[20F] With severe eye pain and blurred vision

Patient Description

A 20-year-old female reports experiencing severe eye pain affecting her temple and behind her right eye for the past couple of weeks. The pain lasts for over 30 minutes and, while it subsides, leaves an ache behind the eye when opened. The patient has a habit of using her phone at night, holding it very close to her face, which she suspects might be causing eye strain. Additionally, the patient has blurred vision from a distance. The pain episodes are severe enough to cause sweating and vomiting if she moves around too much. There is no history of recent head or eye injuries, but the patient mentions that her dog used to accidentally lick her eye frequently, which she would wash out.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Cluster Headaches:

    • Rationale: Cluster headaches are known for causing severe pain around one eye, often accompanied by sweating, nausea, and vomiting. The pain can last from 15 minutes to 3 hours and may leave a lingering ache.
    • Typical Treatments: Treatment often includes medications to relieve pain and prevent future attacks, such as triptans, oxygen therapy, and preventive medications like verapamil.
  2. Eye Strain (Digital Eye Strain):

    • Rationale: Prolonged use of digital devices, especially at close range, can cause eye strain, leading to pain around the eyes and temples, and sometimes blurred vision.
    • Typical Treatments: Reducing screen time, taking regular breaks (20-20-20 rule: every 20 minutes, look at something 20 feet away for at least 20 seconds), and using proper lighting can help alleviate symptoms.
  3. Sinusitis:

    • Rationale: Inflammation of the sinuses can cause pain around the eyes and temples, along with other symptoms like nasal congestion and pressure.
    • Typical Treatments: Treatments may include decongestants, nasal corticosteroids, saline nasal irrigation, and in some cases, antibiotics.

What you can do

Severe Eye Pain and Headaches:

  • Cluster Headaches:

    • Seek medical attention as soon as possible to get a proper diagnosis and treatment plan.
    • In the meantime, try to stay in a dark, quiet room and apply a cold compress to the affected area.
    • Avoid alcohol and smoking, as these can trigger cluster headaches.
  • Eye Strain:

    • Reduce screen time and take regular breaks using the 20-20-20 rule.
    • Ensure your screen is at eye level and at a comfortable distance.
    • Use artificial tears to keep your eyes moist if they feel dry.

Blurred Vision:

  • Schedule an eye exam with an optometrist or ophthalmologist to rule out any underlying vision problems or eye conditions.

General Tips:

  • Keep a symptom journal using MDandMe to track your pain episodes, triggers, and any other symptoms. This can help your healthcare provider make a more accurate diagnosis.
  • Stay hydrated and maintain a balanced diet to support overall health.

What you should look out for

Given the severity of your symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Sudden, severe vision loss or changes in vision.
  • Persistent or worsening pain despite home remedies.
  • Any signs of infection, such as redness, swelling, or discharge from the eye.
  • Neurological symptoms like weakness, numbness, or difficulty speaking.

Remember, while I can provide information and suggestions, it's crucial to consult with a healthcare professional for a formal diagnosis and appropriate treatment. If you have more questions or need further assistance, feel free to continue the conversation.

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6 mo ago

People Also Ask


What are the common symptoms of cluster headaches?

Common symptoms of cluster headaches include severe pain around one eye, which can be accompanied by redness, tearing, nasal congestion, sweating, nausea, and vomiting. The pain typically occurs in cycles or clusters, lasting from 15 minutes to 3 hours.


How can digital eye strain be prevented or alleviated?

To prevent or alleviate digital eye strain, reduce screen time, take regular breaks using the 20-20-20 rule (every 20 minutes, look at something 20 feet away for at least 20 seconds), ensure your screen is at eye level and at a comfortable distance, and use proper lighting. Artificial tears can also help if your eyes feel dry.


What are the signs that sinusitis might be causing my eye pain?

Signs that sinusitis might be causing your eye pain include nasal congestion, facial pressure or pain, reduced sense of smell, and thick nasal discharge. If these symptoms accompany your eye pain, sinusitis could be a contributing factor.


When should I seek medical attention for severe eye pain and headaches?

You should seek medical attention for severe eye pain and headaches if you experience sudden, severe vision loss or changes, persistent or worsening pain despite home remedies, signs of infection like redness or discharge, or neurological symptoms such as weakness or difficulty speaking.


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