Photosensitivity, Tinnitus, Pressure in Head, Dizziness. Help in diagnosis

Hello. I'd like some help in figuring out what's wrong with my eyesight.

Symptoms: Started a month ago. Sudden onset of symptoms.

First week: Reading text onscreen, eyes feel tired, both eyes,  no auras or any visual artifacts, sore feeling at nape of neck (again, it's not actually painful) so I went to bed. The next day there was a weird feeling of pressure in the head, especially at the back of the eyes. Does not hurt, just uncomfortable. Head symptoms seem cyclical. Worse in heat, better at night, but eye sensitivity is constant. Can't concentrate because of the symptoms.

Second week: Same. Vision seems dim at the periphery. Worse indoors. Tried resting my eyes for a bit. Rushing sensation in the head/throbbing. Feeling of fullness at the ears/head. Went to EENT, she checked my eyes and vision. Result: BP normal, eyes healthy, vision 20/20. Diagnosis: Tired eyes, prescribed lens lubricant (Hypromellose).

Third week: Same symptoms with new sensation of dizziness. Similar to being in an airplane while it's taking off. No nausea/vomiting. Lasts for less than a second. Happens about once or twice a day. Eyes still dim. Can't read things for long. Bright lights acquire a sort of 'bloom' effect.

Fourth week: Went to ophthalmologist. Result: eyesight still 20/20, pupils are reactive, no blind spots, no double vision. Very healthy according to him. I asked if I need a CT/MRI scan, but he says the Optic nerve is okay and there is no need. He is puzzled by my symptoms, because as far as he can see, nothing is wrong. Diagnosis: Migraine, until further developments.

Question: Should I still be worried? :/ Symptoms are still there. Eyesight is still noticeably dim, but not debilitating. The rest of the symptoms come and go, worse at the afternoons when the heat is intense (I'm from the Philippines, tropical climates and all), they also respond to headache medication (again, except for the eye sensitivity). Just to clarify, if the optic nerve is okay, that means there is no sign of intracranial pressure right? (i.e. rules out glaucoma, tumor, pseudotumor, etc.?) Also, what other possible reasons for my symptoms are there?

[ericandrew]

Oh, I forgot. I'm a 24 year old male. 5'6", ~147 lbs, average build. I am asthmatic, last attack was last year (2009). Also hmm... head trauma as a kid (around 6 or 7 years of age), hit my head on a bedpost while jumping on the mattress (heh), blacked out for a bit, required stitches, but otherwise okay.

More info on symptoms: no sudden changes in personality aside from irritability from the feeling of malaise. No other sensorimotor symptoms aside from the eyes and tinnitus. No fever.

[Cath278]

Hi eircandrew, Not sure if this will be good news for you or not,but you do not have to have Papilledema, swollen optic discs, to have IIh, PTC .( Idiopathic Intracranial Hypertension.)
It is one of the main symptoms of this illness, but not all patients have them.
The main symptoms, are;
Very bad headaches,also a feeling of pressure in te head.
Visual problems,Double vision, blurring od sight, seeing tracers,sensitivity to light.
Tinnitus. Hearing strange noises, bells ringing, humming, hearing your heartbeat, most noticeable at night time, when you put your head on the pillow, A constant feeling like when a plane lands.
Nausea and loss of balance.

Extreme tiredness.
Lack of concentration.
Short term memory loss.

Not every patient will have all the symptoms but generally share the most obvious, ones.

In order to eliminate IIH, you will need to see a neurologist, have an MRI and a Cat Scan. If all these are clear then you will have a spinal tap, to check your opening pressure. This will determine your diagnoses.

If I can help in any way , please feel free to contact me. Good luck Cath 278.

[ericandrew]

Hello Cath,

Thanks for the help. :)

And definitely bad news, I think... Though the sooner I find out if this is indeed serious, the better. So even without papilledema, it could still be IIH... Hmm... am I correct in assuming that since it could still be IIH, it could also still be an actual tumor?

My main problem right now is that the nearest CT/MRI scan facilities are on another island. *sigh* Expensive as well. I *think* we have a neurologist in the nearest city (I'm from a rural area). I will wait another week for the symptoms to abate, if not I'll go see him.

Thanks again for the help, much appreciated.

[Cath278]

Hi again. Please , dont worry! With IIH , you do not have an actual tumor, only the same symptoms as if you had one.
The idea behind the name PTC, is, which by the way no longer considered accurate as it does suggest a tumor, is that; the increased cerebrospinal fluid takes up space in the brain much as a tumor would, hence the name.

More and more medical people are now using the world recognised new name, IIH. As well as being more accurate, it is also less frighting and confusing!.

How did you do at the "check " list? Do you have a lot of these symptoms?
I understand how expensive these tests can be but please do all in your power to get in to see a neuro.

Altho, you do not ,have paps at the moment , that can quickly change. The biggest threat to IIH patients is sight loss. It can cause permanent damage if left unattended. Even to the point of going blind.


You would have to have a MRI, to rule out anything more serious. Then an spinal tap. This is for two reasons, ;1) to eliminate any thing more serious which would show up in the sample they would take of csf. 2) To check your "opening pressure".
Most normal people have an opening pressure of 11-13..People with IIH , always have an opening pressure over 20. This is the Gold star test for diagnoses.

I do hope you will some how find the way to take of yourself. Any thing I can do to help, let me know. Cath278

[ericandrew]

Re: The checklist:

*Very bad headaches,also a feeling of pressure in te head.
- Somewhat. Mild headaches, not painful, just uncomfortable. Comes and goes.

*Visual problems,Double vision, blurring of sight, seeing tracers,sensitivity to light.
- Yes. Photosensitivity, dimming, and blurring at the periphery. Bright lights acquire a sort of halo, slightly like seeing it through a wet pane of glass. Constant.

*Tinnitus. Hearing strange noises, bells ringing, humming, hearing your heartbeat, most noticeable at night time, when you put your head on the pillow,
-Yes. Feeling of pressure just behind both ears. Can hear throbbing/rushing sounds sometimes when its really bad. Comes and goes.

*A constant feeling like when a plane lands. Nausea and loss of balance.
-Somewhat. Just lightheadedness. Not constant. Happens mostly when I try to read small text. Comes and goes/situational.

*Extreme tiredness.
- Yes. Whereas I was a night owl before, now I can't keep my eyes open past 10PM. I feel sleepy all the time.

*Lack of concentration.
- Yes. Mostly because of the symptoms though.

*Short term memory loss.
- Nope.

I'll go see a neuro as soon as I can. He may know of a hospital closer by with MRI facilities. There were some new hospitals set up in the nearby coastal cities recently, they could have those facilities, though I don't know yet. Heh.

Anyway, thanks a lot. :) Will post back my diagnosis and results when I can.