Pain In The Quiet Eye
DAVID C. FIORE, MD, University of Nevada School of Medicine, Reno, Nevada
ANDREW V. PASTERNAK, MD, Silver Sage Center for Family Medicine, Reno, Nevada
RABAB M. RADWAN, MD, Mercy Medical Center Family Medicine Residency Program, Redding, California
Am Fam Physician. 2010 Jul 1 82:69-73.
Although eye pain is often accompanied by redness or injection, pain can also occur with a quiet eye. Pain in a quiet eye can be the first sign of a vision-threatening condition, a more benign ophthalmologic condition, or a nonophthalmologic condition. Acute narrow-angle glaucoma is an emergent vision-threatening condition that requires immediate treatment and referral to an ophthalmologist. Although most nonophthalmologic conditions that cause eye pain do not need immediate treatment, giant cell arteritis requires urgent treatment with corticosteroids. Other vascular conditions, such as carotid artery disease, thrombosis of the cavernous sinus, and transient ischemic attack or stroke, rarely cause eye pain but must be considered. Pain may also be referred from the sinuses or from neurologic conditions, such as trigeminal neuralgia, migraine and cluster headaches, and increased intracranial pressure. The differential diagnosis of eye pain in the quiet eye is extensive, necessitating a systematic and thorough approach.
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Your Sinuses And Infections
Youve got four air-filled cavities in your head, behind your cheekbones, forehead, and near your eyes. These serve as warming filters for the air you breathe, and they also produce mucus, used to naturally clean your nose under normal conditions.
When your sinuses are affected by infection, these normally empty spaces become filled with fluid. This congestion causes the throbbing pressure sensations you associate with having a cold. Its hard to breathe, your face can feel tender, and you may have a near-constant headache.
Your ears may be plugged, making it hard to hear and throwing your balance off. Your sense of smell may change, and the sound of your voice is different. Youre achy and tired, and you could be running a fever.
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How Sinuses Affect The Eyes
Our faces are full of individual parts that make a whole, and, much like a puzzle, they are all connected to each other in one way or another. Some may notice if they feel a sinus infection, an earache or even a sore throat that it is often accompanied by a symptom in another part of the facial region. One of the main culprits for feeling this way is the sinuses. The sinuses are located all throughout the face in the cheeks, near the ear, behind the eye, and in the forehead and nose. Problems in the sinuses can cause facial pressure, feeling of fluid or fullness in the ears, and even eye pain.
Since sinuses are located behind the eye and near the inner corners of the eyes it is possible that eyes can be affected by infections in the sinuses. When the sinuses get infected and full, the body naturally tries to flush the infection and get it out of the sinuses. Along with this, the proper flow of mucus is blocked, causing feelings of pressure and pain where the sinuses are found. The pressure behind the eyes is a good indication of a sinus infection. In some cases, an infection of the sinus can spread to the eye.
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Eye Pressure From Sinus Infection
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What Is An Eye Pressure And Its Symptoms
Eye pressure is something that causes the eyes to go abnormally red and is visible in the first diagnosis.
It is caused by the hypertensive eye pressure which is due to numerous medical conditions.
It also increases the risk factors for glaucoma which is an eye disease related to the high-eye pressure and can lead to blindness or partial loss of vision.
Some of the most common symptoms of the eye pressure include:
All of these symptoms are far different from the sinus eye pain and can be treated as per the medical suggestions.
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Treatment For Optic Neuritis
If you find yourself experiencing any of those symptoms, you should schedule an eye exam for a possible diagnosis. While it may sound serious, optic neuritis often improves on its own.
Commonly, steroid medications are prescribed to reduce nerve inflammation. If the condition isnt improved after this treatment, then plasma exchange therapy is sometimes used to help recover vision. This treatment hasnt been proven effective, but it has been shown to help in some cases.
Treatment Of Cavernous Sinus Thrombosis
Antibiotics by vein
Surgery to drain infection
Corticosteroids and other supplemental hormones
High doses of antibiotics given by vein are started immediately in people with cavernous sinus thrombosis. The infected nasal sinus may be drained surgically, particularly if the person does not improve after 24 hours of antibiotic treatment. Corticosteroids are sometimes given if the cranial nerves are affected. Corticosteroids and usually other supplemental hormones are given if there is hypopituitarism.
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Potential Causes Of Pressure Or Pain Behind The Eyes
Eye pressure and eye pain go together in many conditions, but they are different sensations. Pressure will feel like something is pushing on your eye from the back. In contrast, pain can be described as gritty, dull, a shooting sensation, or feeling like something is stuck in your eye.
There are many common causes of pressure or pain behind the eyes.
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- Sinus pain lasts more than 24 hours, after using nasal washes
- Thick yellow or green pus draining from nose and not improved by nasal washes. Exception: yellow or green tinged secretions are normal.
