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The Most Common Causes of Eye Pain at 2 Tertiary Ophthalmology and Neurology Clinics

Bowen, Randy C., MD, MS; Koeppel, Jan N., MD; Christensen, Chance D., BS; Snow, Karisa B., PharmD; Ma, Junjie, MS; Katz, Bradley J., MD, PhD; Krauss, Howard R., MD; Landau, Klara, MD; Warner, Judith E. A., MD; Crum, Alison V., MD; Straumann, Dominik, MD; Digre, Kathleen B., MD

doi: 10.1097/WNO.0000000000000601
Original Contribution

Background: Eye pain is a common complaint, but no previous studies have determined the most common causes of this presenting symptom. Our objective was to determine the most common causes of eye pain in 2 ophthalmology and neurology departments at academic medical centers.

Methods: This was a retrospective cross-sectional analysis and chart review at the departments of ophthalmology and neurology at the University Hospital Zurich (USZ), University of Zürich, Switzerland, and the University of Utah (UU), USA. Data were analyzed from January 2012 to December 2013. We included patients aged 18 years or older presenting with eye pain as a major complaint.

Results: Two thousand six hundred three patient charts met inclusion criteria; 742 were included from USZ and 1,861 were included from UU. Of these, 2,407 had been seen in an ophthalmology clinic and 196 had been seen in a neurology clinic. Inflammatory eye disease (conjunctivitis, blepharitis, keratitis, uveitis, dry eye, chalazion, and scleritis) was the underlying cause of eye pain in 1,801 (69.1%) of all patients analyzed. Although only 71 (3%) of 2,407 patients had migraine diagnosed in an ophthalmology clinic as the cause of eye pain, migraine was the predominant cause of eye pain in the neurology clinics (100/196; 51%). Other causes of eye pain in the neurology clinics included optic neuritis (44 patients), trigeminal neuralgia, and other cranial nerve disorders (8 patients).

Conclusions: Eye pain may be associated with a number of different causes, some benign and others sight- or life-threatening. Because patients with eye pain may present to either a neurology or an ophthalmology clinic and because the causes of eye pain may be primarily ophthalmic or neurologic, the diagnosis and management of these patients often requires collaboration and consultation between the 2 specialties.

Department of Ophthalmology and Visual Sciences (RCB, CC, KBS, BJK, JEAW, AVC, KBD), John A Moran Eye Center, Salt Lake City, Utah; Department of Neurology (RCB, CC, KBS, BJK, JEAW, AVC, KBD), University of Utah Health Sciences Center, Salt Lake City, Utah; Departments of Ophthalmology and Neurology (JK, KL, DS), University Hospital Zurich, University of Zurich, Zurich, Switzerland; Department of Ophthalmology and Neurosurgery (HK), University of California at Los Angeles, Los Angeles, California; and Department of Pharmacotherapy (JM), College of Pharmacy, University of Utah, Salt Lake City, Utah.

Address correspondence to Kathleen B. Digre, MD, Johan A Moran Eye Center, University of Utah Health Sciences Center, 65 N Mario Capecchi Drive, Salt Lake City, UT 84132; E-mail:

This investigation was supported by an unrestricted grant from Research to Prevent Blindness, Inc., New York, NY, to the Department of Ophthalmology & Visual Sciences, University of Utah.

Presented at the Annual Meeting of the North American Neuro-Ophthalmology Society, March 1, 2016, Tucson, AZ; Annual Scientific Meeting of the American Headache Society, June 11, 2016, San Diego, CA.

The authors report no conflicts of interest.

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R. C. Bowen and J. Koeppel contributed equally to the manuscript and should both be recognized as first authors.

© 2018 by North American Neuro-Ophthalmology Society