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01/09/2021

The most common causes of headache are migraines, tension headache, sinusitis, visual fatigue and glaucoma.

• Migraines are a chronic type of headache that can have various triggers.

• Tension headaches can develop from tense muscles in the neck, face and shoulders.

• Sinusitis can develop from an infection or congested nasal sinuses.

• Excessive use of the muscles involved in focussing the eyes may cause visual fatigue and, subsequently, headache.

Headaches due to glaucoma can most usually be felt around the eyes and the forehead. The type of glaucoma that usually causes headaches and eye pain is angle-closure glaucoma.

 

Glaucoma

Angle-closure glaucoma, also known as acute angle-closure glaucoma, is brought on by iridocorneal angle closure. It occurs in eyes with characteristics such as hypermetropia, a narrow angle, convex iris and reduced anterior chamber depth.

In predisposed eyes it can be caused by staying in poorly lit environments, use of eyedrops to dilate the pupil, and the use of drugs that affect the diameter of the pupil. 

There are usually 3 types:

1. Asymptomatic narrow angle glaucoma

Angle closure can happen in triggering conditions.

It's most common in long-sighted eyes, in women and increases with age.

2. Primary acute angle closure glaucoma

The symptoms appear suddenly, such as red eye, eye pain, headache and reduced vision.

3. Primary sub-acute angle closure glaucoma

A reversible angle closure forms but only for a while and then it goes away itself.  The clinical picture is similar to acute angle closure but less intense and a shorter duration.

 

Treatment

In the three cases, a YAG laser iridotomy must be performed. It involves making a microscopic orifice in the iris with the laser in outpatients, in just a few seconds.

High intraocular pressure must be treated with hypertension medication. If the pressure cannot be brought under control, more invasive treatments may be required.

Acute closed-angle glaucoma is a disease that can cause headache and an irreversible loss of vision, which can be easily prevented through early diagnosis and a preventive iridotomy.

 

Dr. Francisco Ruiz Tolosa, ophthalmologist at the Barraquer Ophthalmology Center

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