Eye pain/soreness when reading, watching tv or using PC - at end of tether!!!

Hi

Apologies in advance but this is a long post and we are at the end of our tether as no-one can tell us what is wrong or what can be done to solve the problem and relieve the pain. This is now affecting every day life and could lead to him having to quit his training course as he can’t even read now without getting pain. Any help or ideas will be greatly appreciated.

In July 2008 my husband was writing his wedding speech on the PC. His eyes started to hurt (you know when your body tells you it’s had enough of something) and he should have stopped but as the wedding was only 2 days away he pushed on and carried on. The next day he got up and his eye was completely red (no white at all) and he was very sensitive to light.

We went to the opticians, they did a few tests and sent him to A&E. In A&E he was diagnosed with right uveitis and was prescribed antibiotics and topical steroids (one of which kept his pupil permanently dilated). Then we went on our honeymoon and he used the drops as prescribed. Redness went down and light sensitivity subsided after a while. On 25 July he had a check up at A&E, they found a foreign body in his eye and prescribed more eye drops (name unknown).

A few weeks after being back at work he got the pain around his eye again whilst looking at the PC. He also found he could not watch TV without discomfort. The pain he was getting was described as soreness around skin area/eye feels as though he had been slapped in the face and on occasion had tingling sensation around and down check. He had a general eye ache but couldn’t say if it was the eye itself or behind the eye, if pressed the eye itself was tender to touch.

 He then went to an Ophthalmologist (Aug – Sept 08) who gave him 2 sets of drops on separate occasions (name of drops unknown). He also did some other tests (tests unknown). He had x-rays for sinus problems – all came back clear. He said if uveitis comes back it could be linked to ankylosing spondylitis. Referred him to a Neurologist (Sept – Nov 08). He prescribed Indomethacin 25-50mg 3 times per day – no effect. He did several tests. Blood pressure was132/76, no evidence of occipital nuchal tenderness on the right. Fundoscopy is unremarkable, query cluster headache?

 History not right for this. Query Optic Neuritis? But visual acuity is well preserved. Sent him for MRI of orbits, brain, optic nerve, chiasm and cervical spine. Intracranial MRA was carried out. All came back normal. Sent him for visual evoked potentials and blood tests (not sure what was tested for). All clear. Prescribed Prednisolene 40mg per day for week then 30mg per day for week – no effect.

 Blood tests (screen for inflammatory markers and autoimmune disease negative) imaging and electrodiagnostic studies were non contributory. Referred to Moorfields (Dec 08). Prescribed acular drops and visco tears, diagnosed with right sided uveitis (drops didn’t work), suggested filters on glasses, referred to another Ophthalmologist (Feb 09) - Ocular exam unremarkable, ocular motility full, visual fields on confrontation were full, pupils normally reacting, visual acuities 6/6 in each eye unaided, is emmetropic, central corneal thickness is 608 microns right and 615 left. Intraocular pressures little on high side 21mmHg.
Possibly trigeminal neuralgia – back to another Neurologist (March – Nov 09). Possible ocular migraine (once sensitised) (or cluster headache).

Tried a few things but nothing worked (during this period had to defer training course and watched no TV/Computer work etc got a bit better until restarted course in October 09). Neurologist again - Possible Trigeminal Autononomic Celpalgia due to face pain
Prescribed cafergot 1mg x3 a day (6 days), Indometacin 50mg x3 a day after food (10 days), Ranitidine 150mg x2 a day (8am and 6pm) – nothing worked. Referred back to Ophthalmologist (Nov 09) - Diagnosed dry eye, gave various drops again nothing worked. Dec 09 - Emergency appointment when red eye came back, said it was Episcleritis, did blood tests. Prescribed Optive and Lotemax.

Follow up, blood tests, picked up HLU B-27 gene. Referred to rheumatologist. Before seeing the rheumatologist he had a Orthoptic assessment which was all fine. It was suggested to see a Neuro-opthamologist. We saw one in Dec 09 he said - Atypical face pain, exception that symptoms are provoked. Pain being caused by lack of sleep leading to lowered tolerance of watching TV and using PC leading to eye pain. Prescribed amitriptyline nocte – no help only made him really sleep during the day so had to stop taking them.

 Also went to see a colour lens specialist as thought it might be something to do with colour omitted from PC/TVs screens. No assistance (was actually a total waste of time and money!). Saw rheumatologist (Jan 10) who sent him for another Brain MRI and blood test testing for Ankylosing Spondylitis. Blood tests clear but MRI showed Ankylosing Spondylitis, referral for Hydrotherapy and back to Ophthalmologist for eye pain. Feb 10 saw yet another ophthalmologist who did all the usual checks, said eyes completely fine is stumped as well.

 I had been doing some research and asked about problems with rods and cones which could cause these symptoms he said it’s not that. Asked about beta-carotene and lutien deficiency but said no as rods and cones are all fine. He prescribed Froben 100mg, but doesn’t think they will do anything – they didn’t.

