eye problems

[carolynturner]

I have been experiencing pain and pressure feeling behind my left eye for a few years now, at odd times, not frequent.  It comes on sudden and can last for a few hours to a few days - looking periphally is painful, and the pressure is constant.  I am far-sighted  in my left eye, and my right eye is near-sighted with astigmitism, and I wear glasses.  When the pain occurs, my sinuses are clear, and I have no headaches or migraines, it's just the eye pain.  Sometimes I wake up to the pain and pressure, and other times it comes on during the day, usually reaching it's peak pain after an hour (abour a 6 on the pain scale).  And now for something totally different, yesterday morning, I was up sitting and talking with my mom, and my right eye decided to look to the left, on it's own, while I was looking straight ahead.  This was only for about 15 seconds, but made me very disorientated, and dizzy.  My mother who was looking at me at the time, said it had obviosly moved in it's socket.  What can be causing the problems in either eye?  I don't have insurance, and the Dr. at the low-income clinic does'nt listen when you tell him your concerns or symptoms - I am 52, female, and a diabetic, and am currently up to date aboput my disease.

[Houman Vosoghi, MD]

Dr. Shen has done a great job explaining all the possibilities and recommending you get an eye exam by an eye MD to check for glaucoma and diabetic retinopathy.  You could consider contacting the local county hospital to see if they have an eye clinic where you could be examined if you can't afford to go to an ophthalmologist in the community.

HV

[Christopher C Shen, MD]

This presentation definitely sounds like it could be caused due to a variety of causes, although the most likely causes that come to mind would be a a motility disorder secondary to the diabetes, an issue with elevated eye pressure (glaucoma), or a disassociation between the left and right eye working together if there is a significant discrepancy between the corrective error between both eyes (a difference of greater than 1.5 diopters is usually pretty significant, for example if the prescription in the far-sighted left eye is +2 and -2 in your near-sighted right eye, the total difference would be 4 diopters).  The fact that you've had the pain and pressure for a long time rather than sudden onset is more reassuring, although any progression or change in symptoms can be concerning for something more serious.  If you notice the pain worsens during the day, eye strain from difficulty focusing with both eyes from the difference in correction would be more likely, although the fact that you occasionally notice the pain upon awakening is not consistent with this diagnosis.  
With regard to this all being secondary to diabetes, sometimes an elevated blood sugar can compromise circulation towards vessels supplying the eye muscles coordinating eye movement so this would need to be worked up by an ophthalmologist to assess for any deficits in eye movement or involvement of the pupil, which would indicate a more serious condition that may need head imaging to rule out a process behind the eye.  With regards to eye pressure, this is usually a routine measurement in the eye clinic to screen for glaucoma and diabetes can sometimes lead to elevated eye pressure due to the presence of abnormal blood vessel growth within the eye affecting the drainage of fluid within the eye.
In summary, I would try to figure out a means of seeing an eye MD to exclude any serious problems secondary to diabetes or eye pressure and once this is done, perhaps the symptoms may be improved upon with optimizing the correction between both eyes with either a contact lens or optimizing the spectacles to minimize the discrepancy in images between the right and left eye.