Relating Headaches With Eyestrain

Photo Credit: eye-contact.co.uk

Eyestrain and headaches are also among the most common complaints of patients visiting the optometrist. Asthenopia is a synonym for eyestrain and it involves any feeling of fatigue, discomfort or pain localized in or near the eyes or thought to be associated with the use of the eyes; oftentimes reported by patients as headache, especially when the ache is localized near the eyes or is thought to be caused by the use of the eyes.

A patient visiting the optometrist with headache as the chief complaint has self-diagnosed the headache as being caused by a visual problem.

Eyestrain headaches generally accompany prolonged use of the eyes. It could also occur in the morning after prolonged use of the eyes, as an "eye hangover" headache. Most patients come complaining with eyestrain headaches having experienced the headache problem for a matter of weeks and months but not years; as the pain is not so severe that the patient is driven to find the cause within a few days, but it is usually persistent enough that he eventually seeks relief from the problem.

It could be traced to a change in jobs or other changes in the patient's visual requirements. Eyestrain headaches tend to be of "medium" intensity and "dull" in character; as opposed to "sharp", "burning" or "boring", and tend to be located in the eyebrow region or in the area around or behind the eyes. If prolonged use of the eyes gives rise to excessive muscular tension, the pain maybe located in the back of the neck or in the occipital or vertical regions.

Some authorities have attempted to relate headache location and severity to specific refractive and binocular vision anomalies (e.g. hyperopia, hyperopic astigmatism, convergence excess, hyperphoria, aniseikonia).

Photo Credit: wikihow.com

The important thing is for the practitioner to establish that the headache occurs with the use of the eyes, and not to match up symptoms with findings, then to determine whether the correction of the patient's refractive error or binocular vision problem will solve the headache problem. Complaints of eyestrain or visual fatigue by myopic patients are rare, because for an uncorrected myope accommodation would not improve distance visual acuity. However, myopes squint (using the lids) to cut off peripheral rays and allows the central rays to enter the pupil producing a finer image. This can cause eyestrain or headache.

On the other hand, uncorrected hyperope or hyeropic astigmat can improve his/her visual acuity at distance by accommodating, precipitating asthenopia; usually relieved by prescribing the appropriate lenses. Some patients’ eyestrain headaches could be solved by the correction of as low as 0.50D of hyperopia or hyperopic astigmatism. Prescription of placebo lenses for patients with little or no refractive error usually had temporary relief after which the symptoms returned.

Optometrists should be well acquainted with the common headache types, as many patients who believe their headaches are caused by eyestrain may have headaches due to other causes. A large proportion of headaches are vascular. Specific types of vascular headaches tend to occur based on age, i.e. migraine headaches usually occur in young adults; hypertension headaches occur in middle-aged and headache caused by temporal arthritis occur in elderly patients. Other types of headaches of importance to optometrists are muscles contraction headaches, cluster headaches, nasal sinusitis headaches and trigeminal neuralgia- caused headaches. These types of headaches will be further discussed in our subsequent post.