns, abrasions and eye ruptures.

If fireworks are legal in your area, take some common sense precautions like keeping them away from kids and wearing safety glasses.

If you do get hurt, go to an emergency room. Don’t rub, rinse, or apply pressure. Don’t ever try to remove anything that’s in your eye. Leave that to the medical professional.

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An Anatomic Approach to Unexplained Ocular Pain

Diagnosing a patient withunexplained ocular pain can be time-consuming and difficult. Taking an anatomic approach and excluding causes along the way can aid in the diagnosis.

“Patients with pain are underserved. Eye pain is always diagnosable, but you have to think anatomically,” says Kathleen Digre, MD, a neuro-ophthalmologist in practice at the JohnA.MoranEyeCenter at the University of Utah.

Kimberly Cockerham, MD, agrees. She notes that there are not enough neuro-ophthalmologists to treat the number of patients with unexplained ocular pain. “A lot of general ophthalmologists are having to take on the diagnosis and treatment of these patients because it is difficult to refer,” says Dr. Cockerham, adjunct associate clinical professor at StanfordUniversity and neuro-ophthalmologist with subspecialty training in oculoplastics and orbital disease. “General ophthalmologists are, not by their own choice, managing these problems, and a decision tree can be helpful for diagnosing patients with unexplained pain.”

The Surface of the Eye

When a patient presents with ocular pain and few or no other symptoms, the first step in diagnosis is getting a history and examining the surface of the eye and the patient’s face for clues. “The anterior surface of the cornea has some of the densest nerves in the whole body,” says Daniel Durrie, MD, owner of Durrie Vision in Overland Park, Kan.

“Anything that happens on the cornea that disrupts the epithelium or stimulates those nerves can cause significant pain, so the first thing you have to do is get a history of what they were doing when they first noticed pain. Were they sweeping, working on metal or riding on a motorcycle when the pain started? The history is extremely critical for diagnosing a foreign body or conditions that occur after being struck in the eye. “

The history is also important for diagnosing recurrent erosion syndrome, which is most painful when a patient wakes up and then improves throughout the day. “This can be diagnosed almost from the history alone, because the patient reports that the eye waters and he or she feels like something is in the eye in the morning, and both symptoms get better as the day goes on,” Dr. Durrie says.

Patients with shingles who have had lesions around their lids and corneas can experience eye pain even years after the acute inflammation has resolved. “History can diagnose this condition, too. Sometimes, in an early episode of shingles, the only symptom is pain that seems to be out of proportion to what you see,” Dr. Durrie adds.

Dr. Cockerham, who is in private practice in Los Altos, Calif., adds that it is also important to examine patients’ facial features. For example, bulging of the eyes or eyelid retraction is suggestive of thyroid disease. She also looks for abnormalities in contours, such as the lacrimal gland bulging out more on one side than the other or the eye being pushed in or down more on one side than the other, and she examines the temporalis fossa. “In patients with meningiomas or fibrous dysplasia, the temporalis fossa can start to become flat or convex instead of concave,” she explains.

Examining the appearance of the vessels in the eye can also aid in the diagnosis. Patients with a carotid-cavernous fistula can present with pain and bulging of the eye due to dilatation of the veins draining the eye. “Inflamed vessels, particularly over the muscles, could be associated with a myositis or thyroid eye disease,” adds Dr. Cockerham.

According to Mark Packer, MD, the most common ocular finding accompanying pain is dry eye. “These patients may have a poor or partial blink, and they may have eyelid abnormalities,” says Dr. Packer, who is a clinical associate professor of ophthalmology at Oregon Health and ScienceUniversity and in private practice at Drs. Fine, Hoffman, and Packer, in Eugene, Ore. “Dry eye is commonly treated with Restasis and artificial tears. I use topical steroids briefly at the initiation of treatment. Ninety percent of my dry-eye patients respond to Restasis, but it takes a while to work. In fact, it often takes two to three months to reach its effect.”

Dr. Cockerham notes that dry eye is a bilaterally symmetric process. If a patient’s Schirmer test measurement is 2 in one eye and 10 or 20 in the other, it could be indicative of a tumor of the lacrimal gland or in the brain that is affecting the complex neural innervations pathway of the lacrimal gland.

