Shooting eye pain

[Vanlink]

Hi everyone,
First time posting here in hopes of getting some ideas on my current issue.

As of late April, I've been suffering from an unusual stabbing/shooting eye pain in my left eye. And this is not the typical eye strain pain that you get from over PC use, TV watching or gaming; one that can sometimes grows into a headache but goes away with instillation of drops or a good night sleep or some Tylenol.  

No, this is something I've never experienced before. It is literally a shooting/stabbing pain that feels like its in the back of the eyeball. And the more I expose myself to watching tv, PC use or anything remotely with high contrast, the worse it gets. And it actually travels up to the top of the head where it feels like a tingling sensation, and worse, down to the ear area, where it feels like burning/shooting stabbing pain inside the ear, and finally to the back of the throat area. Sometimes it's so bad that it feels like I have a sore throat, while there's actually nothing wrong with it.

It's been going on since and doesn't seem to go away. I've tried all medication, Tylenol, Ibuprofen and the their variances. I had all the eye tests with the Optomologist, Field of vision, eyeball scan and photos, and nothing was found. In fact, my vision is very good and is completely unaffected by any of this, which is the weirdest part. I do wear glasses by the way.  I've been referred to a neurologist which then sent me to get a CT (cat) scan, which revealed nothing other than normal. I've gotten 3 bloodworks done since and nothing unusual.  

My family Doctor strongly believes that it is a strained neck muscle/nerve issue at play here. I undergone 6 Local anesthetic needle pressure injections, which yielded very little improvement. I moved on to acupuncture and had so far 6 sessions, which yielded minimal improvements.  

Any ideas, or has anyone experienced something like this?
Any suggestion is appreciated.

[Houman Vosoghi, MD]

Good thought by MHVC.  Sounds a lot like shingles but usually that has a rash.  Trigeminal neuralgia without shingles is another possibility as are a couple of headache syndromes.  Your eye exam rules out any. Eye problems and CT rules out sinusitis.  I think you need an MRI exam of the brain and Brainstem/neck (important to get both) and possibly an angiography to rule out subtle aneurysm, brainstem lesion or carotid dissection.  The last one becomes more important if you have a droopy eyelid or smaller pupil on that side.  Shingles blood test could also be done but unlikely to be diagnostic this long after.

HV

[Houman Vosoghi, MD]

MRI could pick up some things that CT misses like demyelinating lesions.  Shingles without a rash is not typical but that Zoster virus could do almost anything.  Aneurysm, I agree, would usually be progressive and not stable but given how strange your symptoms are I'm thinking zebras as well as horses in the differential.  Pain syndromes are usually of exclusion and all other potentially treatable causes need to be ruled out.

HV

[MHVC]

Do you know if your were screened for shingles (Herpes Zoster)? It is possible to have shingles without a rash.  Shingles can affect any nerve in the body and can cause a rash, pain, including shooting or stabbing pain, itching and or tingling anywhere along the nerve path it affects.  If it affects the trigeminal nerve it can cause symptoms and sometimes serious complications in the eye, ear, face, mouth, nose, or jaw.  Symptoms on one side of the body that do not cross the center line are a sign of shingles.  Although shingles are more common in the middle aged and elderly you can get them at any age.  The chicken pox reactivates as shingles.  The reactivated virus lasts about a week but the pain can linger for months or years.  There is a blood test for it.  When the virus is active, it is treated with an anti-viral once it goes dormant again, just they symptoms are treated.  

[Vanlink]

Sorry, there's a correction in the second line of the second paragraph. I meant to say that My face or any skin surface along my face or head is NOT overly sensitive.

Sorry about the confusion

[Vanlink]

Thank you for your suggestion Dr. Vosoghi.

I am curious though, I have checked my medical history and noted that I never actually had chicken pox. So is it possible for me to get shingles without being exposed to Chicken Pox first?  I did have measles, but I'm not if it's related.  Any thoughts on that?

Trigeminal neuralgia is an interesting thought, however, I don't seem to exhibit any typical symptoms. My face or any skin surface along my face or head is overly sensitive. I don't get headaches, and the pain I have is not within the scope of episodic trends. My pain is constant and does not go away. But don't get any headaches. I am not sensitive to any loud sounds, in fact, I listen to music through headphones fairly loudly and it doesn't bother me at all.  I also did get all possible Optomology and eye exams, and the Dr. Said that my eyes are perfectly normal. I do have Blepharitis in the eye which I get pain, but he doesn't think it has anything to do with this.  As for the MRI, would that rule out more than what the CT scan has? And is it possible of an aneurysm to do this but not progressing any further? My status as of now is stable, it doesn't appear to progress nor regress. Just sort of is where it's at while being alleviated by physical work (such as walking, running, and in fact, I helped a friend move apartments over the weekend, and I actually felt better afterwards), to being aggravated and agitated by any extensive activity involving PC work, watching TV, video-gaming, and the worse of it, iphone usage, such as texting, email or any app usage. It's very clear that anything of higher contrast and artificial light increases the pain. But sunlight, not so much. It's actually almost comical, yet infuriating at the same time, since I can do pretty much anything, asides from the basic standard things normal people do.   And, I'd like to mention again that my vision is unaffected at all by any of this. I don't have a droopy eyelid, not one that I can tell at least. I do have a slight lazy eye (but that's the right eye, the unaffected side) which as a default has a slightly larger pupil. But the Eye Dr. is aware of this as-well, and believes it is normal.    

However, do you think that this could be some form of Occipital neuralgia?

The symptoms listed for it are by far the closest to what I experience.

Thank you again.

[Vanlink]

Thank you for your reply.  
To be honest, I'm not sure if I was screened for shingles/Zoster. Though I had bloodwork done after seeing the neurologist. If it's possible that this is what I have, I would honestly be very shocked why she would not think of this. Come to think of it, why 2 different M.D.'s, a family Doctor and an optomologist would not consider this would also be very shocking. But I guess anything is possible.  Though, what are the chances of this occurring without hives and rashes, and at the same time combined with the symptoms I exhibit? Is this really possible?  

I also noticed that some of the symptoms include headaches and fever, but then again, nonspecific.  

Interesting indeed. I will definitely ask my Doctor.
Thank you very much for your advise and thoughts,
Much appreciated.