I have had an issue near my left eye for some time now. I have seen an Optometrist and Ophthalmologist and received a clean bill of health from both. The Ophthalmologist actually said both my eyes are amazingly healthy. The only issue I have suffered from in my left eye is a case of Blepharitis, which I have been managing for years. In terms of the pain, it's a dull pain that gets worse throughout the day. It can get so bad at night, that even closing my eyelid feels like intense pressure on my eye and I have to open my eye to find relief. Often times I have to take a pain reliever just to sleep. It is intermittent, but has been happening often since June. Nothing that I know of happened when it came about. Here is a diagram that shows the location of the pain (and secondary pain): http://screencast.com/t/q4A3ohUjZB
Person's Gender: Male
Person's Age: 32
Hi. How often do you get this pain? Do you feel normal between episodes? Is your vision ever affected? How about your sinuses?
I would say it happens 3 to 4 times a week. It tends to worsen later in the day. Vision does not get affected. No issue with sinuses. I do feel fine between episodes. The Ophthalmologist was at a loss and said she was going to refer me to neurology. Which is why I contacted a neurology expert. This is definitely one of the most confusing and uncomfortable experiences I have ever had.
Yes. There is a spectrum of headache and related facial pain disorders like this that are quite widespread and distressing. Many, if not all, involve irritation and/or inflammation of the trigeminal nerve (5th cranial nerve). Most come and go, sometimes with long periods of quiescence between attacks. Often a trigger or triggers can be identified.
If you feel well between episodes, there is not likely to be anything serious going on. However, new and severe symptoms like yours would warrant an MRI of the brain to rule out a source in the central nervous system. Otherwise, these types of attacks are usually best managed as atypical migraines or trigeminal neuralgia.
Thank you Dr. Bob. I decided to read a bit about Trigeminal Neuralgia and MS caught my eye. Obviously I acknowledge that may have been a leap, but I figured best to be informed than not. So I read a little about MS symptoms and a few rang true, especially tingling and numbness. That has been going on for quite some time and my general practitioner has sort of discarded it as potentially related to a poor blood circulation, or high blood sugar levels (I'm not diabetic, but my a1c was 6.0). The numbness and tingling typically affect my legs and arms. With my legs, it can get bad enough that I need to adjust my leg just to feel it again, typically affecting my thigh muscle. With my arms, it's mainly just a tingling and sometimes will itch a bit. Do folks with possible Trigeminal Neuralgia typically experience these symptoms, or would there be reasonable cause to discuss with my Dr and possibly look into MS?
Trigeminal neuralgia is localized to the face only. Numbness and tingling elsewhere would suggest a different process altogether. MS is possible, as it can be quite variable and mimic other disease processes, but is unlikely in your case. For one thing, eye pain like this is unusual with MS, while blurring or double vision is more likely. Also, numbness and tingling comes on for days or weeks with MS, not minutes or hours. If you are really concerned about this possibility, the diagnosis is made (or ruled out) based on physical exam, symptom history, and MRI findings.
Neurology & Int Medicine (US Trained): 20 yrs experience
Thanks Dr. Bob. I'll chat with my GP about next steps. I just wanted to follow up and say you have a great "web-side manner", not sure what the online equivalent of bed-side manner is, but you've nailed it. Although I hope I never have another neurology question again, if I do...I will address it to you.
You're welcome. And thanks for the kind words. Follow up anytime.