Ophthalmic Causes of Headache among Patients Attending Tertiary Care Center in Kathmandu, Nepal

Pranisha Singh,Anu Mishal,Jay Sundar Sunarait

doi:10.3126/nmcj.v23i3.40383

Pranisha Singh, Anu Mishal + Show 1 more

Open Access

https://doi.org/10.3126/nmcj.v23i3.40383

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Abstract

The purpose of this study was to evaluate the ophthalmic causes of headache among patients attending tertiary care hospital. This was a descriptive, cross sectional hospital-based study. One hundred and thirty-two patients with ocular cause of headache excluding primary headache and pediatrics patients during one year were included. Detail ocular examination was done including visual acuity, refraction, binocular vision assessment like convergence insufficiency and fusional insufficiency, anterior and posterior segment examination. Among headache patients, female was 106 (80.3%) and male was 26 (19.7%). The prevalence of headache in female was 6.9% and in male was 2%. Headache was more common in age group 18-29 (59.8%). The mean age of presentation was 29.9 ± 10.2 years (range 18-61 years). Out of 132 patients with headache, 104 (78.8%) had refractive error, 15 (11.4%) had fusional insufficiency, 6 (4.5%) had convergence insufficiency, 10 (7.6%) had anterior segment diseases and 5 (3.8%) had posterior segment diseases. Among refractive errors, both eyes astigmatism was the commonest 48 (36.5%) followed by both eyes simple myopia 44 (33.4 %) which was statistically significant with ocular headache (p=0.000). Ocular anomalies other than refractive error may coexist with headache complaints. Therefore, thorough ocular examination should be done in all patients suffering from headache.

Highlights

Headache is defined as continuous or prolonged dull pain in the region of the head
Posterior segment diseases included 3 (2.3%) cases of optic neuritis and 2 (1.5%) of papilledema which was statistically significant with cause of headache (p=0.000). Both eyes (BE) astigmatism was the commonest 48 (36.5%) followed by both eyes (BE) simple myopia 44 (33.4 %) which was statistically significant with ocular headache (p=0.000)
The present study showed that among headache patients, female was 106 (80.3%) and male was 26 (19.7%)

Summary

Introduction

Headache is defined as continuous or prolonged dull pain in the region of the head. Headache in itself is not a disease but a symptom of a disease. Headache can be sight or life threatening if not treated promptly. Primary headache is not associated with underlying diseases whereas secondary headache is associated with underlying diseases. Ocular cause is the most common cause of headache. Most of the cases of ophthalmic origin is refractive error who first present to neurologists and undergo unnecessary investigations leading to waste of time and money which could be avoided if an Ophthalmologist is consulted initially.[1,2] In Ophthalmology Out Patient Department (OPD), the most common cause of headache is refractive error followed by other ocular causes.

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