At this time my husband restarted his course and found a workaround for the looking at the PC – he put ice packs on either side of his head which stopped the pain allowing him to do his uni work. All was ok with this workaround until just recently. Before we were due to go away in April the red eye came back. He got the same drops that he was prescribed again and that took that down. On going back to uni and starting to study his eyes began hurting again. Now it is hurting him to read and the ice is not helping to allow him to use the computer.

As before I would be very grateful for any suggestions as to what this could be or how we can cure/manage it. He is even willing to have surgery if it comes to it to get this problem sorted.

Thanks

(Edited for eaiser reading) SE

Post Edited By Moderator (Screaming Eagle) : 5/13/2011 6:37:32 AM (GMT-6)

By any chance has your husband been checked for allergies? Even if he has you might want to consult an allergy specialist. I know it is a long shot but it is a possibility.

While I don't have any major allergies like hay fever, etc every once in a while something gets to me and one or both of my eyes will get really red, watery, very sensitive to light, etc. Fortunately it only lasts a few days and OTC Benadryl helps clear things up real fast for me.

Dear k_taz,

I should preface this posting with the fact that I am not a doctor and this is not intended to replace or override any information or advice you may have received from a doctor.

I'm very sorry to hear what your husband is going through. Unfortunately it sounds extremely familiar to me. Since your husband has been diagnosed with ankylosing spondilitis, just from your descriptions of his eye issues, it is possible he has scleritis.

Scleritis is a somewhat rare condition. It is an inflammation of the sclera, the rigid, white outside coating that provides structural support to the eye. The sclera is closely related to the connective tissues that provide support to joints.

As you know ankylosing spondylitis is a connective tissue disorder, like its better known cousins, rheumatoid arthritis and lupus. Unfortunately, scleritis can accompany any of these conditions, since they are autoimmune disorders in which the immune system actually attacks the tissues and organs of its own body.

I have both lupus and RA (aka rhupus), and have had photosensitivity problems for several years now. I wear tinted glasses indoors and out; in fact I rarely go outside because I get sick from even brief sun exposure (nausea, rashes, chest pain which has occasionally landed me in the ER).

Recently I have begun to have bouts of scleritis. First it feels like I have something in my eye. It progresses to pain in the side of my face and deep in the eye socket, and then the white part of my eye turns red. If it's really bad, the white part actually can puff up in spots.

The first time it happened, I quickly did a bit of online research and was able to come up with scleritis as a possible diagnosis, which my ophthalmologist confirmed. He also told me that the prednisolone drops he prescribed would likely get rid of it fairly quickly, but that it would probably recur. And he also told me that, even though my scleritis can be treated, it cannot be truly cured, because it is probably due to my underlying autoimmune disorders.

The only time I would think that scleritis might actually be curable is if it were triggered by an illness like Lyme disease (which I also have). Lyme disease can mimic connective tissue disorders like lupus so it is possible that it could cause scleritis. If someone with Lyme was able to get their Lyme disease under control with treatment, it is likely that any accompanying issues such as scleritis would go away.

I do wish you and your husband the best of luck, and hope that this information may be helpful to you.

Take care,
JoAnn

As mentioned by other members, Sjogren's Syndrome and Lupus (as well as some other auto-immune diseases) can cause inflammation in the eye - a rheumotologist may be able to help you. I find that both computers, TV, and sometimes even reading can cause my eyes to become hyper-sensitive. I don't have anything specifically diagnosed about my eyes, except for mild Sjogren's, but I do have a couple of suggestions from my own experiences with eye stress.

Stay away from florescent lights as much as possible, especially keep them away from the computer or TV. On the computer, make sure you turn the refresh rate as high as possible. Lower refresh rates can been seen by those of us with sensitive eyes, and it only exacerbates the problem. Wear dark UV glasses, avoid the sun, get your car windows tinted with the darkest UV legal in your area. Avoid moving your head while moving your eyes -- things like turning my head and walking and looking at the shelves in a store irritate my eyes (and sometimes make me dizzy). Take frequent breaks from monitors by looking into the distance every few minutes.

Keep yourself as low-stress as possible. This means make sure you are getting enough restful restorative sleep, that you are eating balanced meals at regular intervals, that you get regular exercise. Maybe try meditation or medication if you tend to get worried or stressed unduly. Don't attempt multiple stressful things in one day -- little stresses not really registered by the brain can stress your body out, and the body reacts in crazy ways. Right now every stressful thing for you is going for your eye. Even the tiny stress of using a new recipe in the kitchen counts.

If the classes are on the computer, see if there is another option. Try printing out the material and reading under an incandescent light rather than trying to read under florescent or from the monitor. (Avoid anything that projects light at the eye.)

I hope some of this helps. I tend to freak out when my eyes are acting up so I know how scary this can be.