Bruxism and Visual Symptoms

[Astroturf]

Dr. Hagan:

It seems that many of us with the flashbulb-afterimage-upon-blinking symptom all seem to be highly stressed with a tendency to clench/grind our teeth. I'm really beginning to wonder if the two might be connected.

I had an unusually stressful day yesterday and woke up several times in the night clenching my teeth. This morning, the whole right side of my face hurts, and every time my teeth touch, there is a shooting pain up to my right eye, which is the eye with all the symptoms. And, perhaps not coincidentally, this morning the "flash" in my eye is much worse.

Is there a nerve/muscle that runs from or near the jaw and eye that might be irritated by TMJ disorders and therefore causing a pressure phosphene?

The positive scotoma in my eye is always present, although I only notice it under certain lighting conditions (mostly bright lights/backgrounds or when going from a dark-to-light setting). It is in the upper temporal region and does not move, as far as I can tell. When I'm looking at the sky, it appears almost pinkish. When I'm inside, it looks more grey.

When I clench my teeth, the pain runs from my jaw up to the nasal side of my right eye. Wouldn't that make sense then that a phosphene appears in the upper temporal region of that eye? Is there a nerve/muscle in that area that might be pinched?

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

In the neuro-anatomy of the eye/jaw/teeth I can't visualize anyway that bruxism would initiate a central spot when blinking.  You might go on a dental forum and ask the question in reverse  ie do bruxism patients see spots.

For what's its worth in the office this past week a person came in complaining of the the same spot when blink syndrome. The eye exam was perfectly normal. All I could do was given them this forum address and suggest he enter the discussion.

I am buried in time commitments if I weren't it might be interesting to come up with a Questionaire Sheet and mail it to all the participants regarding associated medical and eye problems, medications, etc. etc.  I think it would make a very interesting scientific paper and perhaps make ophthalmologists and optometrists and visual physiologists more aware of the situation.

JCH III MD

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

I'm sure that computer screens don't have anything to do with it other than if you stare at a bright screen then look away or close your eyes for a short time you can see an after-image.

My patient was healthy and told me that he had noticed it all his life. He was late 50's. Anything going on that long doesn't need a $5000 neurosurgical work up.

JCH III MD

[Astroturf]

Dr. Hagan:

With your patient that had the same symptoms this week, did neurological/brain disorders ever enter into your thoughts for a differential diagnosis? That is my ultimate fear: that this has something to do with my brain, MS, etc. But the fact that so many doctors (of various backgrounds and specialties) keep dismissing that fear as "not likely" makes me think that there is something I'm missing that makes a brain tumor further down on the list of their speculation.

I wonder if computer screens have anything to do with this?

I posted a question in the Dental forum. Will let you know how they respond.

[Gotte]

Here's something I came across a while back. Apparently CRT computer screens with a refresh rate below (I think) 100 can induce Bruxism.

I know it's not directly related to your question above, but thought you might like to know, if you already didn;t.
Here's a link.

http://cellphonesafety.wordpress.com/category/60-hz/