Hi. I'm online and happy to answer your question today.
What sort of symptoms have you been experiencing?
Do you wear contacts lenses?
Hi, yes I do wear contacts
Ok. What symptoms have you been experiencing and how long has it been going on for?
Do you feel like something is in your eye?
Do you have any eye pain or decreased vision?
It's been going on for three days almost, first both my eyes hurt when I moved them, just a dull ache,
Now it's just my left eye when I look all the way to the left
Mostly left/up and left/down
I first thought it might be a cold but I have no other physical symptoms except for sneezing from allergies
No, I don't feel like something is in my eye
And I have no vision problems...
Ok. One more question :)
Is your eye or eyes sensitive to the light?
No, not so much. I can check now
ok. I'll wait.
No, I don't think so, I don't usually like looking at the light without sunglasses on, so I don't think anything is different..
Ok. Try one more thing for me....well two more :)
Right now it even hurts if I look right and down
using your index finger rub around on the side of your nose by the top of your eyeball. Is there pain or tenderness when you do this, especially by your left eye.
No, no tenderness
Ok. Well, I think I've got it narrowed down to a couple of things....
From what we have discussed the most likely cause of your problem is trochleitis, which is inflammation (usually from no cause that can be found) of the superior oblique tendon and trochlea system....one of the 6 muscles that move your eyeball.
It is treated by an ophthalmologist in the office by injecting a long acting steroid in the area. I've done this many times and it is very, very effective.
This condition is a clinical diagnosis and does not need a huge medical workup...
You can expect to feel back to normal within 2 or 3 days after treatment.
Since I can't examine you I can not, from what we have discussed here, rule out scleritis..but an eye exam would be able to easily figure out if this process is at work.
This is not a job for an optometrist so make sure you are seen by an ophthalmologist (eye MD)
Does this make sense to you?
I don't know what the last one was
That is inflammation of the wall of your eyeball. It can also cause pain with eye movement, but given how specific you were able to be in describing what movement causes you the most pain, I feel confident about you having trochleitis.
But I'm much better diagnosing eye problems in person -- chat is not a very sharp medical tool lol!
So it's not a sinus problem? seeing as the pain in my right eye went away now?
Yes....if it come and goes it could be a sinus problem. When it comes to pain around the eyes the sinus are many times at fault. I didn't understand that the pain is not always there...I'll try to pay better attention ;-)
One thing that people always worry about is a brain tumor. If you are considering this as a possibility I can tell you without a doubt, that is not what you have going on.....
There is no pain when I'm just looking normally, it's just when I try to see if I have any pain and I force my eye to the far left and right that I feel it...
My eye is not swollen
That could be from what we have discussed or it could be mild conjunctival irritation. Since your eye is not swollen, red, watering, itching etc I do not feel it is from allergies.
Okay, thank you!
My pleasure. I hope you feel better soon.
I hope this information was helpful for you. But I do work for tips so I want to make sure you are happy with me before rating me. If you have another question on this or a related issue feel free to fire away. You may also receive an email survey after our chat, if you don’t feel that I have earned a “10” rating in all areas, please let me know what I can do to meet your expectations. Thanks in advance, Dr. Rick MD FACS