Eye pain - sinuses?

[Lycurgus]

Approximately one year ago (March/April 2006), I started experiencing some pain in my eyes. I went to an optometrist, who said I had (if I can recall correctly) a minor allergy-related infection in my eye. He prescribed some eye drops (I believe it was Lotomax), and the pain more or less went away. It started coming back several months later, so I went to another optometrist, who prescribed Alrex, Lotomax, and one other I can't recall. She said it was some form of conjunctivitis and that the drops should take care of it. Over the course of a few months, she said it started to clear up.

Eventually, the pain came back so this time I went to an ophthalmologist instead of an optometrist. She said I had Giant Papillary Conjunctivitis, and prescribed me nothing, as she said all the medication deals with symptoms I don't have (itchiness, runny eyes, etc). Discontinue contact lens wear was the onle thing she said to do. Pain only got a little better, up until a few weeks ago.

I played golf, and that night, I got a searing pain in and behind my eye that was so bad I couldn't function and was forced to sleep. Since then, the pain has been pretty rough. I had my follow-up exam, and she prescribed me Alrex. She also said I might have sinus issues and suggested some basic OTC sinus medication, which helps a little.

So, here are the current symptoms: sporadic eye pain, from dull to sharp, that is never localized in one specific area of the eye. Often causes minor headaches and heavy eyes/eyelids. Ibuprofen helps on occasion, as does the OTC sinus medication.

My hope is that it's nothing more than allergies or sinuses, as the pollen level in our city is REALLY high, and my eyes really started hurting again when I spent about 5-6 outdoors playing golf. Someone suggested it might be symptomatic of multiple sclerosis, and that terrifies me to no end.

So, if anyone has any advice, or would like some more information, please let me know. Thanks.

[Forum-OD-MP]

'symptomatic of multiple sclerosis'

um, no.  way off.

likely one of many contact-lens associated inflammatory conditions like GPC or infiltrative keratitis or superficial punctate keratitis, etc.

i totally disagree with the ophthalmologist who says 'all the medication deals with symptoms I don't have (itchiness, runny eyes, etc)'.  i dont know what else to say about that, except i consider it to be wrong.  this sounds to me like it came from someone who doesnt know much about contacts.

in the case of raging GPC (assuming, of course, that is what you do have) and soft contact lens wear in a patient who has known seasonal allergies in a high-allergy area...pretty much the standard treatment is:

1) discontinuation of all contact lens wear until condition is mostly or completely resolved

2) treatment with topical steroids and oral antihistamines

once the problem is mostly resolved...

3) REFIT in daily disposable contact lenses (b/c of low modulus, paper thin, and impossible to have buildup)

if #3 is not possible b/c of prescription limitations... then

3b) refit in the lowest modulus and most disposable lens available in your Rx, and use hydrogen-peroxide based soft contact lens solution only.

[aimee37]

Elevated blood pressure & some atherosclerosis of brian vessels are the most common reasons for "pain in eye", when real reasons in eyes  are absent.
Conjunctivitic do not cause pain in behind  eye
  Best regards

[aimee37]

Thanks for your timely response.

According to my ophthalmologist, on a scale one to four, my GPC is at a 4+. I have not worn my contacts in about 2-3 months, save for three or four times. I'm currently using Alrex. Is there any possibility that this is in some way sinus related?

I guess I just have to be patient.

[aimee37]

"Elevated blood pressure & some atherosclerosis of brian (sic) vessels are the most common reasons for "pain in eye", when real reasons in eyes are absent.
Conjunctivitic (sic) do not cause pain in behind eye"

i hate to keep calling this guy out, but those 2 would be "zebra" diagnoses if i ever heard them.  technically POSSIBLE to be the cause of your eye problems, but  IMO highly HIGHLY unlikely.  actually, in pretty much everyone's opinion highly unlikely.

"Is there any possibility that this is in some way sinus related?"

no.  not really.

"I guess I just have to be patient."

a raging case of GPC can take MONTHS to resolve.  some never do, if the "offending agents" (ie allergens & contact lens wear) are not or cannot be removed.

[aimee37]

Great differences between opht. & optometrists in US, I see.

[aimee37]

great differences in education between docs in the US and Russia?  um, yeah.  understatement.

[aimee37]

I haven't seen actual answer to my question, which I unfortunately obscured through all the back story.

Is the pain I am experiencing cause/can it be caused by GPC?

[aimee37]

"I haven't seen actual answer to my question, which I unfortunately obscured through all the back story.

Is the pain I am experiencing cause/can it be caused by GPC?"

well not to get caught up in semantics here, but your original post never asked that question.  in fact, there is not even a question mark in your original post.  there is no question there are all.  you just told me your story and left it open for comments and advice, which i gave you.  i didnt know you were asking "Is the pain I am experiencing cause/can it be caused by GPC?".  but now that i know thats what you're asking, i will try and answer:

yes, its possible/probable IMO that your symptoms (pain) are likely related to your grade 4+ GPC.  and as an aside i can also tell you what its NOT from: atherosclerosis.

[aimee37]

Rus, why pick two random possible causes for eye pain when there are hundreds, maybe THOUSANDS of causes?

Travel, OD

[aimee37]

I think the purpose of this website is to give the people who post questions ideas or our best guesses. The great majority of eye problems need to be identified with a standard exam. This is impossible over the internet. Of course the pain is real, and I always try to give my best guess but I don't present it in a fashion of flawlessness, nor do I present a clear diagnosis. That'd just be absurd and dangerous.

Travel,OD

[aimee37]

   To ODs: You do not hear your patient, docs. It is sadly. Or you do not understand in english?
  To Lycurgus: Elevated blood pressure & some atherosclerosis of brain vessels are the most common reasons for "pain in eye", when real reasons in eyes are absent. Any  conjunctivitis, Including GPS do not cause pain in behind eye. You must visit opht-gist to exclude eye reasons for pain, if the pain is present again, and then visit therapeutist, neurulogist to find this reason. ((The "Comments"  are provided by individuals and reflect their personal opinions only.))
  To Travel, OD: I pick two most COMMON  causes for pain in behind eye.   Behind exception sinusitis, which  is usually accompanied by a pain behind an eye. I do not want to write thousand-pages monography about eye pain in the forum.
   Education of docs in the US is more high quality than in Rissia (i think),  therefore it is strange to read some  statements of US ODs.
   Good health to anybody, docs and patients.
   Sorry for my bad english.

[aimee37]

To ODs: You do not hear your patient, docs. It is sadly. Or you do not understand in english?

Well technically they are not "patients" as this is for educational purposes only... What do you think, Dr P?

[aimee37]

But the pain is real, not educational. Do you try to help, or you are teacher, or writer?  What do you think?

[aimee37]

To Travel: I agree with you completely, I too want to give the offers. In what there is a problem? Who give clear diagnoses on the Internet?

[HennaGirl]

A related discussion, Eye Pain Related to Sinus? was started.