Eye/orbit pain for a few months, please help

Hi, when I frown or move the right eyebrow or touch/press it, I feel
dull pain in the area and deep inside the head, it's like this for a
few months now, usually feel less in the morning, but getting worse
late at night. I use computer alot but I don't think it's eyestrain
since my left eye is fine even though it has higher degree of
nearsightness.

I tried different type of eyeglasses, not sure if this is caused by
eyeglass nose piece pressing on the sinus area, although putting some
soft tissue cushion seems to help.

I went to see a opathomologist who did a complete eye exam on me, but
he found nothing wrong in the right eye (except central serous
retinopathy which is not realated to pain), he said could be
neuralgia, although he said may not be necessary but he still gave me
a prescription of MRI scan in the orbit area, but I want to get some
idea before I spend the money going that route.

Do you have any suggestion what is causing this pain? it's not sharp
pain but it's always there whenever I move my eyebrow or eye or even
sleep on the right side, it's quite depressing, I never had any injury
or infection that I can think of...

If I have to do the MRI, should I only do the orbit or include the
brain (since it maybe related to head as the pain goes into the head)?
one imaging lab charge double if include the head but the other said
it's the same charge just do the whole head scan. I am a bit lost
here.

thanks a lot!

 

I am a chiropractor and personally prefer natural remedies, but first
you always want to rule out any underlying problems. It's great that
you got checked by the eye doctor and your body passed in that
department, but I would now get checked by a neurologist. He probably
would want to see and MRI of both brain and orbit.

If everything checks out fine, and all major problems are ruled out, I
would try acupuncure, which has been known to work great with
nueralgia. By today's medical explanations it's hard to describe how,
but acupuncture has been around for thousands of years and has helped
people without the use of drugs or surgery.

I assume you don't have health insurance? I know it's really
difficult these days to squeeze out an extra few hundred dollars a
month, but if there's any way you can re-budget, it will be well worth
it in times like these.

Good luck!
Falala

 

thanks for the reply, the doctor back from vacation left a message
today saying my pain could also be migraine and a word sounds like
"arosure" (what is that?). I think if I want to check further I would
do MRI with brain/orbit first, if there's anything wrong there I would
go see a neurologist as you suggested?

is the whole head MRI scan less detailed than orbit only? that's my
concern since one lab said cost the same, which makes me wonder...

thanks

 

thanks for the reply.
I never took that, and no idea what it does... i have never felt this
pain, just happened a few months ago, that's why I am a bit worried if
there's something wrong there like tumor or something like that? I
don't have congested nose or running nose or something like that,
although after I blow nose sometimes I see traces of blood on tissue
but most of the time not.

 

dr. tyner is describing a scenario that is common in patients who
complain of deep pain/pressure in the areas around the eye, at least
in my practice. either chronic or acute sinusitis is a distinct
possibility. to test this hypothesis I would recommend a 10 day round
of antibiotics (cephalexin and zithromax are good candidates and both
are available as generics) as well as taking of 30-60 mg
pseudoephedrine q6 hours. blocked and infected sinuses give rise to
lots of non-specific complaints that include what you are describing.
chronic sinusitis would not be accompanied by nasal congestion and
could certainly give rise to streaking of blood when you you blow your
nose. its simple enough to test that treatment approach! ps-- also,
long exposure to humid warm air might help to open up blocked
sinuses. for example, a long hot shower or a steam bath. good luck.

 

thank you and dr. tyner for the replies.

I think it might be chronic sinusitis turn worse since I have this
streaks of blood when blow nose since years ago just no other symptoms
so I never paid attension. I will try this treatment to see if it
improves and report back. and postpone the MRI (can MRI dectect the
sinusitis?)

what's q6 hours? every 6 hours? I will try antibiotics for 10 days,
how long should I take sudafed and how many times a day?

thank you and appreciate your help

 

thanks for the reply.
I don't particularly notice increased pain when bend over or stand up,
only if I move right eyebrow, also I don't have congested nose and no
problem at all breathing...

