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Dr. A.S. Desai
Dr. A.S. Desai, Ophthalmologist
Category: Eye
Satisfied Customers: 2398
Experience:  MS Ophthalmology with 13 years of surgical expereince
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I have had headaches for 2-3 weeks now. It is behind my eyes

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I have had headaches for 2-3 weeks now. It is behind my eyes and nose. I have pressure and it sometimes feels like a band squeezing my head and nose. The headache is not helped by OTCs or Maxalt. I have a normal brain MRI and normal sinus x-ray. The pain is worse when I am lying down. It is affecting my sleep. Strangly I have a hard time getting my eyelids to open in the mornings after I finally fall asleep. The left one is very sluggish and it takes me a few minutes of trying to get my eye lids to open. It feels like they are drawn shut. I saw my eye doctor and he says eyes are fine. No crust, infection, or tear problems in eyes. Additionally I feel like my face quivers sometimes. My BP is in normal range.

As an aside I got hit between the eyes while moving a big TV on 26 Dec. It hurt and my nose bleed a little but I didn't think I broke anything Any idea what could be wrong?

Dr. A.S. Desai :

Hello, Welcome to Pearl.com

Dr. A.S. Desai :

Are you available for chat now?

Dr. A.S. Desai :

It is good to know that the eye exam and the MRI brain and sinus X-ray are all fine. It helps to rule out some of the possible causes for headache such as sinusitis/ eye problems.

Customer:

yes I am here.

Dr. A.S. Desai :

One of the possible causes for chronic headache is tension headache which can come with stress ( mental or physical ).

Customer:

Not much stress. I am retired and loving it.

Dr. A.S. Desai :

Ok. The other possibility is of common migraine ( could be associated with nausea/vomiting too).

Customer:

I have been taking migraine medication called Maxalt but it does not help. I have no auras or Vomiting. The pain has caused some Nausea.

Customer:

I have strange sensation in my face. Feels tingly and quivers.

Dr. A.S. Desai :

Ok

Dr. A.S. Desai :

These are called facial myokymia or twitching.

Customer:

ok

Dr. A.S. Desai :

They are not serious and can be left alone.

Dr. A.S. Desai :

As they can get exacerbated with stress, anxiety, it is better to ignore them.

Customer:

That's good. Do you thing the pain could be related to my accident with the TV? Maybe a clot that has not resolved or something. Not being able to open my eyes is bothersome. The pain is better when I am upright but as soon as I lay down it gets worse and my eyes hurt.

Dr. A.S. Desai :

Is the inability to open eyes equally present in both eyes? Is it a constant feature or is it noticed only in the mornings?

Customer:

It is present in both eyes but worse usually on the left side. Once I can get blinking it goes away.

Customer:

I am using systane balance just in case my eyes are dry but not helping.

Dr. A.S. Desai :

Though I cannot be sure but I feel that the inability to open eyes is more of a functional problem rather than something more serious or due to the injury as such because blinking helps and the eyes open after that.

Customer:

Ok

Dr. A.S. Desai :

Since the inability to open eyes has only begun after the injury, some amount of the muscle fibres of the levator muscle ( LPS muscle is the one which helps to open the eyelid) could have been functionally weakened . This would not require any treatment and can be expected to improve over a period of weeks.

Customer:

Ok

Dr. A.S. Desai :

If your major concern about an unresolved blood clot, then it would definitely have been picked up on the MRI ( though not better than CT in this regard). Since the MRI was found to be normal, looks like all is fine.

Customer:

So you think this is Migraine and I just don't have the right medication yet?

Dr. A.S. Desai :

Though very unlike typical migraine ( these headaches are not continuous but rather intermittent), it could still be a possibility.

Dr. A.S. Desai :

Did you suffer from any episode of common cold or sinusitis in the last few weeks?

Customer:

I get the HA every night. I don't have a cold or sinusitis that I know of but when I move my head it feels to me like fluid moving in there. Sounds strange I know but the pain moves when I move my head.

Customer:

No fevers or nasal congestion. I can't clear my ears and do have some post nasal drip.

Dr. A.S. Desai :

Do you feel like you have blocked ears?

Customer:

Yes sometimes I do feel like there is a little pressure in my ears.

Customer:

I feel a little dizzy sometimes.

Dr. A.S. Desai :

Ok. It could be likely that you have benign paroxysmal positional vertigo(BPPV).

Customer:

Ok what do I do about it?

Dr. A.S. Desai :

Usually anti-histaminc medicines along with analgesics would help. You can try taking tab.Zyrtec, 10 mg , 1 tablet once at bedtime and Tab.Acetaminophen, 650 mg , 1 tablet twice a day for 1 week. In the meanwhile it is better to take an appointment with an ENT(ear, nose and throat doctor) specialist for a detailed ear check up and further treatment.

Customer:

Ok thank you.

Dr. A.S. Desai :

You are most welcome.

Dr. A.S. Desai :

Please feel free to ask follow up questions if any.



Thank you and best wishes.



It was a pleasure to have answered this question.

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Views expressed are for information purpose only and cannot substitute a visit to an ophthalmologist


 

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