tingling eyes

[hylander193]

Can you please help me doctor.  For the last 5 months I have had weird sensations in both my eyes.  The problem now though is mainly the left eye.  In the last 2 months, it has started to develop a tingling sensation (before it was like a pressing dull ache) sensation.  The sensation can be in the inner corners, outer corners and at the back of the eye.  The blood vessels too are more enlarged than normal in the left.
But most annoyingly it also causes me headaches in my temple, when the tingling gets very strong.  The tingling gets stronger towards night time. I also have photophobia in sunlight.  I have seen 3 certified ophthalmologists, and they could not see anything wrong. My eye pressure was normal too. I also had a MRI done of the brain and sinuses, and all that was found was a small retention cyst on the Maxillary sinus. I had 16 blood tests done also, and they came back fine. So two and half months ago, I went to see a neurologist, and he thought it to be some form of migraine (can a migraine start in your eye?)He prescribed Verap, but my headaches just got worse on this.  I also tried Imigran, but that didn't work either.  I feel like I don't know what to do now. Do you think it sounds like migraine?  Should I try experimenting with other anti migraine medication?  Also do you think the drug timolol would be suitable for my symptoms? Or is there a certain drug that I could ask my regular md for?

I do suffer with perrinial rhinitis also.

I would appreciate your advice.

[Neuro Forum]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

In general, migraine disorder can cause associated visual and eye symptoms. Typically, a migraine with aura is described as visual symptoms (rather than eye symptoms) such as flashing lights or loss of peripheral vision in one eye followed by a headache. While your eye symptoms are atypical (in the sense that your actual eye is uncomfortable rather than your vision), it is still possible this could be migrainous. Lack of response to one migraine medication does not imply that your headaches are not migraines; sometimes, different medications need to be tried.

By timolol, I assume you mean eye drops. I can not comment on whether or not timolol eye drops would be helpful as this is not really in my area and I do not have experience with this.

It sounds like you have had extensive imaging of your brain. One diagnosis that may not show up on a regular MRI that can cause eye pain and headaches is a dissection: a small tear in the blood vessels that travel up the neck to the brain. This can occur spontaneously in people with certain conditions that affect the blood vessels, after neck trauma, or after chiropractic manipulation of the neck. The pain is often but not always associated with some sort of neurologic deficit as a dissection can often lead to a stroke. In order to exclude this, directed imaging of the blood vessels with an MRA or CTA is sometimes necessary. Again please do not think I am implying I think you have a dissection, you symptoms are again not typical of this either (it does not usually cause the type of eye symptoms you describe), I am just trying to provide you with some possibilities.

If you are older than the age of 55, one potential causes is called giant cell arteritis or temporal arteritis. This is due to an inflammation in the temporal artery and other arteries in the body. Symptoms include vision symptoms one sided headache pain in the temple and jaw that may be triggered by chewing. This condition can be diagnosed by a blood test called an ESR and a biopsy of the artery. It is very important to rule this diagnosis out as it is highly treatable and if left untreated it can lead to vision loss. It is exceedingly rare in people younger than 55, and is more common in even older age groups.

The cause of your eye symptoms may not be neurologic. I recommend continued follow-up with both your opthalmologist and neurologist for your headaches.

Thank you for using the forum I hope you find this information useful good luck.

[hylander193]

I am just 32 yrs old. My doctor ruled out temporal arthritis.  Thank you v.much for your time and resonse though.  It has helped.