 

Hi, I tried cephalexin for 10 days and sudafed for 6 days, it didn't
seem to cure it, I still feel the pain. so I went to a MRI imaging
center and did MRI 1.5T for orbits and brain. here is the report:


The ventricles and sulci are within normal limits. The flair imaging
demonstrates a small hyperintensity lesion in the right frontal
subcortical white matter. the brain parenchyma is otherwise normal in
signal intensity and configuration. No acute hemorrhage, mass lesion
or mass effect is demonstrated intracranially. the patient has septum
pellucidum, normal variant. there is no extraaxial collection. the
sella is normal in size. the craniovertebral junction is normal. the
internal carotid arteries and basilar artery show normal flow void
signal intensity.

the globes are normal in size and configuration. the optic nerves are
normal in size, course and signal intensity. the extraocular muscles
and retrobulbar fat are unremarkable bilaterally. the optic chiasm is
intact.

there is mild mucosal thickening of the bilateral ethmoid, frontal
and maxillary sinuses compatible with chronic sinusitis. the right
maxillary sinus demonstrates a polyp versus retention cyst measuring
1.8x.1.8 cm in the inferior all. there's no evidence of air-fluid
level. the osteomeatal complex is patent bilaterally. the nasal
septum is midline. the nasal cavity is unremarkable.

IMPRESSION:
1. single small right frontal white matter lesion is nonspecific and
may represent small vessel ischemic disease or gliosis.
2. normal variant septum pellucidum
3. chronic paranasal sinusitis.
4. polyp versus retention cyst in the right maxillary sinus.


I don't understand much about this report, seems like there's a
sizable tumor that need be removed? is that the reason I feel the
pain? if it's I am happy at least I know what's the cause.
what kind of doctor do I need to see? a surgeon?

thank you very much.

 

It seems like sinusitis, so the answer is almost obvious: ENT.

 

thanks for the reply

 

dr. tyner, thanks for the reply, I just noticed the cysts as you said
is located on the right cheerbone, which is not where it hurts, the
pain is on the right eyebrows area closer to the nose and goes inside
head, and as you said if cysts usually doesn't hurt, is it relatively
safe to assume that it's not the cause of the pain?

chronic paranasal sinusitis is most likely the cause of the pain? can
it be cured? I took 10 days of cephalexin and went back to my old pair
of glass (with nose pieces lower than the new pair and worn for 10
years without pain), the pain is less but still there... I already
mailed the report to my eye doctor.

thanks

 

dr judy thanks for the reply, will ENT doctor know what that "single
white lesion" means? I have 3 print out images, I don't know if ENT
doctor can locate the thing from pictures or need cooperation from
imagining center? I don't see "exact location" on the report. do I
need to see a neurologist?

thanks

 

wrote in @p77g2000hsh.googlegroups.com:

The ENT probably won't deal with the white *matter* lesion, but try to make
sure your primary care physician gets a copy of the report.

It really sounds like your problem is sinuses, though. Give the ENT his
crack at it. You've had three or four practitioners tell you that your
problems sound sinus-related, and an MRI confirming chronic sinusitis. The
"tumor" that is more likely related to your pain is sinus-related, and
likely has nothing to do with the white matter lesion.

Do some googling for gliosis, and make sure your primary doctor knows about
it. My suspicion is that they may want follow up imaging at some time in
the future, but that nothing will really be done unless you show
neurological symptoms-- or maybe if the sinus stuff is cleared up and your
pain remains.

 

dr. tyner, thanks for the reply.

I got a message from eye doctor recommending an ENT doctor, I haven't
decided to go to see him yet (very little information available about
him). I searched for some ENT doctors, I don't see any specialized in
chronic sinusitis, but found a few in Sinus Disorders/Surgery, is that
the specialty best suit my situation?