[23F] With migraine, swollen eyes, eye pain, and fatigue

Patient Description

A 23-year-old female reports experiencing a sudden onset of a migraine this morning, described as all-around head pain rated at 6/10 in severity. The migraine is exacerbated by physical activity and alleviated by rest. Additionally, the patient reports swollen eyes, eye pain, and fatigue. The patient has no prior history of frequent migraines and is currently trying to conceive.

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Arora's Assessment

What might be happening

Based on the symptoms you have described—eye pain, swollen eyes, fatigue, and migraines—here are some possible explanations:

  • Migraine: Migraines are a type of headache that can cause severe pain, often accompanied by nausea, vomiting, and sensitivity to light and sound. They can also cause eye pain and swelling due to the pressure and inflammation associated with the headache.

    • Treatment: Common treatments include over-the-counter pain relievers like ibuprofen or acetaminophen, prescription medications specifically for migraines, and lifestyle changes to avoid known triggers.
  • Sinusitis: Inflammation or infection of the sinuses can cause headaches, eye pain, and swelling around the eyes. Fatigue is also a common symptom.

    • Treatment: Treatment may include decongestants, saline nasal sprays, and sometimes antibiotics if a bacterial infection is suspected.
  • Allergic Reaction: Allergies can cause eye swelling, pain, and fatigue. Migraines can sometimes be triggered by allergic reactions.

    • Treatment: Antihistamines, avoiding known allergens, and using eye drops can help manage symptoms.
  • Eye Strain: Prolonged use of screens or reading can cause eye strain, leading to eye pain and headaches. Fatigue can also result from eye strain.

    • Treatment: Taking regular breaks from screens, using proper lighting, and possibly using computer glasses can help alleviate symptoms.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment plan, here are some steps you can take to manage your symptoms:

  1. Rest: Since rest seems to help, make sure to get plenty of it. Try to rest in a dark, quiet room to alleviate migraine symptoms.
  2. Hydration: Drink plenty of water, as dehydration can worsen headaches and fatigue.
  3. Over-the-Counter Medications: Consider taking over-the-counter pain relievers like ibuprofen or acetaminophen to help manage the pain.
  4. Cold Compress: Applying a cold compress to your eyes can help reduce swelling and pain.
  5. Avoid Triggers: If you can identify any triggers for your migraines or eye pain, try to avoid them. Common triggers include stress, certain foods, and lack of sleep.
  6. Use MDandMe: You can use MDandMe to journal your symptoms, track your progress, get insights, and share longitudinal medical notes with your healthcare provider.

What you should look out for

Seek medical attention if you experience any of the following:

  • Severe or worsening symptoms: If your migraine or eye pain becomes unbearable or significantly worse.
  • Vision changes: If you experience sudden changes in your vision, such as blurred vision, double vision, or loss of vision.
  • Neurological symptoms: If you experience symptoms like confusion, difficulty speaking, or weakness on one side of your body.
  • Persistent symptoms: If your symptoms do not improve with rest and over-the-counter treatments.

Remember, while I can provide information and suggestions, it's important to consult a healthcare professional for a formal diagnosis and treatment plan.

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4 mo ago

People Also Ask


What are common triggers for migraines and how can they be avoided?

Common triggers for migraines include stress, certain foods (like chocolate, cheese, and processed meats), caffeine, alcohol, hormonal changes, and lack of sleep. To avoid them, try to maintain a regular sleep schedule, manage stress through relaxation techniques, and keep a food diary to identify and avoid dietary triggers.


How can I differentiate between a migraine and sinusitis?

Migraines typically present with throbbing head pain, sensitivity to light and sound, and sometimes nausea, while sinusitis often includes facial pain, pressure, nasal congestion, and a runny nose. A healthcare provider can help differentiate between the two based on symptoms and possibly imaging tests.


What are some effective home remedies for reducing eye swelling and pain?

Effective home remedies for reducing eye swelling and pain include applying a cold compress, using over-the-counter antihistamine eye drops if allergies are suspected, and ensuring adequate rest. Staying hydrated and avoiding eye strain from screens can also help.


Can trying to conceive affect the frequency or severity of migraines?

Hormonal changes associated with trying to conceive can potentially affect the frequency or severity of migraines. It's important to discuss any changes in migraine patterns with a healthcare provider, especially when planning a pregnancy.


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