Eye misalignment may cause headache, dry eye symptoms
Click Here to Manage Email Alerts
NEW YORK – Clinicians should consider eye misalignment leading to trigeminal dysphoria in patients with symptoms of dry eye, fatigue, occipital and neck pain radiating to the eye, and light sensitivity, Ray Corbin-Simon, OD, said in a presentation at Vision Expo East.
“Small horizontal prims corrections can provide significant relief in symptomatic patients,” she said.
“Proprioceptive fibers innervate the extraocular muscles and provide afferent feedback to the brain about the location of each eye,” Corbin-Simon said. “The signals are transmitted to the ophthalmic branch of the trigeminal nerve, which detects and reports the pain of dry eye.”
Corbin-Simon said she explains the concept like this: “When our eyes come together, they have a natural position they like to go to. When we’re relaxing on a beach, our eyes feel good. But then we work and are required to pull muscles together for a task. For some people, this isn’t so easy to do and sustain. That’s an overactivity in the trigeminal nerve. Headache, dizziness, dry eye, eye strain, neck and shoulder pain, and light sensitivity result.”
She said she uses a seven-question lifestyle index questionnaire that asks patients about these symptoms and also quantifies them by providing a severity scale from 1 to 5.
“We’re great at prescribing sphere, cylinder and add power, but the national average of prescribing prism is 3%,” Corbin-Simon said. “Small prism corrections can improve visual comfort.”
A 9-month study conducted by Miles and colleagues among 179 patients who experienced chronic daily headaches showed that 93% had positive responses after they were prescribed contour prism, Corbin-Simon said.
“Eighty-two percent of them who were suffering reported the headaches were substantially reduced or basically gone after 90 days. Some came off their medications altogether,” she said.
“We were taught to use cover test, phorias, fixation disparity, Percival’s criterion, Sheard’s criterion and Maddox rod to evaluate eye misalignment,” Corbin-Simon continued. “But they’re subjective. I have to rely on the patient’s answers.”
The Neurolens Measurement Device can help clinicians assess this issue, she said.
“Patients are looking for comfort, looking for an answer,” Corbin-Simon said. “They’re doing more work on devices. For those patients who struggle to stay on a device for long periods of time, what are we doing to help relieve their problems? Check for misalignment.”
Collapse
Corbin-Simon R. Optometry meets neurology: The link between headaches and dry eye sensation. Presented at: Vision Expo East. March 31-April 2, 2022; New York.
Read more about
Click Here to Manage Email Alerts