torn eye muscle?

[remer]

I am 26 years old and just finished law school--last few weeks were very intense reading and looking at powerpoint slides on drop-down screen in classroom as well as on computer.  Recently I've developed pain in my right eye when I look to the left--e.g., when two people are sitting in front of me, it brings discomfort to look to the person to my left; I have to turn my head in that direction to speak to them without pain.  I also have pain in the right eye muscles when I close my eyes and try to "relax" the muscles.  I just had complete exam from an opthamologist four days ago and there was nothing abnormal, but she said my contact lens prescription was "over-minused."  But I haven't worn my contacts in five days and there is no improvement.  Recently I started a bar exam prep course and there are video lectures--again on big drop down screens--and I feel discomfort when I have to focus on the speaker.  Other than that, I'm okay.  No real pain reading or doing normal activities as long as I don't begin to look to far too the left without moving my head.    

I'm wondering what else to do for this to improve.  Could I have pulled an eye muscle?  Should I wear a patch over the right eye?  I am not wearing my contacts right now, so it seems that can no longer be the problem. (For what it's worth, my right eye is dominant--my right eye contacts prescription is -3.75 and my left is -4.25.)

I really need to get a hold on this--can't have distractions with the bar exam coming up!  Just FYI: I started wearing new retainers about the time the pain started.  Could that have jarred the entire area?  

[Michael J Kutryb, MD]

It sounds crazy, but I wonder if pain from your retainers could be referred to the maxillary sinus and perhaps cause some referred pain in the orbial region.  No way to realy prove that -but could try stopping the retainers. Just a wild guess.  Now to more likely probability - it sounds like you  may have a combination of severe eye fatigue and overminused contacts.  You could also hav severe dry eyes and possibly even some orbital inflammation.  Suggest you see a second ophthalmolgist and carefully explain your symptoms.  I'm not convinced that this problem has been fully looked into.  Try to get some rest for your eyes, see another ophthalmologist to look for possible causes. Look into the possibility of sinusitis, or an orbital disorder, or a facial pain syndrome like trigeminal neuralgia.

Michael Kutryb, MD

[remer]

Thanks, Doctor.  I have scheduled another appt with a second opthamologist, and I'll see what happens.