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Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
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Experience:  Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
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pain above left eye - comes & goes - but has been going on

Customer Question

pain above left eye - comes & goes - but has been going on for over a week. Am frightened it could be a tumour??
Submitted: 2 years ago.
Category: Eye
Expert:  Dr. Dan B. replied 2 years ago.

Doctor DanB :

Hello and thanks for your question. What kind of pain is it (dull, achy, pressure, burning, sharp)? Is this near the eyebrow or right on top of the eye/eyelid? Any redness, light sensitivity, burning, itching, tearing, discharge, eye pain, or change in vision?

Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3173
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Dr. Dan B. and other Eye Specialists are ready to help you
Customer: replied 2 years ago.
it is pressure mainly i think - near top of eyebrow. and stinging eyes - pain is bothering me mainly though
Expert:  Dr. Dan B. replied 2 years ago.
Do you spend many hours/day reading or on the computer?
Customer: replied 2 years ago.
some - probably 2 hours per day roughly. and yes I read too. have had my eyes tested quite recently......
Expert:  Dr. Dan B. replied 2 years ago.

There can be a few reasons why someone has this brow-type pain. The first is just a simple headache, but centered over the brow; this is not your usual, tension type headache, but headaches can often times manifest in strange ways, even when the cause is the same as a general headache.

 

Secondly, there is a paranasal sinus behind the eyebrow which, if full or if there were an infection of that sinus, could cause this brow-type pain. If you have symptoms of sinus fullness of discomfort, then this may be something you wish to address with your primary care doctor.

 

Given that you have stinging eyes, it's quite possible that the eyes are to blame for this brow pain. The most common reason for the eyes to be causing these symptoms is due to a dysfunctional tear film syndrome. A dysfunctional tear film can be due to many different factors. Different medicines such as psychiatric medicines, antihistamines, cold medicines and others can contribute to a dysfunctional tear film. Allergies in the eyes can also contribute (and or make worse). Some people have an innate deficiency in making their own tears (these people may also have other dry mucus membranes, such as their mouth, nasal passages, or genitalia). Many people have an inflammation in the eyelids called blepharitis which causes the tear film that is supposed to coat the front of the eye to not function as well, and then the eyes dry out. People with blepharitis can have morning tearing, burning, and often eyelash mattering but they can also have these symptoms throughout the day to also include tearing, stinging, itching, burning, a gritty/foreign-body senstation or just intermittent vision fluctuations . Their symptoms get better as the day progresses, but then they get intermittent blurring when they use their eyes heavily in activities such as reading, watching TV, computer use or driving.

Because blepharitis is so common and the treatment for it is relatively benign, you might consider starting this treatment, while concurrently using artificial tears. In order to treat blepharitis, everyday in the morning you should do two things: 1. hot compresses and 2. eyelid scrubs. You should do hot compresses for 5-10 minutes over each eye at the same time. It should be as hot as you can tolerate without burning your skin, massaging the eyelids while they are on there. Then, use either commercially available preparations or a dilute baby shampoo solution to scrub your eyelashes on all 4 eyelids. The commercially available preparations are called Ocusoft or Sterilid which are both over-the-counter eyelash scrubbing treatments. These cost more money but are quicker to use. Otherwise, the cheaper alternative is the dilute baby shampoo (4-5 drops Johnson's shampoo in 1/4 cup warm water), you will take the wipe (or dip a qtip in the dilute baby shampoo solution) and use that to scrub right on the eyelashes of each eyelid for 15 seconds. That will take 60 seconds when done to all 4 eyelids. The scrubbing is done right on the eyelid margin, where the eyelashes come out. After that, just splash some water on the eyes and you're done.

It does take about 3-4 weeks of doing this consistently every day before it really kicks in, so don't stop it thinking it's not working. Also the eyes are still significantly dry during this 3-4 weeks so I would recommend using artificial tears 4x/day in both eyes (one drop per application). After 4 weeks you should be able to start tapering off of the tears to as you need them.

Just doing the artificial tears, hot compresses and eyelid scrubs alone would likely start to help you after three or 4 weeks--but remember it could take this long of doing it everyday before you see a significant effect, so don't stop it thinking it's not working.

If you are a person that doesn't make their own tears very well, then you may also benefit from a prescription drop called Restasis, which actually modulates a person's immune system to help them make more of their own tears. This drop actually requires constant usage on a daily basis for up to 10-12 weeks before its effect kicks in (takes awhile to change the immune response in the body).

Because there are numerous reasons for dry eye, if not all the reasons that exist in one patient are treated, it can seem as though the ones that are being treated are providing no benefit. If you've tried these recommendations and still don't feel better then you should consider seeing a corneal specialist for a dry eye evaluation.

 

Does that make sense?

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