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Ask Dr. Rick Your Own Question

Dr. Rick
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7760
Experience:  Ophthalmology since 1994 with Retina sub-specialty interest
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I have eye pain now for 4 weeks. It went away for a week but

Customer Question

I have eye pain now for 4 weeks. It went away for a week but returned after so the duration is really 3 weeks. The is pain behind both eyes, more notably in the left. My symptoms are:

Headache
Pain behind the eye
Fatigue
Weakness
Mild muscle spams
Sight dizziness from time to time

I've seen an optometrist and an earth nose and throat doctor. They say it's sinusitis but it makes no sense, my nose is not congested and I don't have mucus, so why are my symptoms not going away? I have a feeling it is neurological.
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Rick replied 2 years ago.

Dr. Rick :

Hi. I'm online and happy to answer your question today.

Dr. Rick :

I agree with your ENT physician. The most likely cause of your discomfort is not the eyes themselves but rather sinus problems.

Dr. Rick :

There are many types of sinus inflammation that do not involve active infection or discharge.

Customer: But the thing is its ongoing and the main concern is my imbalance. Wen I begin walking around I feel fine, but I am afraid it is neurological. I went to an eye doctor when I first had the pain and he said I had no problems in the yes, but I don't know if he can tell its an optic neuritis issue without taking an image of the eye??
Dr. Rick :

That is what the inhaled steroids are for.

Dr. Rick :

An optometrist doesn

Customer: Doesn't what?
Dr. Rick :

doesn't have the training to diagnose or treat optic neuritis. That being said, no imaging study is needed to diagnose that condition as it is obvious on exam.

Dr. Rick :

sorry...hit the enter key in the middle of typing :)

Dr. Rick :

And, even if you had optic neuritis that condition doesn't cause you to feel imbalanced nor does it, in the vast majority of cases, cause the type of pain your are experiencing.

Customer: Ilol not a problem. Well he did do an exam, and said it is fine. But what can cause that pain? I've had sinus issue before but when I did it was congested and I had mucus. I don't have mucus when I blow my nose and it's not congested
Dr. Rick :

As I stated above just because you don't have mucus and you don't feel congested doesn't mean you that you don't have sinusitis. An ENT doc is the best trained person to diagnose and treat sinus issues.......why do you doubt him/her?

Dr. Rick :

Also, as far as ruling out eye pathology you should have an examination by an ophthalmologist and not an optometrist. I don't think, however, that the source of your symptoms is going to be in your eyes.

Customer: I am trying not to doubt him, it's just I read symptoms of multiple sclerosis and they are similar to what I have. Wen I wake up in the morning the pain is still in the eyes. I read how the optic nerve is connect to the central nervous system so it could be an inflammation due to an autoimmune attack hence multiple sclerosis?.
Dr. Rick :

You shouldn't read things on the internet lol! I wouldn't even have considered MS in your differential diagnosis list with what you have told me.....

Customer: Then what should I do about the pain, let it reside? Have you had patients who complain about pain behind e ey( feels like dryness) and dizzness?
Dr. Rick :

If that were the case you would have lost at least some vision......you can't attack the optic nerve without loosing vision and having other findings on exam. I wouldn't give MS a second thought.

Dr. Rick :

Yes. I have. I suggest that you go back to your ENT doc, or choose another ENT doc and let them know you think things should be better by now and that they aren't.

Customer: Well I do have an appointment to the optometrist next week, anything I should tell him? Could he verify if this is serious?
Dr. Rick :

You can also ask your GP to refer you to an eye surgeon for a complete eye exam. Hopefully that would make you more comfortable with the idea that your eyes are not contributing to your current issues.

Dr. Rick :

I would suggest you see and ophthalmologist and cancel the optometrist appt.

Customer: I did go to the clinic and they did a neurology test in the office and said I passed it , that it isn't MS, it's just when I feel dizzy and have eye pain I can't help bu think it is neurological.
Customer: I would probably need a referral to an opthamologist. So what should I do about the eye pain?
Dr. Rick :

Like I said I do not believe that your eye is the source of your pain. I would continue using the nasal spray and put cold compresses on your forehead. A repeat visit to the ENT and an exam by an eye surgeon, not an optometrist, is a good idea. Tylenol would also be helpful for the pain.

Dr. Rick :

Does this make sense to you?

Customer: Yes it does, thank you very much for your help dr.rick.
Dr. Rick, Board Certified MD
Category: Eye
Satisfied Customers: 7760
Experience: Ophthalmology since 1994 with Retina sub-specialty interest
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