[67F] Experiencing severe headache and burning eyes

Patient Description

A 67-year-old female presents with a severe headache, rated 9 out of 10 in severity, that has been ongoing for 12 hours. The headache is exacerbated by light and looking down, with some relief from applying ice. She experiences these headaches nightly but notes that today's headache is more intense than usual. Additionally, she reports a moderate to severe burning sensation in her eyes for the past two days, akin to a sensation of severe lack of sleep. The patient also describes feeling weak and tired, with dull body aches in her shoulders, back, and neck since this morning, rated 7 out of 10 in severity. Her medical history includes neck, back, and lower back disk bulging, fibromyalgia, dry eyes, and mouth. She is currently on multiple medications, including Ambien, baclofen, omeprazole, Lyrica, Cymbalta, Mirapex, a diuretic (Lasix), potassium, allopurinol, and Percocet. She recently reduced her Lyrica dose from two pills to one, which initially caused nausea and a 'weird' feeling, but no current issues since taking an extra pill last week.

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Arora's Assessment

What might be happening

Based on your symptoms, there could be a few things going on:

  • Migraine: This is a type of headache characterized by severe pain, often on one side of the head, and can be accompanied by other symptoms like sensitivity to light, nausea, and vomiting. Your description of a severe headache that worsens with light and looking down, along with your history of nightly headaches, could suggest this. Migraines can be triggered by various factors, including stress, certain foods, and changes in sleep pattern.

    • Treatment typically involves pain relief medication and lifestyle modifications to avoid triggers. In some cases, preventive medications may be prescribed.
  • Dry Eye Syndrome: This condition, which you've been previously diagnosed with, can cause a burning sensation in the eyes, as well as other symptoms like redness, a gritty feeling, and blurred vision. It's possible that your current eye symptoms are related to this condition.

    • Treatment usually involves artificial tears, lifestyle changes, and addressing any underlying conditions that may be causing the dry eyes.
  • Fibromyalgia: This is a chronic condition characterized by widespread pain and tenderness, often accompanied by fatigue, sleep problems, and mood issues. Your description of dull body aches in your shoulders, back, and neck could be related to this condition, which you've been previously diagnosed with.

    • Treatment typically involves a combination of medication, exercise, stress management, and healthy lifestyle habits.
  • Medication side effects: Some of the medications you're taking, such as Lyrica and Cymbalta, can cause side effects like dizziness, sleepiness, and fatigue. It's possible that some of your symptoms could be related to these medications.

What you can do

  1. Maintain a headache diary: This can help you identify any patterns or triggers associated with your headaches, which can be useful information for your doctor.
  2. Stay hydrated and maintain a healthy diet: This can help manage your symptoms and overall health.
  3. Regular exercise: This can help reduce stress and improve your overall well-being, which can in turn help manage your fibromyalgia symptoms.
  4. Regular eye care: Use artificial tears as needed for your dry eyes, and consider wearing sunglasses outdoors to protect your eyes from wind and sun.
  5. Regular sleep: Try to maintain a regular sleep schedule, as changes in sleep can trigger migraines and worsen fibromyalgia symptoms.
  6. Consult your doctor: Given the severity of your headache and the fact that it's worse than your usual headaches, it would be a good idea to consult your doctor. They can review your symptoms, consider whether any changes to your medication regimen might be helpful, and possibly refer you to a specialist if needed.

What you should look out for

Seek immediate medical attention if you experience any of the following:

  • A sudden, severe headache that's different from your usual headaches
  • A headache accompanied by a stiff neck, fever, confusion, seizure, double vision, weakness, numbness, or trouble speaking
  • A headache that worsens after coughing, exertion, straining, or a sudden movement
  • Any new or worsening symptoms

Remember, while I strive to provide accurate and helpful information, I'm not a doctor. Always consult with a healthcare professional for a formal diagnosis and treatment.

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10 mo ago

People Also Ask


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

Common triggers for migraines include stress, certain foods (like aged cheese and processed meats), caffeine, alcohol, changes in sleep patterns, and hormonal changes. Managing migraines often involves identifying and avoiding these triggers, using pain relief medications, and sometimes taking preventive medications prescribed by a doctor.


How can dry eye syndrome be effectively treated and managed?

Dry eye syndrome can be managed by using artificial tears to lubricate the eyes, making lifestyle changes such as reducing screen time, and addressing any underlying health conditions. Wearing sunglasses outdoors can also help protect the eyes from wind and sun.


What are the typical symptoms of fibromyalgia and how can they be alleviated?

Fibromyalgia is characterized by widespread pain, fatigue, sleep disturbances, and sometimes mood issues. Alleviating symptoms often involves a combination of medication, regular exercise, stress management techniques, and maintaining a healthy lifestyle.


What are potential side effects of medications like Lyrica and Cymbalta?

Lyrica and Cymbalta can cause side effects such as dizziness, sleepiness, fatigue, dry mouth, and sometimes nausea. It's important to discuss any side effects with a healthcare provider, as they may need to adjust the dosage or switch medications.


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