Serious Causes of Headache and Vision or Eye Problems

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What may be going on when both your head and eyes hurt?. Paul Venning/The Image Bank/Getty Images

Sometimes people with headaches also complain of eye or vision problems—like blurry vision or eye pain. If your eye or vision complaint cannot be attributed to a migraine aura, your doctor will consider other medical conditions that cause a headache and eye problems. 

Optic Neuritis

Optic neuritis is an inflammatory condition of the optic nerve, a nerve located in the back of the eye that sends signals to the brain.

People who suffer from optic neuritis usually have pain, especially with eye movements, and experience some vision loss over a period of 7 to 10 days. Some recovery of the vision loss usually occurs within 30 days of onset. Patients who have a diagnosis of optic neuritis should undergo a brain MRI to assess their risk of multiple sclerosis (MS)

Stroke

A stroke is a medical emergency and is defined as either an ischemic stroke (in which blood flow is interrupted to the brain) or a hemorrhagic stroke (in which there is bleeding into the brain). In one study in Cephalagia, of 240 patients with a stroke, 38 percent had a headache. The location and intensity of headache varied based on the type of stroke.

Finally, a headache was the most common in patients presenting with a vertebrobasilar stroke. This type of stroke can also produce visual disturbances, in addition to a number of other symptoms like vertigo, drop attacks, and difficulty swallowing.

It is caused by bleeding into or restricted blood flow to the vertebral and basilar arteries of the neck.

Increased Intracranial Pressure

Headache and vision changes can also result from increased pressure buildup in the brain. This pressure buildup can be a result of a brain tumor, infection, or a condition known as hydrocephalus in which there is an excess amount of cerebrospinal fluid in the cavities of the brain.

Doctors can detect increased intracranial pressure by doing an ophthalmoscopic exam to check for papilledema.

Idiopathic Intracranial Hypertension

Idiopathic Intracranial Hypertension (IIH) is a medical condition that results from increased spinal fluid pressure around the brain, in the absence of a tumor or other brain disorder. The cause is largely unknown, but the majority of cases occur in obese women of childbearing years, especially in those who have recently gained weight.

Nearly all patients with the condition present to the emergency room or doctor’s office with a complaint of a headache and blurry or double vision. Treatment is typically weight loss and acetazolamide (Diamox). If this fails, patients may be treated with a shunt, which diverts the flow of the cerebrospinal fluid (CSF) to other parts of the body.

Temporal Arteritis

Giant cell arteritis, also known as temporal arteritis, is an inflammatory condition of the arteries, especially near the head and neck area. Impaired blood flow to the eye structures can lead to a number of vision changes, like double vision or even vision loss.

Individuals with this condition are usually age 50 or older and complain of  a new-onset headache that frequently affects the temples.

Herpes Zoster Opthalmicus

Herpes zoster opthalmicus (or shingles of the eye) is due to a reactivation of the varicella-zoster (chickenpox) virus in the ophthalmic division of the trigeminal nerve—a cranial nerve that carries sensory and certain motor (movement) signals from the face to the brain. The virus can harm the eye and produces a classic dermatomal rash, in addition to pain in or around the eye. Individuals may also experience a headache prior to the development of the rash.

A Word from Verywell

If you have a headache along with new vision changes or eye pain, please seek the advice of a healthcare provider so that a proper diagnosis can be made.

Sources:

Arboix A, Massons J, Oliveres M, Arribas MP, Titus F. Headache in acute cerebrovascular disease: a prospective clinical study in 240 patients. Cephalalgia. 1994 Feb;14(1):37-40.

Frohman EM, Frohman TC, Zee DS, McColl R, Galetta S. The neuro-ophthalmology of MS. Lancet Neurol. 2005 Feb;4(2):111-21.

Gonzalez-Gay MA, Barros S, Lopez-Diaz MJ, Garcia-Porrua C, Sanchez-Andrade A, Llorca J. Giant cell arteritis: disease patterns of clinical presentation in a series of 240 patients. Medicine (Baltimore). 2005 Sep;84(5):269-76.

Mounsey A, Matthew LG, Slawson DC. Herpes Zoster and Postherpetic Neuralgia: Prevention and Management. Am Fam Physician. 2005 Sep 15;72(6):1075-1080.

Wall M et al. The idiopathic intracranial hypertension treatment trial. JAMA Neurol. 2014 Jun;71(6):693-701.

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