The headache is one of the main complaints in ophthalmologic practice, but there are cases where the doctor is sought to be a neurologist.
Changes in vision followed by severe headache, nausea, malaise, intolerance to loud noise and sleepiness are symptoms of a disease that affects about 1% of the world: the ophthalmic migraine or retinal migraine, also known as visual aura, distinct from classic migraines by affecting vision and other senses.
The ophthalmologist Virgilio Centurion, director of the Institute of Eye Diseases (IMO), explains: "Although called ophthalmic migraine, neurological disease originates. This is a fast disorder, intermittent and reversible cerebral circulation, which precedes the onset of headache crises. "
There are several triggers for crises, according to Virgilio. Menstrual period, starvation, contraceptive use, sleep disorders, stress, consumption of fried food, coffee, chocolate and alcohol problems in the cervical and disorders of the TMJ (Temporo Mandibular Joint).
Since the problem affects the vision first, patients resort to ophthalmologists for diagnosis. "After examination, when discounting the possibility of problems in the eyeball, we send these patients to a neurologist," says the director of the IMO.
Symptoms
It is for this reason that the diagnosis of ophthalmic migraine is so commonly done by the ophthalmologist.
"As the patient usually inform the perception of light (as a zig-zag), the loss of half the visual field (recovered over the crisis), severe headache (more than one side, called a" migraine "), and photophobia been nauseous all at the same time, he fears losing his eyesight, which may occur temporarily, with some people," he explains.
The pain of migraine ophthalmic may also manifest itself in one or both eyes. Both eyes, as above, below and around them. This pain may be throbbing and / or weight or pressure, and its intensity can vary from very mild to very strong.
In a very small portion of patients with migraine, the upper eyelid of one eye (the same side of pain) may fall partially.
"This phenomenon is known as ptosis and occurs during painful crisis. After the crisis, the eyelid returns to normal. This form of headache is called migraine Ophthalmoplegic, "says ophthalmologist.
Treatment
Over time, the visual symptoms preceding the migraine attack alert us to refer the patient to the appropriate diagnosis and not just the use of medication to relieve pain.
"Why is this so important to continue the treatment. Headache is a very complex disease that is the subject of comprehensive study of various specialists, neurologists, ophthalmologists, psychologists, clinical ... Now there are even clinics and hospitals dedicated exclusively to the headache, "said Virgilio Centurion.
And if the headache is caused by vision problems?
"The headache is caused by refractive vision problems such as hyperopia, myopia and astigmatism, usually begins after a period of eyestrain. The patient wakes up fine, but during the day or the end of the school or work, the headaches begin. This type of abuse is called asthenopia.
Usually, this problem tends to disappear after the use of prescription glasses or contact lenses, ophthalmologist tells the Eduardo de Lucca, who is also part of the clinical staff IMO.
Other eye diseases can also cause headache, such as strabismus, convergence insufficiency, uveitis and acute glaucoma, says Eduardo.