Are your eyes the cause of your headaches?

It’s all in the eyes, according to the cliché. However, when it comes to headaches and migraines, this is rarely true.
While poor vision or an incorrect eye prescription might lead to eye strain and pain around the eyes that feels like a headache, eye issues are not usually the cause of headaches. In fact, migraines — a neurological condition that can cause intense headaches — can be the cause of eye discomfort, as they often lead to sensitivity to light.
According to Dr. Arvind Saini, an ophthalmologist affiliated with Sharp Community Medical Group, when someone has sudden onset headaches or worsening headaches, an exam to rule out other causes of the pain is important. There are life-threatening conditions that need to be considered first, such as bleeding in the brain, new tumors and aneurysms. However, in his entire career, he has seen very few instances where the eyes are a cause of chronic headaches.
“Most eye inflammation and sudden eye problems are identified as ‘eye pain’ by patients,” Dr. Saini says. “Where it gets confusing is in headache syndromes and medical conditions where there can be light sensitivity (also known as photophobia), visual disturbances or pain around the eye.”
Some examples of such conditions:

• Classic migraine headaches are usually preceded by a visual distortion called an aura that lasts for 30 minutes or so. When the headache arrives, there can be light sensitivity associated with it.

• Headache syndromes, such as tension headaches and cluster headaches, can also cause light sensitivity.

• Eye strain from glasses with the wrong lens power will usually be simply felt by the patient as blurry vision and not a headache. The one exception may be with kids, teenagers and young adults who can be accidentally fit with glasses that are too strong, often called “over-minused.”

• Sinus congestion can also be felt by many patients as pain around the eye.

“If there is a common eye problem that is sometimes confused with headaches, it would be ocular surface disease,” Dr. Saini says. “This is because it can lead to nonspecific irritation, strain and pain around the eyes. Two common conditions are dry eye disease and eyelid inflammation, or blepharitis.”
Surprisingly, most glaucoma syndromes with elevated pressure do not lead to a “pressure feeling” — with the exception of acute angle closure glaucoma — which is why regular screenings by an ophthalmologist are so important. The American Academy of Ophthalmology recommends that everyone over 65 have an eye exam every one to two years to screen for eye diseases that can be associated with aging, such as cataracts, glaucoma, macular degeneration, ocular tumors and other eye conditions.
If you do not have any blurry vision and are under 40, Dr. Saini recommends you have an eye exam every five years or so. Patients who have certain diseases, such as diabetes, need an annual exam regardless of age. And anyone with a family history of vision loss from retinal detachments, glaucoma or macular degeneration should see an ophthalmologist regularly.
“Most people do start to have changes in their visual system and need to be examined when they are in their 40s, due to the need for reading glasses,” Dr. Saini says. “Of course, you should always see an ophthalmologist if you have any sudden change in vision, pain or new eye redness.”

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