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Dr. Stan
Dr. Stan, Ophthalmologist
Category: Eye
Satisfied Customers: 2701
Experience:  Johns Hopkins Fellowship Trained, Certified and Licensed Medical Physician and Surgeon
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Further to several earlier questions, I wonder if anyone can

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Further to several earlier questions, I wonder if anyone can help me answer the following please. After my friend squeezed my head with his knees for about 15 seconds three and a half months ago, my vision has been disturbed and I have experienced daily headaches and eye pain. I have had an MRI and seen several opthamologists but the problem persists. I had a mild bout of uveitis and floaters, but the uveitis has now cleared. After my friend released my head, there was an immediate shift in my vision and what I now realise was mild vertical diplopia. This lessened over the next week, but then got a little worse and plateaued. It feels like my left eye has somehow been dislodged and is not sitting correctly within the socket and I feel very 'otherworldly'. I get occasional twinges of pain in my right eye. My left eye still feels like is it somehow in front of the other one and when moving from looking at a view or object from the left and moving towards my nose, there is a slightly curving upward trajectory. It also feels like the left eye is slightly higher. I believe my superior oblique muscle has been somehow damaged. I have had a continuous feeling that something is pressing/resting against the top inside corner of my left eye. This is coupled with a developing pushing/tugging feeling during the day to become a deep ache within my eye by the early evening. The pain appears to be getting worse and I'm concerned that a muscle is being eroded by rubbing against the side of my eye. The headaches and eye pain become very difficult to deal with by evening as there is no respite from them. It isn't very painful first thing in the morning, but soon starts over again. I'm due to see another opthamologist next week, but I fear the problem will still not be resolved. When I increased my glasses prescription, it produced a pain in my eye, as well. Does anyone have any idea what the rubbing against my eye could be? Also, it is likely that eye muscle damage will resolve itself if the problem has existed for over three months or is it unlikely? What would it feel like if it was resolving? Could the tugging feeling be a part of the resolution? Any answers would be gratefully received. Thanks.

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It is likely that you are experiencing eye muscle rubbing and pain from nerve due superior oblique nerve injury with muscle inflammation and tightness. The solution to this problem is eye muscle surgery to relief the tightened superior oblique tendon and muscle. The surgery could either involve superior oblique tenotomy or release of any scar tissue around the superior oblique tendon which may be causing entrapment. Such entrapment of the superior oblique muscle could develop due to chronic inflammation around and within the eye socket caused by the "between knee head injury". I suggest that you follow-up with the strabismus ophthalmologist for detail evaluation to determine to nature of the restrictions, including vergence and ductions. Any co-morbid thyroid eye disease or underlying orbital myositis should be excluded TFTs and/or MRI of the orbit. The use of prism glasses may not effective correct the problem if there is significant refractive error imbalance caused by the superior oblique muscle tightness. Eye muscle surgery should be closely considered.

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