Swollen eye with scalp tenderness,...

4 weeks ago my brother started having headaches, his eye began to swell and he has pressure behind the eye. Also blurred vision. He has been on two different kinds of antibotics. It is no better, maybe worse. His scalp is so tender it hurts to comb his hair. The eye is so badly swollen in the AM that it takes awhile to get it open. He is going for an MRI and is afraid he has a brain tumor. He has never had sinus problems,which is what the doctor thought it might be when he first went to see him.  Any chance that it is a tumor. Is it possible to have shingles of the eye? Thanks

Rosie

[John C Hagan III, MD, FACS, FAAO]

There is an urgent need for your brother to see an Ophthalmologist if not as an emergency on Sunday then on Monday at the latest. Yes shingles can cause these symptoms and can get into the eye. It is extremely important in shingle to start an oral antiviral like acyclovir ASAP.

A brain tumor would likely not cause the scalp problem.  If your brother is older than 40 he also need as soon as possible blood tests called a sedimentation rate and a C-reactive protein test to rule out a disease called temporal arteritis (giant cell arteritis) that can cause those problem also.

Try and get this looked at on Sunday as an Emergency.

JCH III MD

[rosie28531]

7:20 PM Sunday Nov 25
My Brother is in the emergency room as I write this . He has had a Cat-scan and an MRI. The Cat-scan did not show anything. The MRI is being reviewed. The doctor on call has not mentioned shingles as a possibility. Is there a test for shingles? Should my brother ask the doctor about the possibility of it being shingles or should he request to see an Ophthalmologist ASAP. The pain must have been really bad for him to have gone to the emergency. I had not had a chance to tell him of your answer.

[John C Hagan III, MD, FACS, FAAO]

I would ask specifically about shingles. Its often a difficult diagnosis to when there is just pain but usually within 3-4 days a wet, blister like rash breaks out. Also ask the ER doctor about temporal arteritis and drawning a "set rate and CRP test".

JCH III MD

[rosie28531]

Thank You,
The ER doctor has released him. MRI was also clear. He asked the doctor about shingles and the doctor told him he had considered it but ruled it out.  I guess because he doesn't have any blisters or a rash on his face. He has had a headache, sometimes severe, almost continually for 4 weeks. Also my brother asked about the test you recommended and it had also been considered, but I don't think it was done.  He was told to see a Neurologist.  He was given a prescription for the pain. i was wondering if he should see the Opthamologist also?

[John C Hagan III, MD, FACS, FAAO]

How old is your brother?

Yes he should see an ophthalmologist Eye MD physician ASAP. His family doctor may be able to arrange a consult expeditiously or you can go to www.aao.org and find an Eye MD near him.

JCH III MD

[rosie28531]

45

[rosie28531]

Thank you for your help!

[rosie28531]

My brother  has a boat building business. He works quite a bit with fiberglass resins and epoxy products.  I was just wondering if these products could cause symptoms such as he is having, after years of exposure.  I know they are harmful if inhaled, but I am not sure if they can cause neurological problems.

[John C Hagan III, MD, FACS, FAAO]

I don't think that his work and the exposure is a problem. While temproal arteritis is classically felt to be a disease of older (>80) adults in my practice I have two biopsy proven cases of the disease. I think it is important to have someone either the ER doctors or his family doctor to draw a Sed Rate and CRP blood test ASAP.

this is more information on the condition:  

http://www.emedicine.com/EMERG/topic568.htm
I would push to get these done tomorrow morning if he's already home from the ER.

JCH III MD