Bacterial, viral and fungal keratitis can also cause pain; however, these patients typically have accompanying symptoms. “Acanthamoeba keratitis can be very painful and is often misdiagnosed as a bacterial or viral keratitis,” Dr. Packer says. “If it is mistreated with steroids, it can be made worse. This condition is typically seen in contact lens wearers who have used tap water to rinse their contacts, and confocal microscopy is needed to diagnose Acanthamoeba infection.”

Intraocular Causes

If a diagnosis cannot be made after taking the history and examining the face and surface of the eye, intraocular causes, such as glaucoma, should be considered. “Then, there are conditions that cause intermittent pain, where the eye exam is actually normal but only at the time you are examining the patient,” says Andrew Lee, MD, chair of ophthalmology at the Methodist Hospital and professor of ophthalmology at Weill Cornell College of Medicine in Houston. These conditions include uveitis and intermittent angle-closure glaucoma.”

Another intraocular cause of pain is Posner-Schlossman syndrome. “Out of the blue, these people de-velop a high pressure in the eye that is due to inflammation of the trabecular meshwork. When you look at them, the eye looks quiet, and there is no redness, but the pressure is really high. They respond to steroids immediately,” Dr. Packer explains.

Another inflammatory condition that can cause eye pain is giant cell arteritis, which is most commonly found in elderly patients. “To look for inflammation, we can do a sedimentation rate and a C-reactive protein,” says Dr. Lee. Treatment for giant cell arteritis includes oral steroids. If left untreated, these patients could experience visual loss or, rarely, cardiac events or a stroke.

Another condition to consider is pituitary adenoma. According to Dr. Cockerham, if a patient has a tumor on his pituitary gland and hits his head or takes a large dose of aspirin or other blood thinners, the tumor can start to bleed into itself (pituitary apoplexy). “These patients may present with pain initially without the other classic symptoms of double vision and bitemporal visual field defect,” she explains.

Headache Syndromes

Headache syndromes, while not an eye condition, are a significant source of eye pain. “Many headache syndromes can be diagnosed just by history, and criteria for diagnosis were developed at a consensus conference of the International Headache Society, Dr. Lee explains. “This society defines the criteria for conditions that can cause eye pain but are really headache syndromes. The three most common are migraine, tension and cluster. They can be associated with eye pain because the pain itself is in the eye, even though the pain is not from the eye.”

According to Dr. Digre, migraine is the most common disorder, affecting 20 percent of women and 10 percent of men. Migraines can cause pain in the eye or orbit, and they can occur with or without aura. “These patients are light sensitive, may be sound sensitive, may have throbbing pain, and may have some nausea. Then, they have a totally normal eye exam,” she says.

Cluster headache can occur directly over the eye and is more common in men. “You may see an associated Horner’s syndrome during the attack and sometimes even in between attacks. These patients present with excruciating eye pain, tearing, lacrimation, rhinorrhea, stuffiness of the nose, possibly swelling around the lid, and maybe some conjunctival redness,” she adds.

Another headache disorder, hemicrania and paroxysmal hemicrania, is most often seen in middle-aged women. Attacks typically occur five to 40 times per day, and each attack lasts between two and 45 minutes. Hemicrania continua and chronic paroxysmal hemicrania can cause continuous pain around the face and eye. Fortunately, these disorders can be effectively treated with indomethacin.

Another, less common headache disorder is short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing (SUNCT). “This rare condition is seen mostly in men, but can occur in women. It lasts seconds and goes away, and it can occur 100 or 150 times in a day. You can even have it without the conjunctival injection and tearing, and that’s called SUNA,” Dr. Digre explains.

During the initial exam, Dr. Cockerham asks patients to point to the location of the pain. “Sometimes, with unexplained pain, they will point right at their trochlea. Trochleitis is a condition where the trochlea becomes inflamed,” she says. Trochleitis is characterized by localized swelling, tenderness and severe pain superomedially. It has been associated with triggering or worsening migraine headaches in patients with pre-existing migraines.1

“Then, there are other patients who don’t meet the criteria for a specific headache diagnosis according to IHS criteria, who have normal eye examinations and don’t have any other evidence for an intraocular cause. Those patients sometimes have an intraorbital cause, such as myositis or orbital inflammatory pseudotumor. These patients typically have severe pain that is made worse with eye movement,” Dr. Lee explains. In addition, some patients with optic neuritis can present with the eye pain before the typical vision loss.

