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Dr.S Riaz
Dr.S Riaz, Ophthalmologist
Category: Eye
Satisfied Customers: 2822
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Frequent dull aches in behind right eye. recent testof

Customer Question

frequent dull aches in behind right eye. recent testof pressure showed assymetry of pressure being measured as 19 in right eye and 15 in left eye. no headache in left eye. Vision correction very different in each eye. +1.25 in left eye and +2.75 in right eye(eye with dull heDACHES). Corrected with contacts. Opthomologist says he has never seen anyones eye trying to focus so hard. also potentially narrow angle glaucomA ..occasioanl blurred /cloudy vision when focusing. Would these existing facts cause this chronic dull ache behind R eye. wanted to add right eye pupil at times larger than left but completely reactive pupil. one ocular migraine in that eye back in Sept 2009. starting with squiggly line. seems to have this chronic ache on and off since then.
Submitted: 7 years ago.
Category: Eye
Expert:  Dr.S Riaz replied 7 years ago.


A narrow angle glaucoma can cause these symptoms. The raised eye pressure during an attack of glaucoma can cause pain behind the involved eye. Enlarged pupil can be due to raised eye pressure but 19 is normal. So, you should try to confirm/rule out this diagnosis. If the angle is narrow, it can be widened by laser. You can discuss that with your ophthalmologist. Difference in the prescription of two eyes is not going to cause these symptoms. If you were not wearing contacts or glasses then of course you may get a headache. Another possibility could be sinusitis. Thanks and best wishes.

Customer: replied 7 years ago.

Thanks so much for your response . The narrow angle seems to be bilateral tho so why the aching in just one eye. I am also in the medical field and have myself talked into a ""brain tumor" of some sort due to the chronicity of the matter and the pupil assymetry at times. Just additional information ..... There is a puff of air machine that he said my numbers were higher than he had ever seen??? i dont think it was the glaucoma machine and I wish i was able remember what it was . i think it measures how hard your eye is working to focus. Is this eye focusing muchharder than the other based on the +2.75 correction along with the reading of this number. when apply pressure to the eye i get relief. There is also an area at the right base of my skkull that if i massage i get immediate relief and can feel the connection to that right eye. feedback please. Thanks for addressing these stress causing issues! Also is there a correllation with stress and blurry vision. I have found iin recent experiences when i get anxious about vision become temporarily cloudy.

Expert:  Dr.S Riaz replied 7 years ago.

The puff of air that you are talking about is most probably the the tonometer that is used to measure the eye pressure. The eye pressure is measured with the help of a puff of air. This is not very reliable and if found raised is usually confirmed by another tonometer called applanation tonometer.

Narrow angles are usually bilateral but in one eye the angle could be more narrow giving rise to episodes of raised eye pressure. Gonioscopic examination will help to confirm that.

When the eye pressure is raised it may be difficult to focus as cilairy muscles do not work well due to raised eye pressure. Another reason for difficulty in focussing could be your age. Presbyopia sets in about 40 years of age. However, once the eyes are corrected you should not have a problem in focussing.

Anxiety can also be a reason for your symtoms. If no cause can be found then probably anxiety is to blame. Tumour is very unlikely as it will produce many more symptoms. Thanks.

Customer: replied 7 years ago.
This will be my last question and i thank you for taking the time to answer me. YES, it was a that measuring glaucoma???...because i was never encouraged to follow up. He just said my numbers were the "highest" he has ever seen. How common is pupil assymetry. It scares me to death!!!!!!!! sometimes it will be larger wheni wake up annd then normailze throughout the day? sometimes its just random but typically common when i am having the dull ache. What are your thoughts about the pressure point that relieves achiness when i push on the right side base of my skull. I can also locate an achy point on the top of my head to the right of midline that is tender and seems related. Nerve endings? He continues to identify that my vision is VERY difficult to correct due to its complexity to get sharp vision. Lots of computer and texting use daily . Please address each of these issues? thanks again for everything!
Expert:  Dr.S Riaz replied 7 years ago.

Tonometer is used to measure eye pressure. I am not sure what reading he got. 19 is absolutely normal. You should see a glaucoma specialist rather than a general ophthalmologist.

Pupil asymmetry is quite common and can be physiological. Pressure point that relieves achiness is surprizing as I have never read or heard about it. Probably related to anxiety. Sitting on computer for long can cause dryness in your eyes which can cause blurring. You should use a presrvative free lubricating drop like Refresh Tears frequently(4-6 times a day). Also see a glaucoma specialist. He will be very helpful. Thanks and best wishes.

Customer: replied 7 years ago.

actually the machine was called an HRT... I just called his ofice. does that change anything.???.but isnt glaucoma painless in its symptoms? I will try drops and will follow up on narrow angle. and if my right eye "is working soooo hard to focus as he says, would that cause the headache in that eye.? Wouldnt i have other symotms of sinusitis. none other? but when i push on eye it is tender and relieves pressure?

Thanksfor your feedback once again

Expert:  Dr.S Riaz replied 7 years ago.

Narrow angle glaucoma is not painless. Open anglae glaucoma may be painless as the eye pressure is raised gradually in this condition. HRT helps in diagnosis of glaucoma. If right eye is working hard to focus than that could be due to raised eye pressure and headache can occur. Sinusitis may cause nasal stuffiness and other signs but can cause pressure behind eye and also headache. What I feel is that you may be having episodes of raised pressure in the concerned and as a result these symtoms. If the angle is narrow then you can definitely go for a laser procedure called YAG peripheral iridotomy which is done to widen the angle. You can discuss with your doctor. Thanks.

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