- Sinus congestion and fullness lasts more than 14 days
- Nasal discharge lasts more than 2 weeks
- You have other questions or concerns
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So You Might Have Epiphora How Can We Help
Since there are so many possible causes of epiphora, each patient requires a personalized treatment plan. Inammation and irritation can be treated using antibiotic drops. Rinsing your eye and using a warm compress can also help reduce irritation. To x tear duct obstructions, an endoscopic procedure is typically necessary.
The key to nally put an end to excessive eye tearing is a personalized treatment plan. The severity and cause of epiphora determines which course of treatment is best for you. At Houston Advanced Nose & Sinus, we promote personalized treatment plans. Our rhinologist, Dr. Kuperan, is fellowship trained in performing endoscopic procedures and providing relief to all patients so they can start living their best life again. If you suffer from epiphora, then feel free to contact us for a consultation today at 832-720-6673.
Pressure Or Pain Behind The Eyes: A Symptom Indicating Several Problems
Many people experience eye pain or pressure at some point because of an infection, headache, allergies, or a similar cause. Often, temporary pain does not mean anything serious.
If you experience frequent or constant pressure or pain behind your eyes, there may be a bigger health issue. Visiting an optometrist or ophthalmologist can help, but you may also need to see a physician or a specialist to determine the underlying cause.
Eye strain is a common problem in the modern world. This is because more workers than ever before use computers and other screens. Chronic and untreated allergies, viruses and bacteria, corneal damage, inflammation of various parts of the eye, and even tumors can be underlying causes of pain or pressure behind the eyes, which need different approaches to treatment.
Reviewing information on symptoms and treatments can help you understand a little of what is happening with your eyes, but it is best to work with medical professionals if you are concerned.
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When To See A Doctor For Neck Pain
According to the American Academy of Orthopedic Surgeons, you should seek medical care if your neck pain is:
- accompanied by pain that radiates down your legs or arms
- accompanied by headaches, tingling, numbness, or weakness
In general, its a good idea to see a doctor if youre worried about your neck pain, or if the pain is affecting your quality of life.
How Are Sinus Headaches Diagnosed
Most of the time when people diagnose themselves with a sinus headache, its really a migraine. So, its important to see your healthcare provider to get an accurate diagnosis and appropriate treatment.
Your healthcare provider will perform a physical exam and ask about your symptoms. If your symptoms are severe or ongoing, you may also need imaging tests. A magnetic resonance imaging test can rule out serious brain conditions. Multiple imaging tests can reveal sinus blockages and include:
- Nasal endoscopy .
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Is Digital Imaging Necessary For Sinus Infection Diagnosis
In most cases, the examination and conversation with a doctor are sufficient to diagnose the infection and put together a treatment plan. For cases of acute sinus infection, it usually isnt necessary to have digital imaging.
But if the infections are recurring, the ENT will want to see what is happening with the structure within your sinuses. In this situation, you will likely need to have a digital scan, such as sinus x-rays or computerized tomography .
Primary care physicians can provide basic diagnostics and treatments for sinus infections. Patients are usually referred to an ENT for help with chronic or recurring sinus infections. If you need fluid samples for a lab culture, an endoscopy, or digital imaging, then our team of ENT specialists can offer these services in our office.
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Treatments Your Physician May Prescribe
If appropriate, your doctor may prescribe over-the-counter medications described above. Decongestants can be particularly helpful in sinus headache.For more difficult allergies, medications that decrease secretion formation may be prescribed. Steroid nasal sprays can also be used effectively. For severe allergies, your doctor may refer you to an allergy specialist for other desensitizing therapies.Your doctor may order a CT or MRI scan of the sinuses to determine the extent of a bacterial infection, if present. If your doctor suspects a bacterial infection, he/she may prescribe antibiotics. Many sinus infections are caused by viruses that the body can effectively eliminate with time, which do not require antibiotics. Different agents designed to kill fungus or other organisms may be prescribed depending on your medical history. Additionally, some of the fluids draining from you sinus may be taken to identify the infection.Other headache syndromes, such as migraine or cluster headache, can mimic sinus headache. Your doctor will discuss these possibilities and advise you accordingly.
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How Are Dry Sinuses Diagnosed
Diagnosing dry sinuses is fairly easy. Doctors are quickly able to notice irritation with a minor examination, and the symptoms you describe will say a lot about your condition. However, the more difficult diagnosis is often finding the underlying cause of your dry nasal passages. Symptoms can be a helpful clue to determine the source of your issues.
To diagnose allergies as the source of your dryness issues, doctors will perform a simple allergy test either in the office or from the comfort of your home. The allergy test will bring to light exactly what you are allergic to, and how severely, allowing you to either avoid these allergens or find the best form of relief with help from an ENT specialist.
To diagnose other sinus or nasal issues such as deviated septum, nasal polyps, doctors may complete an endoscopy, where the nasal and sinus cavities are inspected using a long skinny tube with a light or camera attached to the end.