Imaging studies, such as a CT scan, MRI, or ultrasound can confirm the presence of inflammation. According to Dr. Lee, treatment includes nonsteroidals or a short course of steroids.

Other Neurologic Causes

The trigeminal nerve provides sensation to the eye, face, and most of the head. “Some patients who have trigeminal pain or neuropathic pain feel it in their eyes. The greater occipital nerve can also be involved and radiate pain to the eye,” Dr. Lee explains.

Dr. Digre adds, “The trigeminal system, whether it is trigeminal neuralgia or trigeminal activation from migraine, can cause a lot of problems with pain in the eye, and there won’t be any ophthalmic findings. Everything will look completely normal. I see a lot of eye pain from trigeminal nerve disorders; it’s pretty common. You have to think about it every time you see a patient.”

Dr. Digre explains that the eyes are innervated by the first division of the trigeminal system, and this same division is also responsible for all of the pain in the cranial cavity, including the dural vessels and the meninges that cover the brain. “People can have something going on in their heads that manifests itself as pain in the eye, she says. “This system is very complex because it has other nuclei that even go down into the cervical system—C1 and C2. If there is a problem even in C1 or C2, I’ve seen people present with eye pain when they actually had a problem at the cervical cranial junction. One woman had pannus of her odontoid that was compressing her C1-2 region, and she presented with eye pain.”

A 2009 report by Perry Rosenthal, MD, and colleagues described patients who have corneal pain suggestive of dry eye, with no clinical signs.2 The authors suggest that this is a disease in its own right. “It’s a trigeminal disorder. It isn’t just dry eye because when you do dry eye testing, these patients don’t have the results that go along with it. I think this condition is really underdiagnosed. The nerve endings are extra sensitive, and things like zoster and diabetes can cause it. Dr. Rosenthal has even diagnosed this condition in refractive surgery patients,” Dr. Digre says.

Researchers in Finland have also observed this condition in refractive surgery patients.3 In 2007, a group described 20 eyes in 20 patients who underwent LASIK for high myopia. They found that the majority of these patients reported ongoing dry-eye symptoms that were not demonstrated through objective clinical signs. They concluded that the symptoms represent a form of corneal neuropathy rather than dry eye syndrome.

“It seems to be related to abnormal nerve re-growth, but I’ve done more than 20,000 LASIK procedures, and I have never seen it,” Dr. Durrie says.

Although isolated ocular pain can be difficult to diagnose, it is often not serious and is easily treated. “If you have a normal eye exam, your history doesn’t suggest any defined headache syndrome, and there is no other finding, the chance of it being something bad is extremely low,” Dr. Lee says. “It is extremely unlikely that someone who has an isolated eye pain would have something serious, except elderly people who might have giant cell arteritis or patients who have neuropathic pain. Those are the things that ophthalmologists need to worry about.”

1. Yanguela J, Pareja JA, Lopez N, et al. Trochleitis and migraine headache. Neurology 2002;58:802-805.

2. Rosenthal P, Baran I, Jacobs DS. Corneal pain without stain: Is it real? Ocul Surf 2009;7(1):28-40.

3. Tuisku IS, Lindbohm N, Wilson SE, Tervo TM. Dry eye and corneal sensitivity after high myopic LASIK. J Refract Surg 2007;23(4):338-342.

90,000 Why do my eyes hurt when I blink?

Most often it becomes painful to blink when a foreign body enters the eye. But it also happens that pain in the eye is a sign of an ophthalmic disease .

In this article, we will figure out why there is pain when blinking and how to eliminate it.

The causes of pain in the eye when blinking can be divided into mechanical and infectious.

Mechanical reasons

Pain when blinking may occur due to the ingress of a foreign body and liquid into the eyeball.

If small objects (dust, sand, eyelashes) get into the eye, they will come out together with the tear fluid and the pain will go away in 1-2 days.

