Understanding Headaches
Headache is one of the most common complaints brought to the ophthalmologist. Most headaches are not serious, and are commonly related to tension.
Unfortunately, many people incorrectly believe that eyestrain and the need for glasses are very common causes of headaches.
Almost all headaches can be divided into three groups; muscle contraction, migraine and diseases of the head, eyes, and ears. The most frequent type are muscle contraction headaches. The pain, which results from the pulling of muscles in the neck and at the base of the head, is usually not felt locally where the muscles are contracting. Instead, it frequently is "referred" to and felt in areas such as the forehead or the temples or the eye sockets. This can mislead the patient (and sometimes the doctor) as to the source of the headache. Muscle contraction headaches can result from stress at work or at home. They may be a result of sleeping or working in a strange position, or of an unusually long period of close-up work. Usually, these headaches are quickly relieved with over-the-counter pain relievers. Headaches caused by eye strain may feel like muscle contraction headaches, but are clearly related to extended use of the eyes.
Migraine headaches are the next most common cause of headache. This type of headache pain is caused by stretching of the blood vessel walls in the head. Migraine headaches tend to run in families and affect about one person in ten. It can produce different symptoms in different people. In some, several very brief, severe headaches may occur close together. In others, a visual display of moving jagged lines may be followed by a severe headache. Still others may see the visual display without headache, and some may have a severe headache without other symptoms. However, there are some common features of migraine headache. The pain tends not to be continuous and is often more severe on one side of the head. It may be associated with nausea and vomiting, but rarely with more serious complications. Migraine may occur with a sudden increase or decrease in stress level and can be closely associated with one's diet. Red wine, cheese and chocolate can trigger migraines.
Diseases are the least common cause of headache. Headaches caused by eye disease are usually felt within the eye or in the brow on the side where the disease occurs. Frequently these headaches are associated with some other symptom, such as blurred vision, haloes around lights, or extreme sensitivity to light. Headaches may be caused by disease of the ears, sinuses, teeth, jaw joints, or facial nerves. High blood pressure can rarely induce a headache. Headache caused by a brain tumor is, fortunately, quite uncommon. However, tumors may cause a sudden onset of pain with an increasingly severe headache pattern over several weeks or months. The intensity of the headache may change depending on body position, sometimes becoming unusually severe when the head is down. It is often associated with other symptoms such as numbness, dizziness, weakness, or seizures. Most of all, such headaches tend to become dramatically worse with the passage of time.
Because headache is such a common problem, a thorough medical examination is advisable for any chronic or recurring headache. Your family physician can help determine the cause of headache. Because headaches often produce symptoms which suggest that the eyes are at fault, many people ultimately have their eyes examined. Your ophthalmologist is prepared to detect and diagnose an eye or medical disease, a need for glasses, or other causes of your headache.
The treatment of headache determined by its cause. If serious medical disease is found, it needs to be treated medically (or surgically). If migraine or tension is responsible, accurate diagnosis, reassurance, and your physician's suggestions for medication, self-help, and assistance are the best solutions.
