eye disorders
Eye Pain
Evaluation of Eye Pain
Mild eye irritation or a foreign body sensation is common and not usually serious. However, true pain in the eye can be a sign of a severe, vision-threatening disorder. The following information can help people decide when to see a doctor and help them know what to expect during the evaluation. In people with eye pain, certain symptoms and characteristics are cause for concern. They include Vomiting Seeing halos around lights Fever, chills, fatigue, or muscle aches Decreased sharpness of vision (visual acuity) Bulging of one or both eyes ( Bulging Eyes ) Inability to move the eye in all directions (such as right, left, up, and down) People who have severe pain, eye redness, or warning signs should see a doctor right away. People with mild pain and no eye redness or warning signs can wait a day or two to see if the discomfort goes away on its own. Doctors first ask questions about the person's symptoms and medical history. Doctors then do a physical examination. What they find during the history and physical examination often suggests a cause of the eye pain and the tests that may need to be done (see table). Doctors ask the person to describe the pain, including when it started, how severe it is, and whether it hurts to look in different directions or blink. They ask about whether the person has ever had eye pain and whether the person is sensitive to light, has blurred vision, or feels as if the eye contains a foreign object. During the physical examination, doctors check for the presence of fever or a runny nose. They check the face for tenderness. Most important is the eye examination, including the entire eye, eyelids, and the region around the eye. Doctors check Whether the eyes are red or swollen How clearly a person can see using a standard eye chart ( Refraction ) Whether the person can see in each part of the field of vision ( Visual Field Testing ) How the pupils react to light Whether shining a light into the unaffected eye causes pain in the affected eye when the affected eye is closed (called true photophobia) If doctors suspect a foreign object but do not see one, they turn the eyelids inside out to search for hidden foreign objects. Doctors usually do a What Is a Slit Lamp? . A slit lamp is an instrument that enables a doctor to examine the eye under high magnification. Doctors place a drop of Sometimes findings are helpful in making a diagnosis. Particular findings or combinations may point to particular disorders. Findings may also help suggest or eliminate certain types of disorders. Introduction to Corneal Disorders , among other disorders, tend to cause eye redness, tearing, and pain. If those symptoms are absent, a corneal disorder is very unlikely. Pain on the surface of the eye, a foreign body sensation, and pain with blinking suggest a foreign object. People who wear contact lenses may have a corneal scratch, a corneal ulcer, or contact lens keratitis. When measuring eye pressure, doctors put a drop of anesthetic into the eye. If pain then disappears, the cause of pain is probably a corneal disorder. Deep, aching, throbbing pain often indicates a possibly serious disorder, such as Glaucoma , Fever, chills, and tenderness suggest infections such as orbital cellulitis or sinusitis. The need for tests depends on what doctors find during the history and physical examination. Testing is usually not necessary. However, if doctors find increased intraocular pressure (indicating Glaucoma ), they may refer the person to an ophthalmologist (a medical doctor who specializes in the evaluation and treatment—surgical and nonsurgical—of eye disorders) for gonioscopy. A gonioscope is a special lens that allows doctors to examine the drainage channels in the eye, which can help determine whether the glaucoma is of the open-angle or closed-angle type. Bulging of the eye and inability of an eye to move in all directions without moving the head can indicate Orbital Cellulitis or Doctors send a sample of fluids from inside the eye (vitreous or aqueous humor) to the laboratory if Endophthalmitis seems likely. They may send a sample from the cornea or a blister if 