Large objects, such as metal shavings, cannot be removed by yourself, therefore the help of a surgeon is necessary here.

The ingress of foreign bodies into the eyes is accompanied by cuts, a feeling of sand, reddening of the conjunctiva, itching and inflammation of the mucous membrane.

Thermal and chemical burns (alkali, acid, alcohol, water) cause intense pain, stinging, burning, increased tearing, swelling and redness of organ tissues.

In this case, you must immediately provide first aid and contact a specialist.

Infectious Causes

Infectious diseases that can cause pain when blinking include:

Barley – reddening of the mucous membrane, fever and swelling of the eyelids.

Sinusitis – discomfort in the eyes when blinking.

Conjunctivitis is an inflammation of the mucous membrane of the eye.

Dacryocystitis (inflammation of the lacrimal sac) – severe redness of the eye and the formation of a tumor under the lower eyelid.

Myositis – damage to the muscles of the eyeball, pain in the eyes and head.

Blepharitis – inflammation along the edges of the eyelids, severe redness of the eyes, swelling and pain when blinking.

Glaucoma – pain in the eyes, sensitivity to light, redness of the mucous membrane.

Sometimes pain occurs when blinking in one eye. Most often due to mechanical damage. If, upon examination by a specialist, they are not found, then an infectious disease may become the cause.

In addition to mechanical damage and infectious diseases, blinking pain can be caused by:

– ulceration of the cornea

– astigmatism

– inflammation of the iris

– sclerite

– inflammatory processes in the vessels of one eye and hemorrhage

– stress and fatigue

– disturbances in the work of the central nervous system

– spread of the herpes virus.

To avoid pain in the eyes, try to eat right, maintain personal hygiene, protect your eyes from injury and burns, and do not touch them with dirty hands.

And if you spend a lot of time at the computer, be sure to do eye exercises and take breaks from work. You can read more about preserving vision while working at a computer here.

If you experience discomfort when blinking and continues for more than 1-2 days, contact a specialist . Timely examination and diagnostics will help to find out the causes of pain in time and speed up its elimination.

90,000 Eye pain – why do eyes hurt?

One of the most common complaints that patients come to us with is eye pain.The nature of the pain can be different: acute, aching, throbbing, pain can be permanent or appear periodically, accompanied by additional complaints and symptoms, or be the only manifestation of the disease.

That is why eye pain is a symptom in which it is necessary to immediately consult an ophthalmologist in order to determine the cause of pain in time and begin treatment at the initial stages of the disease.

Main causes of eye pain:

Pain in the eyes can occur as a manifestation of an ophthalmic disease, and accompany disturbances in the work of other body systems.

Common diseases that can lead to a sensation of pain in the eyes include:

Migraine

This is a headache that is usually accompanied by strong throbbing and lasts for a long time – up to several days. Against the background of a migraine headache, patients may experience pain in the eye (as a rule, only one eye hurts). Additional symptoms may include nausea and impaired light perception.

Cluster headaches

This is a disease characterized by frequent headache attacks.Unlike migraines, cluster pains last from one week to several months. Against this background, pain may also occur in one or two eyes at once.

Nasal sinus infections

Sinusitis (sinusitis, frontal sinusitis, ethmoiditis) is a common cause of pain in the eyes. With inflammation of the sinuses, stagnation of their contents and swelling of the mucous membrane occurs, which leads to a narrowing of the passages connecting the nasal sinuses to the nasopharynx. These changes can cause sinus pain, headache, and eye pain.

Among ophthalmic diseases, pain is most often accompanied by:

Inflammatory eye diseases:

Conjunctivitis – inflammation of the mucous membrane of the eye, uveitis – inflammation of the choroid of the eye, scleritis – inflammation of the sclera and others.

Glaucoma

The disease, one of the main symptoms of which is an increase in intraocular pressure, can also be accompanied by a sensation of pain in the eyes. This disease leads to irreversible loss of vision, therefore it is very important to carry out a vision diagnosis at the slightest suspicion of glaucoma.

Visual fatigue is a common cause of eye discomfort and pain.

Usually appears after long-term work at the computer, in front of the screen of the gadget, while reading books or documents. Also, the pain may be accompanied by redness of the eyes.

