Sudden Eye Pain and Tears: Is It a Sign of High Eye Pressure?

Q: Sudden Eye Pain and Tears: Is It a Sign of High Eye Pressure?

Hello, concerned individual：<br>1. <br>Sudden sharp pains are not necessarily due to elevated intraocular pressure; it can occur if the oil secreted around the eyelids enters the eye. <br>In such cases, washing your face and cleaning your eyelids may help alleviate the situation.

Suspected high intraocular pressure with eye pain and tearing?

Hello, Dr.
Gao.
This evening, while I was having a bowel movement, I suddenly experienced severe stabbing pain in both eyes, accompanied by tearing, making it almost impossible to open my eyes.
Upon looking in the mirror, I noticed many blood vessels in my eyes.
Just two months ago, I had an examination at an ophthalmology clinic, where it was found that my optic nerve head had a cup-to-disc ratio exceeding 0.8.
I was referred to a larger hospital for further examination, and the doctor indicated that the degree of optic nerve cupping shown on the OCT scan had not yet reached the red zone in the illustrations (although both eyes had two cupping areas pressing against the boundary between yellow and red).
The visual field test showed no issues.
The sudden stabbing pain and tearing today made me very anxious, but I did not experience the eye pressure-related symptoms such as eye bulging, orbital pain, or migraines.
After about 30 minutes, the blood vessels in my eyes noticeably became finer and lighter.
Since I have a history of allergic conjunctivitis, the clinic doctor advised that I could use eye drops (steroids) if I felt uncomfortable, as it would be difficult to eliminate the issue without changing my environment.
Therefore, I am confused about these symptoms and would like to ask Dr.
Gao:
1.
Is the severe stabbing pain and tearing in both eyes that I experienced during bowel straining a warning sign of a sudden increase in intraocular pressure that could harm my eyes? Should I seek immediate medical attention?
2.
It seems that my optic nerve cupping is precariously close to a critical point, which worries me.
Fortunately, my visual field has not been affected, so the doctor has not initiated any treatment, and I only need to follow up every six months.
Besides eliminating improper eye usage habits and taking nutritional supplements, I feel there is little I can do to ease my anxiety.
During several visits to the clinic, my intraocular pressure has been around 20, which does not seem particularly high, yet I remain very concerned that my eyes may deteriorate rapidly and that I could eventually go blind.
How should I adjust my mindset? Do patients in this state typically progress quickly to optic nerve atrophy, experience constricted visual fields, and potentially go blind within their lifetime?
3.
I have allergic conjunctivitis; should I actively pursue medication for a cure? Will long-term neglect of eye inflammation or the aggressive use of steroid eye drops (Fluorometholone) at every meal and before bed increase my intraocular pressure? Thank you, Dr.
Gao, for taking the time to respond.

danxin de ren, 20~29 year old female. Ask Date: 2016/09/11

Dr. Gao Pilin reply Ophthalmology

Hello, concerned individual:
1.
Sudden sharp pains are not necessarily due to elevated intraocular pressure; it can occur if the oil secreted around the eyelids enters the eye.
In such cases, washing your face and cleaning your eyelids may help alleviate the situation.
2.
Some individuals naturally have deeper eye sockets, so it is important to assess based on intraocular pressure and visual fields.
Please continue to monitor your condition and do not worry.
3.
It is best to avoid long-term use of steroid eye drops, as some individuals may have a significant reaction to steroids, leading to increased intraocular pressure.
For allergic conjunctivitis, antihistamine eye drops can be used, as they generally have fewer side effects.
Taiwan E-Hospital Puzi Hospital Ophthalmology: Monday to Friday, 8:00 AM to 12:00 PM; Wednesday afternoon, 1:00 PM to 4:30 PM.
Online responses should only be used as a reference; if necessary, please seek medical attention at a healthcare facility.
I hope to have the opportunity to assist you.
Dr.
Gao Pilin

Reply Date: 2016/09/11

More Info

Understanding sudden eye pain and tearing can be quite concerning, especially when you have a history of optic nerve cupping and potential eye pressure issues. Based on your description, let’s address your questions and provide some insights into your symptoms.

1. Sudden Eye Pain and Tearing: The intense pain and tearing you experienced during straining could be attributed to several factors. While high eye pressure can cause pain, your symptoms do not align perfectly with typical acute glaucoma symptoms, which often include severe pain, nausea, and visual disturbances. The sudden onset of pain and tearing could also be related to dry eyes, an allergic reaction, or even a spasm of the eye muscles. The presence of bloodshot eyes suggests irritation or inflammation, possibly exacerbated by the physical strain. If the pain subsides and your vision returns to normal, it may not be an immediate cause for alarm. However, if you experience recurrent episodes or if the symptoms worsen, it would be prudent to seek medical attention.

2. Concerns About Optic Nerve Cupping: Your anxiety regarding the optic nerve cupping is understandable, especially given your family history and personal concerns about vision loss. While optic nerve cupping can be a sign of glaucoma, it is essential to consider the complete clinical picture, including eye pressure and visual field tests. Regular monitoring is crucial. Maintaining a positive mindset can be challenging, but focusing on what you can control—such as adhering to follow-up appointments, managing stress, and adopting healthy eye habits—can help. It’s also important to remember that not all individuals with optic nerve cupping will progress to significant vision loss, especially if monitored closely.

3. Management of Allergic Conjunctivitis: Allergic conjunctivitis can lead to inflammation and discomfort, and while it is essential to manage this condition, the use of corticosteroid eye drops like Fluorometholone should be approached with caution. Long-term use of steroids can potentially elevate eye pressure, which is a concern given your history. It may be beneficial to explore alternative treatments, such as antihistamine eye drops, which can alleviate symptoms without the same risk of increasing intraocular pressure. Regular follow-ups with your eye care provider can help ensure that your treatment plan is effective and safe.

In summary, while your symptoms warrant attention, they may not necessarily indicate a severe underlying issue like acute glaucoma. However, given your history of optic nerve cupping and the potential for increased eye pressure, it is essential to maintain regular check-ups and communicate any new or worsening symptoms to your healthcare provider. Managing your anxiety through education, support, and proactive health measures can also contribute to better overall well-being. Always consult with your eye care professional for personalized advice and treatment options tailored to your specific situation.

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