Help! Eye pain that radiates into face

[jax8it]

I have been dealing with LASIK induced dry eye for seven months. Recently my left eye hurts so badly that pain radiates down into my check and into my forehead. This only happens on my left side not my right. My left eye has always been the drier of the two eyes. I have never experienced pain like this. The pain has always stayed in my eye (ie. burning and stinging). I recently saw a new doc that pulled all my plugs and told me to stop all drops to see if I could auto-regulate. My right eye pain is tolerable, but my left is unbearable. Has anyone felt pain that radiates into the face? If so, what causes it and is there anything I can do about it? Thank you for any help.

[abbygirl]

Jax8it,
Yes!! I have had that kind of pain off and on for the past 3 years (since I had retina and cataract surgery). The pain is only in my left eye and 99% of the time wakes me up in the middle of the night and can last up to 15 hours. It is the worst pain!! Feels like it starts in my eyeball then radiates into my brow bone, forehead and jaw. I have to take pain pills to function. I have been to countless doctors and no one can figure it out. Does this sound like you?

[Nancy Derby]

I have that pain in the eye socket and up into the eyebrows, mainly the left eye. It comes and goes. I have dry eye (DES) and posterior blepharitis (MGD) in both eyes. I also found here is never any definite anwer from doctors, my own thinking on that is, it is inflammation. I call it a flareup, just as arthritis will flareup on occasion in other areas of the body, cause pain, and then lets up. If you ever get an answer from a doctor, please post it. I don't want anyone out there to base this on my own assumption. A medical answer is the best, not self diagnosis. But, it's a thought.

[Rebecca Petris]

I know I'm playing a broken record here but every time I see this I think trigeminal nerve. Not by any means suggesting it as a diagnosis just saying the patterns are so suggestive it's at least worth learning about. I guess in my non-medical brain I think of it as uncontrolled eye inflammation/pain and whatnot playing dominos during a flareup - irritating the TN causing TN pain to radiate along the usual pathways, esp. T1 but sometimes the others too. Google it and look at the pics.

[kanon]

Yes! I used to have this in my first "round" of dry eye 10 years ago- If I didn't get a good 8.5 or 9 hours of sleep I would have horrible pain in one eye that would radiate to my cheek, jaw, sometimes down the neck and arm. It did not go up to my head. I told doctor after doctor about this and they didn't know what to do. So I would just try to get a lot of sleep, but was a new teacher, young etc. and the idea that I had to get so much sleep every night stressed me out to the point that I couldn't sleep. Some doctors said trigeminal nerve...but then it got somewhat better when i got plugs for dry eyes.

[jax8it]

You know I am really thinking it is the nerves flaring up because of the dryness which then leads to inflammation. I wonder if I should get plugs put back in my left eye only. I can manage my right eye with my moisture goggles, but my left has gotten so bad the goggles don't help with this type of pain. My new doctor does not think I need plugs because I have mg dysfunction and dropout. But he is willing to do whatever helps even if he does not agree with it. I went back two weeks after having plugs removed and stopped all drops. He said my corneas looked great. I had been wearing my onion moisture goggles 24/7 and he knew that too. So I am guessing that he was right about mgd. I am making tears they just wouldn't stay on my eyes. So that's where the googles came in. This doc encouraged me to wear the goggles. I was still waiting for the custom moisture chambers to be made. I went a week to work without any goggles and used a few drops and this is when the radiating pain started. I have now been wearing my custom made moisture chambers for two days at work. They really help my right eye, but in the left eye I still feel pain in my eye that radiates to forehead and check. Could I have screwed things up in my left eye the week I went to work with no eye protection and very few drop? I don't know this is all so confusing. I see my doctor in two week. I will ask him. Any otc med I can take that will take the edge off. Thanks for all the replies!

[abbygirl]

The trigeminal nerve diagnosis is an interesting one and I did see a neurologist awhile back. He could not confirm and gave me gabapentin to take. I took a few times but found it did not help. The odd thing is the pain doesn't seem to correlate with my eye being overly dry. I can't seem to find a pattern and have actually gone to my doctor while having the pain and nothing is identified. I have to use a pressure drop in this eye and even my pressure is normal while having the pain. Also, the pain can last all day, be gone in the PM and return again the next day. It can continue for weeks and then be gone for months!!

[poppy]

I have a similar problem too. Doesn't correspond in any way to the severity of the surface pain.

I am really angry because I can't get eye docs to examine the inside of my eyes, they won't do a dilated eye exam, and I'm sure an eye ultrasound is out of the question. I'm wondering if any of the others have at least had the eye doc examine the inside of their eyes before fobbing them off?

I really can't understand why the docs won't consider possibilities such as my severe (and uncontrollable with steroid drops) external inflammation spreading to the inside of my eyes (and therefore causing this type of deep pain). I've also had corneal ulcer in the past, which I've read can spread inflammation to the inside of the eyes quite easily. Still they won't look inside my eyes. Also since the dry eye the entire inside of my eyeballs have completely filled up with literally tens of thousands of floaters, which I keep trying to explain to them are NOT the normal few floaters that many people have, and still the docs can somehow know there is nothing wrong inside my eyes without even looking. I don't know WTF is going on with them and why they won't examine my eyes properly! I have very clinically severe dry eye, for no reason at a young age and they just won't consider the possibility of the problem coming from or spreading to further inside the eye. Often I wonder what is the point of having doctors at all.

Edit: I read that the trigeminal nerve diagnosis in the vast majority of cases is in one side alone. Mine can be in either side, or in both at the same time. Adding to my feeling that this is eye pain...

[abbygirl]

Poppy,
Yes, you are right in being upset about not having a through eye exam!! The best way to get a good look into the inside of the eyeball..retina etc. is to do a dilated exam. There are many different causes of eye pain and several of these include anterior inflammation and also elevated eye pressure can cause pain. Long term use of steriod drops can cause your pressure to rise also. Are they at least checking your eye pressure??
Floaters are inside the eyeball and I don't think are related to dry eye. Another reason you should have a good check up..I have floaters and they are from laser surgeries I had on my retina. Floaters also increase with age etc.

[littlemermaid]

I'm finding that even in neuro-ophthalmology, most don't seem to know much about trigeminal neuralgia. How to get neuro-ophthalmologists on the job since neuros won't go near the eyes, is another question. I guess it's Dr Google again, as Rebecca says, then seeking out the rare doc who is current, leading and interested. Imagine if neurologists and ophthalmologists talked to each other, how much happier docs and patients would be.

[Rebecca Petris]

I'm finding that even in neuro-ophthalmology, most don't seem to know much about trigeminal neuralgia.

QUITE right. I was talking with a really canny cornea doc recently who agreed that neurophthalmologists tend to be completely out of the loop on corneal pain research as well. It is so frustrating. We go to cornea docs for dry eye and find they are refractive surgery specialists not cornea disease specialists. We go to neurophths and they don't know anything about corneal pain. It'll change, but change is so slow!

[rm14dp]

Hello - you sound like me. I had cataract surgery a year ago which triggered blepharitis, MGD and DES. I only get the pain in my right eye which is my worst eye. it starts deep in the bottom of my eye and radiates to the back of my throat, cheek and forehead. I have to resort to strong painkillers, which dont really help. It lasts from several hours, and the worst for 3 days. I havent been able to get an answer either. Recently I started using Blephasteam goggles, and the pain has not been as bad and hasnt lasted for long. Too soon to say if this is long term relief.