Mechanical damage to the cornea

Pain occurs after a foreign body or injury (dust, shavings, tree branches, etc.) has entered the eye. The pain in the eye is also accompanied by lacrimation, redness of the eyes, which can worsen over time.Corneal injury is a formidable disease that can lead to loss of vision if treatment is not started on time.

Incorrectly selected method of vision correction.

Incorrectly selected glasses can provoke eye strain, which will be accompanied by all signs of visual fatigue, including pain in the eyes.

Even more difficult is the situation with the incorrect selection of contact lenses. At the same time, in addition to eye strain, there is a chance to get other complications, including inflammation of the surface of the eye.That is why ophthalmologists recommend not to choose the method of vision correction on your own, but to consult a specialist.

Eye pain can be a symptom of a serious illness and requires careful diagnosis, therefore, in case of eye pain, it is necessary to consult a doctor so that he can establish a diagnosis and help choose a treatment.

If you feel dull, sharp or aching pain in the eye, especially if it is accompanied by redness of the eye, discomfort, nausea and deterioration in the quality of vision, see a doctor immediately.

We invite you for a consultation at the Expert Ophthalmology of Doctor of Medical Sciences Maria Znamenskaya. The doctors of the clinic will help to identify the causes of pain in the eyes, establish a diagnosis and choose the optimal method of treatment.

90,000 Causes of eye pain

When unpleasant sensations arise, one must remember that it is not pain, which is a symptom, that should be treated, but a disease that causes malaise.

Pain in the eyes can cause a lot of discomfort and inconvenience.Sometimes it occurs due to ordinary fatigue or overexertion, and in some cases it is a symptom of serious medical conditions that lead to loss of vision.

Eye pain rarely occurs on its own. Most often, it is accompanied by other symptoms. It can be redness, dryness, tears, light sensitivity, or decreased visual acuity. Ophthalmologists classify eye pain into five types, which occur for different reasons.

Pain on eye movement. This pain occurs due to the tension of the inflamed structures in certain parts of the eye, for example, in the muscular membranes of the eye muscles.Malaise can occur due to inflammation of the nerve sheaths of the optic nerve.

Most often, pain that is felt when moving the eyes occurs for two reasons. The first is the flu or cold. The second is retrobulbar neuritis (inflammation of the optic nerve).

Pain on touch. Contact pain that occurs when touching the eyes occurs due to a variety of problems. Unpleasant sensations can cause inflammation of the periosteum of the bone orbit or ligamentous apparatus.

It is also a characteristic symptom of scleritis – inflammation of the dermis of the eye, dacryoadenitis – inflammation of the lacrimal gland, or barley – inflammation of the eyelid.

Pain in the eye socket. Orbital pain, or orbital pain, is felt as constant pain that originates deep behind the eye. An unpleasant sensation arises from a variety of diseases of the orbit, as well as hemorrhage behind the eyeball or cancer of the lacrimal gland.

Pain in the eyeball. This is the most common type of untidy sensation in the visual organ.It occurs for various reasons, including trauma and inflammation of the eyeball, chemical eye burns, irritation of the conjunctiva (conjunctivitis) or cornea (keratitis) due to allergies or trauma.

The eyeball can hurt due to inflammation of the iris and the ciliary body (this is a disease of iridocyclitis), due to irritation of the ciliary body with increased intraocular pressure in glaucoma or cataracts, or due to a foreign body that gets into the eye and injures the cornea. Unpleasant sensations arise from eye strain and unsuitable glasses – too strong or too weak.

Strong light effects, for example in a tanning bed, welding or snow on a ski trip, can lead to corneal inflammation. It also causes pain in the eyeball.

Pain not associated with the eyes. Eyes can be sore due to non-visual problems. Unpleasant sensations can occur due to trigeminal neuralgia or migraines.

When unpleasant sensations arise, one must remember that it is not pain, which is a symptom, that should be treated, but a disease that causes malaise.

Excessive eye strain is treated with suitable glasses or contact lenses. The foreign body is removed, the chemicals are washed out. Dry eyes can be eliminated with the help of moisturizers and artificial tears of inflammation – with the help of antibiotics in ointments, tablets and drops. In extreme cases, doctors resort to injections or surgery.

