I Have a Headache, Now What? Perspectives from an Optometrist.


One of the first questions that I ask my patients during an eye exam is if they are experiencing headaches.  Headaches are the brain’s way of signaling the body that something is wrong and can reveal a lot about someone’s eyes and even their overall health.

Why do we get headaches?  

As an Optometrist, most of the headaches that my patients tell me about can be related directly to their visual system.  Of our five senses—sight, hearing, taste, smell and touch—sight is most predominant in humans. We rely on our vision more than anything else for information of the world around us.  If our visual senses our not performing optimally, our brains know it and send us a signal, often in the form of a headache, that there is a problem.

13The visual system has many components and the eyeballs are directly connected to the brain via the optic nerve.  There are also many smaller nerves that branch off of the eye that go to the brain. As the muscles that are responsible for focusing the eye, become over worked and tired they get strained.  This eye-strain often causes headaches. We can get the headaches behind our eyes, above our eyebrows on our forehead and even in the back of the head. These headache places are often eye-related headaches and should be checked out by your doctor.  Taking breaks, wearing/updating eyeglasses and taking NSAID’s all can help.

Another type of headache that is very common is a migraine headache.  Interestingly, migraine headaches are thought to originate in the neurological system and manifest in certain areas of the head.  Migraines are not a serious medical emergency, but they can be debilitating. There can be lots of triggers for migraines, including foods and hormone changes, and there are medications and lifestyle modifications that can help.

There are other, more serious problems that headaches can indicate.  If something is pressing on a nerve in the brain or head, it could trigger pain and sensitivity.  Often, tumors will cause headaches. These headaches would necessitate a visit to your doctor and, of course, should be taken seriously.

I would not want my patients to ever assume the worst and think that every headache should be evaluated.  There are, however, some guidelines that I would follow: Any sustained headache that does not go away with rest or medicine, headaches that cause blurry or double vision, headaches that are accompanied by nausea or vomiting, headaches that you wake up with, and any type of headache that is unusual or uncommon for you, I would visit your doctor. You can also use EyeQue at home vision testing products to track if your headaches are truly causing vision changes (change in your refractive error or visual acuity). Whatever the symptoms are that are unique to your headaches, make sure to not ignore them, be proactive and test at home and seek medical care.