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Eye-Strain Headache?
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Patients complaining of headache often claim one of three things:
sinus
disease, brain tumor, or simply that their eyeglasses no longer work.
The International Headache Society (IHS) does recognize headaches
associated with refractive errors (HARE) but notes that their
importance is widely overestimated. The diagnostic criteria for HARE
are as follows:
a. uncorrected refractive errors;
b. mild headaches in the frontal region and within the eyes; and
c. pain absent on awakening and aggravated by prolonged visual tasks
at the distance or angle where vision is impaired.
One group of researchers (Gil-Gouveia R, et al. Headache. 2002;42:
256-262) undertook an observational-interview study to compare the
overall headache frequency in healthy patients with refractive errors
(n = 105) compared to normal controls (n = 71). Jeffrey Reich, assistant
professor of neurology at New York Presbyterian Hospital-Cornell
Campus, notes that the overall headache frequency between the groups
was similar (45% vs. 52%). There appeared to be no difference in
headache characteristics, nor was there a difference in the relative
frequencies of migraine, tension-type, or other primary headache
disorders. Reich notes that there were indications suggesting that
improvement in headache in the patients with refractive error was
associated with correction of vision. Only seven patients fulfilled HIS
criteria for HARE, and three of these improved with correction of
vision.
"While there are methodological flaws in this small study, it is
reassuring to find that, contrary to popular belief, headaches are only
rarely identified in individuals with refractive errors," he adds. "In
patients with chronic headache, proper correction of vision should be
considered as one of several factors."
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