In order to avoid serious vision problems and various complications, you need to see a doctor as soon as possible if you have some symptoms.For example, after various actions in which a foreign body could enter the eye – sawing wood, grinding metal, etc. Serious reasons – severe pain due to a blow, pain accompanied by nausea or vomiting, swelling and discharge from the eye, severe photosensitivity or immobility of the eye.

Mucormycosis: a black fungus that causes eye loss for Covid-19 patients in India

• Sutik Biswas
• BBC Correspondent in India

May 10, 2021

Photo Credit, Getty Images Photo caption,

Spores of pathogenic fungi are found in abundance in soil, manure, rotten fruits and even on the mucous membrane of healthy people

Eye surgeon from Mumbai, Dr. Akshay Nair, on Saturday morning preparing to operate on a 25-year-old woman who only three weeks ago had been ill coronavirus.

In the meantime, an otorhinolaryngologist was already working with a patient with diabetes: he removed from the nasal cavity tissues affected by an aggressive fungal disease that affects the nasal mucosa, eyes, and sometimes the brain.

After his colleague finished his work, Dr. Nair was to undergo a three-hour operation to remove his eye.

“I will have to remove the eye to save the patient’s life, because this is the course of this disease,” the doctor explained to me before the operation.

Not only is the second wave of Covid-19 raging in India, but now doctors are also reporting a sharp increase in cases of a rare infection called “black fungus” among those who have survived or are still sick with coronavirus.

What is mucormycosis?

Mucormycosis in humans (these diseases are also susceptible to animals) is a very aggressive disease that is caused by various types of fungi of the Mukorovye family.

These fungi feed on organics and are widespread: they are found in the ground, plants, decaying fruits and vegetables and animal dung.

Usually the fungus is not dangerous, but for people with weakened immune systems, for example, people with diabetes, cancer or HIV / AIDS, it can pose a deadly threat, affecting the nasal mucosa, lungs and even the brain.

“This fungus can be found in the soil, in the air, and even in the nasal mucosa of healthy people,” says Dr. Nair.

Dr. Nair believes that in patients or those who have had coronavirus, the impetus to the development of mucormycosis (and in 50% of cases, everything ends in death) can be steroids, which are actively and successfully used in case of severe course of Covid-19.

Steroids relieve pneumonia and prevent the immune system from causing additional harm to the body when it overreacts to the coronavirus. But at the same time, steroids reduce immunity and increase blood sugar levels.

It is this weakening of the immune system that can lead to the development of mucormycosis.

Photo author, Getty Images

Photo caption,

For many coronavirus patients, steroids are the only hope of salvation

“Diabetes reduces the body’s defenses, coronavirus aggravates this effect, and then steroids that help fight Covid-19 are added fuel to the fire, “says Dr. Nair.

He works in Mumbai, one of the cities hardest hit by the second wave of coronavirus, and has seen about 40 patients with fungal infection in April. Many of these people were diabetics who carried the coronavirus at home. Eleven of them were hospitalized, where they had to have their eyes removed.

Between December and February, six of Dr. Nair’s colleagues in Mumbai, Bangalore, Hyderabad and Pune reported 58 cases of mucorvicosis, with most of the patients contracting 12-15 days after recovering from the coronavirus.

According to Dr. Renuca Bradu, head of the otorhinolaryngology department at one of Mumbai’s leading hospitals, Zion, there have been 24 cases of fungal infection in the past two months, up from six in the entire last year.

In this case, 11 infected had to remove one eye, and six died. Most of Dr. Bradu’s patients were middle-aged people with diabetes, and the fungal infection struck them a couple of weeks after they underwent the coronavirus.

“Now we have two or three cases of mucorvicosis every week. This is a nightmare against the backdrop of the pandemic itself,” Renuca Bradu told me.

Photo author, Getty Images

Photo caption,

Doctors are surprised by the frequency and severity of this fungal disease during the second wave of the pandemic in India

A similar story is told by Dr. Raghuraj Hegde from Bangalore in southern India. Over the past two weeks, he observed 19 cases of mucormycosis, mostly in young patients.According to him, “some of them were in such serious condition that we could not even operate on them.”

