Headache

An Overview
Headaches may occur for any number of reasons including:

• Sinus conditions
• Hypertension
• Allergies
• Tumors
• Hormonal Changes
• Stress

They are occasionally associated with eye strain.

Migraine Headaches
Migraine, a type of headache that is often hereditary, usually first surfaces between the ages of 15 to 30. They are most common among women and are thought to be related to stress and some foods.

Migraine headaches may cause visual symptoms such as:

• Light flashes
• Temporary blind spots
• Blurred vision

Migraines are thought to be caused by the dilation and constriction of arteries in the head. These headaches can be extremely painful. The pain is often limited to one side of the head, and may be accompanied by nausea and vomiting.

In many cases, migraines are believed to be brought on by stress.

This "Friday night" headache often follows the stress relief of a frantic week during which the blood vessels in the head relax and constrict. Certain foods and additives such as chocolate, alcohol, dairy, and MSG are also attributed to migraines. However, for many, the cause is variable and extremely difficult to pinpoint.

Migraine is a familiar disorder characterized by recurrent attacks of headache that vary in intensity, frequency and duration. Attacks are commonly unilateral and are associated with nausea and vomiting. In some cases they may be preceded by, or associated with, neurological and mood disturbances.

The main types of migraine are:

• Common migraine - characterized by headache accompanied by nausea and pallor or paleness. The headache starts anywhere on the head and is pounding or throbbing. It usually spreads to involve one half or the whole head. In some cases, the pain is behind the eye and may be mistaken for sinus problems. During the attack, which lasts for hours to a day or more, the patient has an increased sensitivity to light (photophobia) and seeks relief in a quiet, dark environment or through sleep.
• Classical migraine - characterized by a visual or an auditory aura which lasts about 20 minutes. Visual aura may consist of bright or dark spots, zig-zags, heat haze distortions, jig-saw puzzle effects, scintillating scotoma, tunnel vision, fortification, and other visual field defects.
• Ophthalmoplegic migraine - rare and typically starts before age 10. It is characterized by a recurrent transient 3^rd nerve palsy which begins after the headache.
• Cluster headache - type of migraine which typically affects men in their 40s and 50s. It is also characterized by a typical headache accompanied by tearing, red eye, and rhinorrhea (discharge from the nose). The headache is usually unilateral, oculotemporal, excruciating, sharp, and deep. It begins relatively abruptly and decreases over a few minutes. It lasts for 10 minutes to 2 hours and then clears quickly. It may occur several times in a 24-hour period often at particular times. Once the 'cluster' is over, there may be a long headache-free interval of several years

Eye-related Headaches
Eye-related headaches typically occur after extended periods of reading, watching television, computer work, or other close work that requires intense concentration. This type of headache usually disappears after a period of rest. In some cases, headaches may be caused by eyestrain related to eyeglasses. A tendency for the eyes to cross or drift outward may also initiate headaches.

One eye problem known to cause an intense headache is angle-closure glaucoma. With this type of glaucoma, the headache is only part of the problem. Patients suffering from an angle-closure attack also may experience nausea, intense pain around the eye, blurred vision, and haloes around lights.

Headaches caused by eye disease are unique in their symptoms and types of pain. It is important to make detailed notes of your symptoms, type of pain, lifestyle and what you were doing when the headache began. This information is very helpful to the physician to diagnose the type and cause of the headache you are experiencing.

Signs and Symptoms
The symptoms from headaches can be extremely variable and depend on the underlying problem. Because the scope of the various types and causes is so immense, the following headaches are described with the typical symptoms as they relate to the eye.

Headaches related to eye fatigue:

• Headaches that begin after an extended period of reading, computer use, watching television, or close work.
• Burning eyes
• Fatigue

• Throbbing pain
• Sensitivity to light and sound
• Nausea and vomiting
• Visual "aura" including light flashes, jagged lights, missing areas of vision

• Intense headache that is usually centralized over brow area
• Nausea and vomiting
• Glare or halos around lights

Detection and Diagnosis
Dr. D will use a series of steps to determine if your headaches are caused by eye problems are some other problem.

Treatment
Stress reduction, control of blood pressure, or medication to maintain appropriate hormonal levels may be necessary. New glasses or different work lighting may be prescribed.