Diagnosing Sjögren syndrome can take more time, but doctors will once again begin with assessing your symptoms. A Salivary flow or blood test may be conducted to determine if you have the antibodies that typically indicate this condition.
Chemical And Environmental Irritants
Many chemicals and products for cleaning, home repair, and more can irritate your nasal passages and sinuses. This can cause you to have dry sinuses, sore throat, dry nose, nosebleeds, or other symptoms similar to allergies. Some chemicals and products that can irritate your sinuses include:
- household cleaning products
- industrial irritants
- paint or varnish fumes
There are many ways you can treat dry sinuses at home to alleviate discomfort caused by seasonal allergies, irritation from chemicals, or drying from medications or dry air. To get relief, you can:
- place a humidifier in your bedroom at night to keep the air from getting too dry
- stop taking drying medications, such as antihistamines
- drink plenty of water to stay hydrated
- get some fresh air if the air in your house is stale or stagnant
- remove as many allergens and irritants from your environment as possible
- irrigate your sinuses with sterile saline using a neti pot or similar product
- use nasal spray to hydrate and lubricate your nasal passages and sinuses
- take a hot shower and inhale the steam
In some cases, your doctor might need to recommend treatment for your dry sinuses. Make an appointment with your doctor if you:
- have an autoimmune disorder like Sjögren syndrome
- are taking prescription medication that causes dry sinuses
- think you might have a sinus infection
Your doctor may:
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How Long Does A Sinus Infection Last
There are a couple of primary forms of sinus infections or sinusitis acute and chronic.
Chronic sinusitis is ongoing and might seem as if itâs improving, but then it recurs with symptoms that can be just as bad as they were initially. Chronic sinusitis can last for months. Both acute and chronic sinusitis can be bacterial or viral.
From a clinical standpoint, itâs important to distinguish between âsinogenicâ and ânon-sinogenicâ facial pain to avoid the wrong treatment.
Warning Signs And Symptoms Of A Dangerous Sinus Infection
Sinusitis describes inflammation of one or more of the paranasal sinuses, the air-filled spaces in the facial bones that open into the nasal cavity. This condition often occurs because of infection. Although infectious sinusitis is certainly uncomfortable, it usually does not pose a serious health threat. However, rare complications of infectious sinusitis can be dangerous and potentially life threatening if not diagnosed and treated promptly. These complications involve spread of the infection to the structures around the eye, the facial bones and/or the nervous system. Although rare, itâs important watch for warning signs and symptoms that might signal a potentially serious infectious sinusitis complication.
If you are experiencing serious medical symptoms, seek emergency treatment immediately.
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What Helps Tooth Pain Caused By Sinus Infection
The key to completely resolving tooth pain from sinus infection is to clear up the sinus infection. Once the inflammation of your maxillary sinuses goes down, the pressure on the nerves to the maxillary teeth should subside as well, ending the sinus-related toothache. In the meantime, pain relief measures used to manage the pressure from your sinus infection may also help with the discomfort, including the use of:
- Over-the-counter pain relief medications,
- Nasal sprays, and
- Over-the-counter decongestants.
If your sinus infection is actually caused by a dental issue, only resolving the dental issue will resolve your sinus pain and toothache long-term.
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Sleeping Pills Antidepressants & Parkinsons Medication
While sleeping pills, antidepressants, and Parkinsons medication might not seem like they have a lot in common, they all work by blocking signals between nerve cells. This can be helpful in treating insomnia, depression, anxiety, and neurological conditions like Parkinsons.
However, these types of medications can also block the signals that tell your eyes its time to produce more tears. If you are experiencing dry eye as a side effect of a medication, you can talk to your doctor about adjusting your dose. Your optometrist may also be able to recommend a dry eye therapy option like medicated eye drops to provide you with relief.
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How To Do A Nasal Rinse
Nasal saline rinses are a good way to treat discomfort and congestion. They can help flush out mucus, debris, and irritants, and soothe nasal passages.
A neti pot can be used to do this. You fill a pot with a saline rinse that you can buy.
- Place the spout of the pot against one nostril.
- Tilt your head to the side.
- The saline will pour out of the lower nostrilthanks to gravity.
- Repeat steps with the other nostril.
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How Can I Tell If I Have A Sinus Infection Cold Or Nasal Allergy
It can be difficult to tell the difference between a cold, allergies, and a sinus infection. The common cold typically builds, peaks, and slowly disappears. It lasts a few days to a week. A cold can transform into a sinus infection. Nasal allergy is inflammation of the nose due to irritating particles . Symptoms of a nasal allergy can include sneezing, itchy nose and eyes, congestion, runny nose, and post nasal drip . Sinusitis and allergy symptoms can happen at the same time as a common cold.
If you are fighting off a cold and develop symptoms of a sinus infection or nasal allergy, see your healthcare provider. You will be asked to describe your symptoms and medical history.
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