Doctors admit that they are surprised at the frequency of fungal diseases and the severe course of the disease during the second wave compared to what was during the first wave of the pandemic last year.

Dr. Nair says that in the past two years in Mumbai he has seen no more than a dozen cases of such infection, but this year it is different.

And Dr. Hegde in Bangalore for 10 years of practice and did not meet this more often than one or two times a year.

Photo author, EPA

Photo caption,

Mumbai suffered from the second wave of the pandemic more than many other cities in India

Usually, mucormycosis patients have a stuffy or bleeding nose, swelling and sore eyes, drooping eyelids, worsening, and then completely losing sight … Blackening of the skin can also occur around the nose.

Doctors say that patients with mucormycosis often come to them at a late stage of the disease, when they already lose sight, so surgeons usually have to remove one eye to prevent infection from entering the brain.

In some cases, according to Indian experts, people go blind in both eyes. There are rare cases when in order to stop the spread of infection, you have to remove the jaw.

Only one drug is effective against the disease, an antifungal intravenous injection, which costs $ 48 per dose and must be given every day for eight weeks.

According to Mumbai-based diabetologist Dr. Rahul Baksi, fungal infection can be prevented by following the correct dosage of steroids during and after treatment for coronavirus.

He claims that of the 800 patients with diabetes who contracted the coronavirus who were treated with him, not a single one contracted mucormycosis.

“Doctors should closely monitor blood sugar levels in discharged patients,” advises Dr. Baxi.

The Indian authorities say there is no major outbreak of mucormycosis, while new infections continue to be reported from all over the country.

“This strain of the virus is very virulent, which greatly increases blood sugar levels in patients,” says Dr. Hegde.“And oddly enough, a fungal infection affects a lot of young people.”

His youngest patient last month was a 27-year-old man who did not even have diabetes.

“We had to operate on him when he was sick with coronavirus for the second week and remove the eye. Of course, it was a real disaster for him, “says the doctor.

Home first aid kit, eye drops

90,000 Why eyes hurt after sleep

A very common phenomenon resulting in eye discomfort after sleep. Eyes ache, itching is felt, photophobia arises.In some cases, purulent discharge dries up on the eyelashes. Sometimes the vision itself after waking up for some time deteriorates greatly.

Most often, patients get used to such symptoms and solve the problem by washing their face with cold water in the morning, being sure that their eyes are simply rubbed during sleep, or dust has got under the eyelids. In fact, the reason for such unpleasant sensations is much deeper.

Causes of morning discomfort in the eyes

Insufficient hygiene

Poorly washed off makeup for women at night and not washed off daytime dust from the face of men can become, and most likely, sooner or later will necessarily cause eye irritation.Micro particles of the irritant accumulate on the eyelashes, from where they get to the mucous membrane. Over time, this can cause micro-trauma to the eyes, which will react very quickly to stimuli.

Insufficient rest

Overexertion of the muscles of the visual organs, for example, due to hours of sitting at the computer monitor, reading or work requiring attention, causes a kind of pain in the muscles of the arms if physically overworked. If you don’t get enough rest, your eyes will ache after sleeping.With prolonged exposure, insufficient rest will affect vision.

Inconsistency between contact lenses and glasses
This topic has been touched upon several times. An improperly selected optical power will strain the eye muscles. In addition, the material from which contact lenses are made can cause individual intolerance, and as a result, irritation.

Injuries

Mechanical damage and thermal burns to the eyes may not be noticeable at all.The patient simply does not pay attention to it. But, the trauma manifests itself after waking up, when the eye muscles begin to tense after relaxation. Remember that a mote that has gotten into the eye also belongs to injuries.

Allergy

An allergic reaction, regardless of origin, can irritate the mucous membranes of the eyes and even contribute to the appearance of purulent discharge. Once the allergen is eliminated, the discomfort stops.

Colds

Cough, severe runny nose, nasopharyngeal infection – all this can also cause severe, pressing pain in the orbits of the eyes.It is not uncommon for blood vessels to burst.

