A Case-Based Guide to Eye Pain

Table of Contents

I. Ophthalmic disorders

A. Grossly normal eye exam

1. Dry eye syndrome

2. Corneal erosions

3. Post LASIK pain

4. "Eye strain"

5. Intermittent pressure elevation

6. Blepharospasm 7. Superior limbic keratoconjunctivitis



8. Trochleitis

9. Lacrimal gland disorders

10. Posterior scleritis



B. Grossly abnormal eye exam

1. Idiopathic orbital inflammatory syndrome

2. Uveitis

3. Conjunctivitis

4. Thyroid eye disease 5. Orbital mass



6. Ocular ischemic syndrome

7. Horner syndrome

8. Microvascular cranial nerve palsy

II. Neurologic disorders

A. Relatively normal exam

1. Migraine

2. Photophobia

  3. Trigeminal neuralgia



4. Cervicogenic headache 5. Ice pick headache



6. Sinus disease

7. Chronic daily headache

8. Supraorbital neuralgia

9. Trigeminal autonomic disorders: Cluster headache

10. The trigeminal autonomic disorders: SUNCT syndrome

10. Trigeminal autonomic disorders: Hemicranias

11. Valsalva headache ^; 12. Pituitary tumors

< 13. Aneurysm



14. Meningitis

15. Intracranial hypotension

16. Cluster headache

17. Giant cell arteritis

18. Thunderclap headache

19. Post-traumatic headache

B. Abnormal neurological exam



1. Optic neuritis

2. Idiopathic intracranial hypertension

3. Carotid cavernous fistula

4. Herpes zoster ophthalmicus

5. Periocular skin cancer

Michael Lee, MD, is Professor in the Department of Ophthalmology and Visual Neurosciences, Department of Neurosurgery, Department of Neurology, and is the Mackall-Scheie Research Chair in the Department of Ophthalmology and Visual Sciences at the University of Minnesota. He is also the Ophthalmology Residency Program Director, Co-Director for the Center for Thyroid Eye Disease, and Director of Neuro-ophthalmology at the University of Minnesota. Dr. Lee sees patients with a variety of neuro-ophthalmic problems, including blepharospasm, hemifacial spasm, optic neuritis, ischemic optic neuropathy, double vision, eye pain, pseudotumor cerebri, thyroid eye disease and giant cell arteritis.
Kathleen Digre, MD, is Professor, Neurology and Ophthalmology, Director of Neuro-ophthalmology Moran Eye Center, Director of Neuro-Ophthalmology Fellowship, and Director of Headache Clinic, at the University of Utah. She is also Adjunct Professor of Obstetrics and Gynecology and Adjunct Professor of Anesthesia.