TMJ and dry eye

[LasikRelatedDES]

Hey-

I'm working on a new idea for what is causing my dry eye to be so much worse in my right eye than in my left since after LASIK I had morning dryness that was equal in both eyes. Now, I have constant pain in my right eye and only mild pain in my left.

I have a dislocated TMJ (temporomandibular joint - "jaw joint) on my right side that often causes me pain in the morning if I've clenched my teeth while sleeping. I've noticed on days when it hurts bad enough to give me a headache, my eye pain is always worse. I'll also feel tingling in my nose and fullness in my ear.

I'm going to run it by my primary doc and see what specialist I should see for something like this. Has anyone seen or heard of a connection between TMJ and the eyes? Or facial pain and the eyes?

[irish eyes]

This isn't quite the same but a few years ago, the pain and misery of constant Dry Eye pain was so bad that I developed TMJ.

Intense discomfort `gripped' me so completely that my face was in a constant state of tension.

Crying can often release tension caused by pain but of course in our case, it's not always possible is it? The psychological lack of control serves only to exacerbate this.

Physiotherapy helped `release' some of the muscles in my face but it was not pleasant at all. My jaw improved but my eyes didn't.

[LasikRelatedDES]

This isn't quite the same but a few years ago, the pain and misery of constant Dry Eye pain was so bad that I developed TMJ.

Intense discomfort `gripped' me so completely that my face was in a constant state of tension.

Crying can often release tension caused by pain but of course in our case, it's not always possible is it? The psychological lack of control serves only to exacerbate this.

Physiotherapy helped `release' some of the muscles in my face but it was not pleasant at all. My jaw improved but my eyes didn't.

I'm sorry to hear that. I know a big reason why I clench my teeth at night is built up stress over the constant burning in my eye. So, if the TMJ pain is aggravating the eye - it's a vicious cycle.

Glad to hear you got some relief from facial pain. Hope you find some for the eyes.

[kitty]

Do a search here for TMJ and you will find my inquiry regarding the same. Some massage therapists believe there is a link but I have not found any science to support it. I also have not noticed any increase in my DES when my TMJ pain is at its worst. I was diagnosed with both at about the same time, but I now know that I had TMJ for 20 or more years before the onset of my DES.

[LasikRelatedDES]

Do a search here for TMJ and you will find my inquiry regarding the same. Some massage therapists believe there is a link but I have not found any science to support it. I also have not noticed any increase in my DES when my TMJ pain is at its worst. I was diagnosed with both at about the same time, but I now know that I had TMJ for 20 or more years before the onset of my DES.

I'll do a search.

I'm not sure if there is science to support it, but my own observation says that right now I have a throbbing from my jaw, across my face, to my nose. And I think that must affect the eye in some way. I'm sick of being beyond the realm of commonly seen cases though...

[Aaron77]

This isn't quite the same but a few years ago, the pain and misery of constant Dry Eye pain was so bad that I developed TMJ.

Intense discomfort `gripped' me so completely that my face was in a constant state of tension.

Crying can often release tension caused by pain but of course in our case, it's not always possible is it? The psychological lack of control serves only to exacerbate this.

Physiotherapy helped `release' some of the muscles in my face but it was not pleasant at all. My jaw improved but my eyes didn't.

irish eyes,

this sounds very much like the problem that I've been having the last few months after lasik, just not sure if the facial strain is from the dry eye pain or the extra strain that my eyes are under right now.

Glad to hear that relief was found. What type of physiotherapy worked for you?

[irish eyes]

Hi Aaron

A diagnosis was made - checking overall posture, state of my teeth, any predisposing factors such as arthritis etc Things were fine in those areas and the physio accepted that managing the eye pain seemed to be causing so much psychological and real stress, that this was the likeley cause. My jaws were so tense that I could just about open my mouth to eat - so the main objective was to reduce the pain.