Dry eye syndrome

Insufficient moisture in the mucous membrane due to being in a dusty, dry or smoky room causes unpleasant sensations that pass quickly enough. But, if the negative atmosphere of stay affects a person for a long time, this syndrome will develop, and will cause a lot of unpleasant sensations that intensify after sleep.

Hormonal changes in the body

This point should not be ruled out either, especially during menopause.

Diseases Eye

It is logical that eye disease also causes unpleasant symptoms. For example: conjunctivitis, keratitis, uveitis, blepharitis, cyclitis, as well as a disease such as glaucoma.

So how do you know the reason?

Unfortunately, at home, on their own, the patient simply cannot determine the cause of painful sensations in the eyes in the morning. The only sure way out of this situation is to visit a doctor for further examination.This is the only way to be sure of the correctness of the diagnosis and the correct treatment.

Come to the diagnosis at the address: Almaty, Tole bi street, 95a (corner of Baitursynov street).

Phone: +7 (775) 007 01 00; +7 (727) 279 54 36

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90,000 Inflammation of the eyes. Symptoms and Prevention.

3.May 2017

The most common ocular problem is inflammation of the eye, which is the totality of various inflammatory processes that can affect any part of the eye.

As a rule, eye inflammation manifests itself in reddening of the connective tissue elements of the organ, and due to plethora, the vascular pattern of the eye is sharply expressed. The inflammatory process can also affect the area around the eye (for example, the eyelids), resulting in uncomfortable phenomena.The causes of inflammatory processes in the eye are not so numerous and consist of several main groups.

So, eye inflammation can be caused by:

Any infectious inflammation (tuberculosis, syphilis, herpes, staphylococcal, streptococcal infections).

Traumatic injury to the eye (blow, hit of a foreign object in the eye, and so on).

Impact of aggressive substances (acids, alkalis, dust, etc.)

Symptoms of eye inflammation.

In inflammatory diseases of the eyes (both outside and inside) and eyelids, as a rule, there is pain in the eyes, which has a different intensity. In the event that the mucous membrane of the eyes is inflamed (conjunctivitis), then, as a rule, there is redness of the eye, as well as discharge from the eyes. With inflammation of the muscles of the eye – the eyes also hurt, and the pain can be observed in the depths of the orbit, and can increase with the movement of the eyeball. If the vascular tract of the eye becomes inflamed, pain in the eyes appears again, which increases with pressure on the eyeball.In addition to all this, with inflammation of the eyes, there can be a burning sensation in the eyes, they can watery and even fester.

A few words about inflammation prevention:

You should never rub your eyes with the inside of your fingers, unless you have just washed them, because this is the easiest way to get an infection.

If inflamed eyes itch and hurt, then wipe them with a clean napkin or clean handkerchief. As a last resort, you can use the outside of the finger joints.

Remember to remove makeup before bed.

Try to blink more often.

If you have to work a lot at the computer, take breaks. So you can easily restore the water balance of the eyes and relieve tension. Due to concentration of attention, a person stops blinking, because of this, the mucous membrane of the eye dries up and there is a burning sensation, pain. You will get the impression that there is sand in the eyes. Take off every 30-40 minutes from the monitor and look at the foreign objects that surround you.

Buy special drops that are almost identical in composition to a human tear. They will help moisturize the retina and relieve irritation. Drop such drops several times a day if you are constantly sitting at the computer.

Treatment of eye inflammation.

Treatment of eye inflammation, as a rule, begins with a visit to a doctor (ophthalmologist), who will determine the cause of the disease, as well as select the treatment appropriate for the disease. Thus, the correct treatment for eye inflammation is chosen depending on the cause that caused this inflammation.If a foreign body gets into the eye, the doctor will remove it and prescribe medications that prevent infection from entering. If eye inflammation is caused by contact lenses, then it is recommended to start treatment with a temporary refusal to wear them.

In the event that the eyes become inflamed, as a result of infection, antimicrobial drugs are usually prescribed. Well, when eye inflammation is of a viral nature, special drugs are used that are aimed at fighting viruses.If there is an allergic inflammation of the eyes, then in this case antiallergic drugs are recommended. It should be noted that during the treatment of eye inflammation, you should protect your eyes from ultraviolet rays (for this, you should choose glasses with a special coating that absorbs ultraviolet light).

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