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I'm a 32 year old female who's been suffering with the

Hello Dr. Dan - I'm a...
Hello Dr. Dan -
I'm a 32 year old female who's been suffering with the sensation of severe pressure over the right eye for about 6 months now. The sensation is accompanied by a "clicking" noise which is audible to others around me - almost like an air bubble, which relieves said pressure momentarily until it builds again. It's a daily occurrence, but doesn't seem to follow a trend, and comes and goes.
Any ideas?
Kathy
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Answered in 2 minutes by:
11/6/2013
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Verified
Dr. Dan B. : Hello and thanks for your question. Are you available to chat?
Customer:

Yes, thanks so much!:)

Dr. Dan B. : Does this clicking noise happen spontaneously, or when you move your eye, or when you press or touch on the eye or eyelid?
Customer:

It's when I blink

Dr. Dan B. : Is the eye tender to the touch?
Customer:

Not to the touch, but it can be accompanied by a "headache" in the orbital area that ranges from dull to severe

Dr. Dan B. : Is it in the upper, inner corner of the orbit?
Customer:

Yes, that's exactly where it is

Dr. Dan B. : So, if I'm understanding you correctly, this clicking happens dozens of times per day, is that correct? Is there something that relieves the pain or is the pain they are constantly?
Customer:

Any otc pain relievers do help the pain, just not that pressure sensation. And the clicking happens pretty frequently during the day, yes

Dr. Dan B. : Any double vision? You ever have a popping sensation that happens once that relieves the pain?
Customer:

No double vision - but the vision in that eye isn't the greatest, I do wear glasses for reading. No popping sensation that relieves the pain but the 'click' relieves the pressure momentarily

Dr. Dan B. : Okay thank you for being patient and supplying me with answers all my questions. Give me a couple of minutes I'm going to type out that response to you regarding what I think is happening.
Customer:

Thanks so much!:)

Dr. Dan B. : Sorry. I actually have one more question. Do you have any of the following symptoms: Burning, itching, discharge, foreign-body or gritty sensation, tearing, redness, pain, caking or mattering of your eyelashes in the morning, or intermittent vision blurring?
Customer:

No, nothing like that

Dr. Dan B. : I know this may seem like a strange question, and please don't be offended by it because it may be clinically relevant, but are you obese?
Customer:

lol no, I'm not:)

Dr. Dan B. : Thanks. To be quite honest with you your symptoms sound quite unusual. At first blush, they remind me of somebody who has swollen and or lax eyelids that are not opposed to the eyeball very well. When this person blinks and creates kind of a vacuum every time they blink and it can be associated with the clicking sound. That doesn't sound like it is the case with you. Alternatively...
Dr. Dan B. : It's possible that this is an unusual presentation of what is called Brown's syndrome or superior oblique tendon sheath syndrome. This is where one of the muscles that move the eyeball that passes through a tendon sheath in the upper inner corner of the orbit is actually being constricted as it passes through this tendon and can cause that pain and clicking or popping sounds. But your presentation does not sound all that classic for it. What I would suggest...
Dr. Dan B. : Is to start treating this conservatively as though there may be some dysfunction of the tear film which is very common. I would recommend, at first, using one drop of artificial tears and that eye 3 to 4 times per day, every day, on a regular basis for the next 2 to 3 weeks. If after doing this, you find that there is no relief are your symptoms are the same, I would recommend seeing An ophthalmologist to determine if there's something more unusual going on. Very likely, the use of the artificial tears will help this. Does this make sense?
Customer:

Yes, very much so!:)

Dr. Dan B. : Good. Do you have any other questions about this?
Customer:

No, this has been very very helpful!:)

Dr. Dan B. : Excellent. Good luck. Your feedback is important to me and will help me improve my encounter with future customers. Please rate your encounter with me by providing positive feedback (by pressing the smiley face); any bonus you may feel prompted to provide would be welcomed and is appreciated. If you feel like your concerns are not resolved or you have a problem or issue with anything I have said or haven’t said, please don’t issue a negative feedback rating—My goal is your satisfaction and I would rather work together to solve your concerns, until you are satisfied, than have you leave our encounter unhappy and unsatisfied. My opinion is solely informative and does not constitute a formal medical opinion or recommendation. For a formal medical opinion and/or recommendation you must see an eye doctor. Thanks for your inquiry!
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology
Verified
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Dr. Dan B.
Dr. Dan B.
Dr. Dan B., Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 3,343
3,343 Satisfied Customers
Experience: Eye surgeon experienced in cataracts, glaucoma, retina & neuro-ophthalmology

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