Nothing is worse than having a headache, whether it lasts for a few hours or days. Headaches can be debilitating and can make daily tasks more difficult. Headaches are one of the most frequent reasons patients visit my office second only to blurry vision. While patient's often think their headaches are completely unrelated to their eyes, the opposite is actually true.
Headaches can be due to several conditions both ocular and systemic. Some of these conditions require nominal changes like new glasses or better lighting at work, while others are medical emergencies and require immediate care and treatment. Below is a list of the 5 most common causes of headaches seen in my practice and what I do to treat them.
1.) Refractive Error: This is particularly true when uncorrected hyperopia, astigmatism or early presbyopia is present. In all of these conditions, your accommodative system (i.e. focusing system) is working extra hard throughout the day to help you see clearly. By the end of the day your eyes become tired and fatigued, leading to "heavy feeling eyes", headaches and/or blurry vision. This strain will be even more apparent for those who are avid readers or computer users. Patient's will often express they have to blink a few times to help refocus their eyes. Similarly, a prescription that is stronger than needed will also cause headaches and asthenopia. Anytime I suspect headaches are from an incorrect refractive error, a dilated eye exam is necessary and new glasses are prescribed.
2.) Digital Eye Strain: With the significant increase in daily computer use, headaches can often result from improper lightening, poor office ergonomics, and/or incorrect computer prescription. I am a firm believer in using customized digital computer glasses, especially if you are using the computer more than a few hours a day. Incorrect eyeglass designs may cause you to have to excessively tip your head upward to see the computer which will lead to neck pain and headaches. Also the blue light emitted from digital devices has also been shown to aide in ocular strain. Customized computer glasses will incorporate blue light technology to reduce these additional harmful effects.
3.) Brain Disorders: Your eyes are an extension of your brain, eye exams can help to rule out brain conditions that can lead to headaches. Conditions like adult brain tumors, mini strokes (Transient Ischemic Attack), pituitary tumors, aneurysms, hemorrhages and increased intracranial pressure can all be seen during a medical eye exam. A medical eye exam will ensure your retina, optic nerve, and macula are normal and healthy in appearance. Abnormal findings will typically require additional testing. Below are pictures of a patient who had been suffering from severe headaches. She had been in and out of the ER with no solutions for months. After being seen at our office she was diagnosed with increased intracranial pressure and referred to a neurologist who discovered a brain tumor was present.
4.) Hypertension: High blood pressure (hypertension) is a serious condition that affects one in three adults in the United States, according to the Centers for Disease Control and Prevention (CDC). High blood pressure increases your risk of stroke, coronary disease, heart attack and other serious health problems. Hypertension is also called the "silent killer" because it often doesn't have any symptoms associated with it. However if your blood pressure is extremely elevated it can lead to blurry vision and headaches. It can also lead to damage of the small delicate blood vessels in your eye which depending on severity can cause permanent loss of vision.
5.) Low Blood Sugar: If your blood sugar is too low it can cause your vision to become blurry and cause headaches to occur. Your blood sugar is considered low when it drops below 70 mg/dL. Immediate treatment for low blood sugar levels is important to prevent more serious symptoms from developing. If everything with your eyes is healthy after having an eye exam, your optometrist may refer you to a primary care physician for a further blood work up to rule out diabetes, hypertension, and other systemic conditions.
Headaches are often due to changes in refractive error but they also could be due to more sight and life threatening conditions as well like increased intracranial pressure, high blood pressure or low blood sugar. While your eyes may not be the sole cause of your headaches, they may be playing a larger role than you think. A thorough eye exam is the only way to truly rule out vision related headaches. So if you're having headaches and haven't had your eyes examined recently, I would definitely add this to your to-do list. See you soon.
Dr. Nicolette Zawilinski