From what I recall, she used low intensity ultrasound / electrical stimulation and massage - although maybe there is a different approach nowadays. I also had a warmed pillow - anything that would help release the tightness.

I then had to do `mouth opening' exercises - which was hard to do but what choice did I have? I had a number of visits to the clinic and of course had to do my `homework' in between.

[LasikRelatedDES]

Update:

My primary doc this afternoon said it was likely that the TMJ pain was exacerbating my right eye (thru the trigeminal nerve) but doubted very much that it was the underlying cause. Pretty much the answer I expected.

I pick up my bite splint on Friday and I'm hoping that helps my jaw ease up and possibly even get realigned a bit. We'll see if that has any impact on my eye.

[kitty]

Update:

My primary doc this afternoon said it was likely that the TMJ pain was exacerbating my right eye (thru the trigeminal nerve) but doubted very much that it was the underlying cause. Pretty much the answer I expected.

I pick up my bite splint on Friday and I'm hoping that helps my jaw ease up and possibly even get realigned a bit. We'll see if that has any impact on my eye.

Thanks for the info. The trigeminal nerve irritation has been my theory all along. Too bad it is not the cause of the DES though. I hope you get relief from both.

[mary kenny badami]

Well, I'm not a doctor; and yes, there seems to be a lack of scientific studies on this topic.
But that won't prevent me from chiming in on this thread to offer A Case Study of One -- ME -- with the following testimonial:
solving my TMJ problem brought unexpected relief from years of headache pain as well.

I'd been to my primary care physician as well as to a chiropractor trying to deal with the "clicking in my jaw" (in my case, on both sides), which they had identified as TMJ.
This meant that I had a diagnosis, but not a solution. However once I found a thoughtful dentist we resolved it, with a surprising bonus.

He provided me with a mouth device (known variously by names such as: mouth guard, night guard, splint, stint, and stent) to wear every night for at least three months. Skeptical as I was (also petulant because I have a pretty strong gag reflex), I was thrilled to report at my next dental checkup that the jaw-clicking was totally gone.

Even better, when I visited my primary care physician several months later, he offered to renew the heavy-duty prescriptions for debilitating "migraine headaches" from which I had suffered for more than 30 years . . . and until he asked, I hadn't even realized that once the TMJ problem was resolved, so were my headaches. . . and that is true even now today . . . no more jaw-clicking = no more headaches.

Now, I didn't notice a change in my dry eyes problem. But given my experience, I really do believe that the trigeminal nerve may be the villain in a variety of facial-related problems, including pain around the eyes and headaches.

Therefore I am delighted to hear, LasikRelatedDES, that you'll be getting a bite splint. I trust that you'll be faithful in giving it a try.
Although it may not directly improve your dry eyes, I think that relief from pain is a mighty good motivation for trying such a relatively simple and non-invasive remedy!

[Lucy]

My 2 cents on this subject. I do not have TMJ, first of all. :-) What Mary and the others say sounds plausible, especially about the "bite plate." When I was still working, I was surprised one day when several women around me started talking about their "bite plates." Seems this is an often used device.

About the trigeminal nerve, I do have some experience. Lasik started the pain in my left eye (the pain over and above dry eye pain) a few months after lasik. It stayed and stayed. I had to use icepacks and stay in bed or on the couch alot. I had cataract surgery in the same eye and it cranked it up in a major way. That has been 4 years since the cataract surgery and I still have the trigeminal nerve pain in and around my left eye.

About 6 or 7 months ago, my rheumatologist suggested I try Lyrica. Seems my insurance company would not pay for it. I appealed and they agreed to pay for it. Docs kept me supplied with samples in the meantime. I felt some of my facial numbness (from the Sjogrens) get better right away on the Lyrica. After a few weeks, I noticed the TN pain was much less. It's about 50% less and this is a great deal for me. Nothing in almost 10 years made this better. Even meds like Vicodin just tame it a little. I would suggest a trial of Lyrica for anyone with facial pain. Lucy

PS. Also use the mouth appliance.