Eye Pain

Eye pain may result from a variety of causes. Ask the patient the following questions:

''Can you describe the pain?" ''Did the pain come on suddenly?'' ''Does the light bother your eye?'' ''Do you have pain when you blink?'' ''Do you have the sensation of something in the eye?'' Do you have headaches?'' ''Do you have pain on movement of the eye?'' ''Do you have pain over the brow on the same side?'' ''Do you wear contact lenses?''

Pain may be experienced as ''burning,'' "aching," "throbbing," ''tenderness,'' or pain behind the eye. Each of these descriptions may have a range of causes. It is important to determine whether the patient has the sensation of a foreign body in the eye. Pain in the eye while blinking occurs in corneal abrasions and with foreign bodies in the eye. Photophobia is eye pain associated with light, as seen in inflammations of the uveal tract (i.e., iris, ciliary body, or choroid). Inflammations of the conjunctiva, conjunctivitis, produce a gritty sensation. Diseases of the cornea are associated with significant pain because the cornea is so richly innervated. Headaches and eye pain are common in acute narrow-angle glaucoma. Pain on motion of the eye occurs in optic neuritis. Eye pain associated with brow or temporal pain may be an indication of temporal arteritis (see Chapter 25, The Geriatric Patient). Contact lens wearers may have corneal irritation and may complain of eye pain.

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