OPHTHALMIC EDUCATION (6) Understanding Headaches [Archives:2000/30/Health]

Is there a problem with your eyes?
Headache is considered one of the most common symptoms among people. The income of pharmaceutical companies from the sale of the different types of medications used to treat headaches reaches millions of dollars every year. Most people consider headache a benign symptom and is usually due to tension and fatigue. Also many people think Ð and that is wrong Ð that eye problems and the need for glasses are the most common causes of headaches. The need for glasses and eye fatigue are not the main causes of headaches.
Causes and symptoms:
Most types of headaches can be divided into three groups: –
1. Tension headache: is the commonest cause of headaches and is due to spasm of the neck and upper spine muscles. Usually the pain radiates to a different place mostly to the frontal area of the face, the brows and the orbit. This usually leads to confusion between the cause of the headache and the area that it presents at.
Usually tension headache results from spasm of the neck muscles due to stress from daily life events such as stress at work or at home. Other causes are related to the abnormal sleeping or working positions or doing close work for a longer period of time. Generally tension headache is usually temporary and it gets better after taking a pain-killer.
All types of headaches get worse when we use our eyes more than usual. Some types of tension headaches can present for long periods and has relation to depression and stress. And in rare cases can be related to inflammation of the neck joints.
2. Migraine headache: is the second most common type of headaches. It is a group of headaches caused by dilatation of the head blood vessels. Some people have tendency for their blood vessels to dilate while others don’t have that tendency. Migraine headache affects one in ten people and tends to run in families and it can affect small children.
It is usually difficult for patients to know if they have migraine headache because it usually results in different symptoms from one person to another. In some cases the headache presents as recurrent bouts of severe headache lasting for a short period of time while in others zigzag lines can appear in front of one or both eyes followed by sharp headache. Occasionally the zigzag lines can appear without the headache.
Migraine headache usually tends to last for a short period of time; it affects one side of the head and can be associated with nausea and/or vomiting. Generally migraine headache is not associated with serious illnesses.
3. Headache due to diseases of the head, eyes, sinuses, ears and teeth: these are rare causes of headache. The headaches due to eye diseases are localized in the eye or eyebrow and are associated with blurriness of vision, haloes around light or photosensitivity. Headaches related to diseases of ears, sinuses or teeth are usually different from other types of headaches.
Headache can also be related to high blood pressure and it is very important to measure the blood pressure in cases of continuos or recurrent headaches. Headache due to brain tumors is rare and has specific criteria known by the eye specialist.
Where to go if you have headache?
Headache is a common problem and it usually needs a medical opinion especially if it becomes chronic or recurrent. Most patients with headaches have symptoms related to the eye and they usually seek medical attention by the eye doctor. The eye specialist has the training to diagnose the different types of headaches and to answer the question if the headache is related to the eye or not.
If there are signs of certain diseases the eye specialist will advice you where to go and what type of investigations to have.
How can headache be treated?
It depends on the type of headache. Always tell your doctor all the problems and symptoms you have because the information you give to your doctor will help to reach the diagnosis. Stress and depression has to be ruled out and migraine headache has to be treated according to the severity.
REMEMBER:
1) Give your doctor all the information and symptoms you have so that he/she can reach the diagnosis
2) The need for glasses and eye problems are not the main causes of headaches
3) Tension headache is the commonest cause of headaches and migraine headache is the second most common.
4) All types of headaches get worse when we use our eyes more than usual
5) Migraine headache is not associated with serious illnesses.
Routine eye exam by an eye specialist is very important. It is your sight and your eyes need every care they deserve.
Reference: PAACO educational leaflets, Cairo
Mahfouth A Bamashmus FRCSEd, FRCOphth
Consultant Ophthalmic Surgeon
Ibn-Al-Haitham Clinic,
University of Science & Technology, Sana’a
 

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