The eye pain is stinging sensation, diffuse or limited pulsatile to the eye that can be representation of involvement of the cornea, spaces other than the organ itself or the body in general.
When there is eye pain, the main involvement is the cornea, which is the transparent membrane in front of the iris and the pupil in front of the eyeball. Another common manifestation of eye pain is a foreign body sensation or slight irritation to the eye.
On the other hand, disorders that affect the cornea can affect the anterior chamber of the eyeball, the space between the iris and the back of the cornea, causing spasm of the ciliary muscle -which allows the pupil to contract- intensifying the pain even more under bright light stimuli.
Alarming symptoms of eye pain
There are accompanying symptoms of eye pain that are warning signs to go immediately to a health center. These signs are:
1. Vomiting
2. Halos around the light.
3. Fever, chills, muscle weakness and / or pain, and joint pain.
4. Decreased visual acuity.
5. Inability to move the eye in all directions.
6. Bulging in the eye
If the pain is intense and there are these warning signs, you should see a doctor immediately but if, on the contrary, the pain is mild and there is no presence of any of these signs, you can wait 1 to 2 days to see if the discomfort subsides due to If only.
The doctor, when faced with a reason for consultation such as eye pain, will take a medical history that includes: personal history, habits, onset of pain and accompanying symptoms, and a physical exam that can presume a diagnosis.
Regarding the ocular physical examination, the doctor will look for the presence of a foreign body, will corroborate the mobility of the eyeball in all directions, will apply intense light to cause reflections that are normal in the individual and will determine whether or not there is pain upon exposure and It will also assess visual acuity using acuity charts.
The doctor may subject the patient to more detailed examinations such as the use of a slit lamp that allows the eye to be observed under high magnification and thus search for very small foreign bodies, ulcers, and trauma that may be causing the pain.
After this, the intraocular pressure should be evaluated through tonometry to rule out the presence of glaucoma and prevent its progress and finally, the doctor will do an examination of the fundus, where the internal ocular structures are evaluated.
By performing these examinations and explorations, findings are obtained that allow orienting the diagnosis as follows:
· If an eye is found that is not red, tearing, and painful, the cornea may not be the affected structure.
· The doctor when measuring the intraocular pressure places anesthesia in drops to the affected eye, if the pain disappears with the anesthetic, the affection is of the cornea the safest
· People who wear contact lenses can suffer cornal scratches or ulcers that are traumatic causes of severe pain.
· If there is a diffuse and very intense pain that is difficult to determine its location, orbital cellulitis, endophthalmitis and orbital pseudotumor should be considered.
· A deep and diffuse pain can be an indication of something very serious such as acute angle-closure glaucoma due to increased intraocular pressure
Causes of eye pain and treatment
There are many causes of eye pain but here we will name the most common with their treatments:
Keratitis:
Keratitis is inflammation of the cornea that causes tearing, redness, discomfort when exposed to light, and severe pain. It can be caused by trauma such as bumps and scratches and contact lens rubbing injuries.
The treatment depends on whether bacterial, fungal or viral but also varies according to the intensity. If it is a mild inflammation drops with antibacterial, antiviral or antifungal drugs, respectively, will be administered. But if it is severe, medications will be given by mouth.
Conjunctivitis:
It is the inflammation of the blood vessels located in the conjunctiva -membrane that covers the front of the eye and inside the eyelids. The main symptoms of conjunctivitis are swelling, itching, tearing, and pain.
The treatment should be symptomatic in the first instance with artificial tears and cold compresses and if not improve, suspect a bacterial, fungal or viral cause in which the doctor must prescribe drops with medication or oral treatment depending on the severity of the case.
Glaucoma:
It is the pathological increase in intraocular pressure that causes damage to the otic nerve and progressive loss of peripheral vision (on the sides). There is intense and deep pain and treatment should be as soon as possible, which consists of the use of drops that lower intraocular pressure with alpha-adrenergic drugs, beta-blockers or laser surgery that releases pressure.
Sinusitis:
It is the inflammation of the paranasal sinuses that radiates to the head and eye region with symptoms such as sore throat and shortness of breath. It usually improves with medications applied directly to the nasal passages, antibiotics or anti-flu.
There are many other causes of eye pain related to the use of contact lenses, dry eyes, inflammation of the eyelids, orbital and periorbital infections, pseudotumors, endophthalmitis, among others, where the best option is to consult a doctor who is who through the Performing a good general physical examination and specifically ocular, will be able to diagnose early and grant timely treatment to avoid complications.
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