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The Eye and Headache

Friedman, Deborah I. MD, MPH, FAAN

CONTINUUM: Lifelong Learning in Neurology: August 2015 - Volume 21 - Issue 4, Headache - p 1109–1117
doi: 10.1212/CON.0000000000000204
Review Articles

ABSTRACT Purpose of Review: This article highlights painful conditions involving the eyes that are encountered in practice, emphasizing those that do not have obvious findings on the neurologic examination.

Recent Findings: Peripheral and central sensitization are associated with chronic neuropathic ocular pain, and hyperalgesia is associated with dry eyes. The aorta and its branches are involved in 25% of patients with giant cell arteritis.

Summary: Eye pain is a common concern and one of the most difficult symptoms for the clinician to evaluate. Eye pain may be a manifestation of a primary headache disorder, as is common in migraine, the trigeminal autonomic cephalalgias, and primary stabbing headache. Secondary headache disorders, such as posterior communicating artery aneurysm, Tolosa-Hunt syndrome, and microvascular ocular motor neuropathies, frequently produce eye pain. Ophthalmic conditions producing eye pain include orbital masses, angle-closure glaucoma, intraocular inflammation, and ocular surface (corneal) disease. Of these, corneal problems are the most commonly encountered.

Address correspondence to Dr Deborah I. Friedman, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, MC 9322, Dallas, TX 75390, deborah.friedman@utsouthwestern.edu.

Relationship Disclosure: Dr Friedman has served as a consultant and received personal compensation for the development of educational presentations from Avanir Pharmaceuticals, Inc. Dr Friedman serves on the board of directors of the American Headache Society, provides expert legal testimony regarding pseudotumor cerebri syndrome for several law firms, and receives personal compensation for speaking engagements from Allergan, Inc and Teva Pharmaceutical Industries Ltd. Dr Friedman receives research support from Autonomic Technologies, Inc; electroCore Medical, LLC; Eli Lilly and Company; and Merck & Co, Inc.

Unlabeled Use of Products/Investigational Use Disclosure: Dr Friedman reports no disclosure.

© 2015 American Academy of Neurology
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