Your Child's Headaches are PROBABLY NOT Caused By Their Vision

So says a NEW STUDY. "Many parents assume that frequent headaches mean their child needs glasses, so they ask their doctor to refer their child for an eye exam. But, according to a new study, vision or eye problems are rarely the cause of recurring headaches in children, even if the headaches usually strike while the child is doing schoolwork or other visual tasks." I completely AGREE, and have said this for years. MOST children who SEE FINE and go to their pediatrician complaining of headaches get a referral for an eye exam...and almost none of them need new glasses. Ok, I'm not mad about getting a referral (who would be?). But I often feel like the pediatrician is just "punting" the problem off on me b/c headaches in children are common and famously hard to diagnose and treat. I also feel like the parents are HOPING it's "their eyes" b/c that would be an easy/fast/cheap solution to their problem. It's almost never the case, and so the parents are often disappointed. Throw in that the kid feigns blur during the exam and I get the "are you sure?" and "how do you know?" questions from the parents. It is especially errr annoying (wish I had a better term here) to me for a patient who already has glasses (known refractive error) and sees 20/20 thru them to get referred back to me for another eye exam b/c they have headaches. It is really, REALLY unlikely that the glasses are the problem in those cases. In my opinion the vast majority of children do not need "reading glasses". I see this posted all over the net as if it were fact for children who complain of reading problems, headaches, etc etc. I even see a LOT of other O.D.'s (one in the article above) expounding on the need to test accommodation, etc. Ok does that exist in medicine? Sure. Is it COMMON, though? No...in my opinion it is probably NOT COMMON to have a pediatric lag of accommodation so great that reading glasses or bifocals are indicated. Somewhere in New York, some of my vision therapy teaching docs at S.U.N.Y. are having steam come from their ears haha. As I always say: "I am not the 'headache doctor'". If the MAIN COMPLAINT of your child is headaches, in the ABSENCE of blur...glasses are probably not the answer. Just my opinion, and it's my blog so I'm entitled!

Comments

  1. hello this is abhi frm india.I hv ambloypia in my left eye whereas my right eye is perfectly fine.whn Iam nervous dizzy or tired or angry thn there comes a squint in my left eye n it is towards my right eye means esotropia ths squint is not constant it is intermittent .since my left eye is ambloypic so i don't hv binocular vision,means all the vision (clear) is of my right eye.I also went to opthalmologist nd she prescribed me to use glasses left eye(-0.75) right eye(0.00).bt ths squint cms n goes as i said tht whn iam nervous.So is thr any cure for ths intermittent squint....plz help me..nd i hv seen in mirror tht my left eye deviates such tht it sees wht my right eye is watching i.e they both focus at one point.

    ReplyDelete
  2. hello this is abhi frm india.I hv ambloypia in my left eye whereas my right eye is perfectly fine.whn Iam nervous dizzy or tired or angry thn there comes a squint in my left eye n it is towards my right eye means esotropia ths squint is not constant it is intermittent .since my left eye is ambloypic so i don't hv binocular vision,means all the vision (clear) is of my right eye.I also went to opthalmologist nd she prescribed me to use glasses left eye(-0.75) right eye(0.00).bt ths squint cms n goes as i said tht whn iam nervous.So is thr any cure for ths intermittent squint....plz help me..nd i hv seen in mirror tht my left eye deviates such tht it sees wht my right eye is watching i.e they both focus at one point.
    n sry for bad english.

    ReplyDelete
  3. squints (tropias) that are not constant...are not surgical candidates. so surgery is pretty much out. if the left eye points IN (esotropia), a -0.75 would, in theory, make an esotropia MORE prominent and point in MORE OFTEN. if you really don't see that well out of the left eye, I wouldn't bother with the -0.75 for that reason.

    no there is no "cure". some advocate "vision therapy" for this kind of eye problem, but I personally believe that as an adult that probably wouldn't accomplish very much. just my opinion

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  4. Dr Very nice to see u r blog and i find lot of information about eyes,
    sir i from India, recently in my right eye i noticed a type of layer from nose side to eyeball with one big inflamed blood vessel. This blood vessel has been irritating my eye (i thought itching), when my body got over heated, or when i use to see computer for long hours.
    1. What type of diseases it is?
    2. I need any medical emergency?
    3. Will it affect my vision in future if I neglected it?
    --datta

    ReplyDelete
  5. 1) sounds like "pinguecula" (see link)

    http://myeyepod.blogspot.com/2011/04/pingueculitis-aka-inflamed-pinguecula.html

    2) not an emergency
    3) could possibly affect your vision, yes, if it grows over your cornea and turns into a "pterygium"

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  6. Nice blog!! I am so glad I found it. Super useful for contact newbie like me!

    I just started wearing soft contacts, here is my spectacle prescription:
    OD: Sph -0.75 Cyl -0.5 Axis:105
    OS: Sph -1 Cyl -0.75 Axis:70

    Currently wearing Biofinity:
    OD: Sph -1
    OS: Sph -1 Cyl -0.75 Axis:70


    Question 1:
    My doctor told me that there are no soft contact that correct -0.5 astigmatism(minimum is -0.75). What if I wear something like Sph -0.75 and Cyl -0.75 instead of just -1 Sph on my right eye? As far as I understand, that will leave me with -0.25 Astigmatism at the perpendicular axis. Although it's not a perfect correction, but an it's improvement from -0.5 Cyl. Am I right? I am very fussy about my vision(since I play with high end camera lens alot), and I feel my right eye can still have some improvement.

    Question 2:
    Is it OK to take a ~30 minute nap in daily disposable with Dk/t ~22(such as J&J Moist 1 Day)? I am afraid to go for daily disposable toric because of their relatively low Dk/t value. I hope they come out a Toric version of the Trueye soon.

    Question 3:
    Any experience on the B&L PureVision 2 toric? I heard it's designed to reduce halo at night time. I tried Biofinity toric for a week. Although my vision had been great, the Biofinity generates generous amount Halo at night driving.

    Sorry for the high number of questions!

    -Steven


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  7. 1) probably not. on paper it sounds "closer" (-0.25 cyl overcorrecttion vs -0.50 cyl undercorrection) but in a clinical setting *MOST* people have more problems with overcorrection of cyl than undercorrection...hence the "standard" of using the spherical equivalent for a -0.50 cyl. you could try it, but it probably will create more problems than it solves (now you have to deal with toric rotation, ballast, etc etc etc) it's not a super great idea, hence your doc not doing it

    2) I say yes fine. no trueye toric coming that I know about

    3) nope haven't used it yet. but all these new lenses all claim better halos at night (b/c they're accounting for spherical aberration). again it sounds new and cool and different and special...but it's probably not.

    people with yout Rx, especially your left eye with just as much cyl as sphere...it's just never going to be GEAT vision in contacts. I hear you photographers (believe me, my wife is one!) who want/need great vision and have high acuity demands...and glasses get in the way. they do. but you should not expect any brand/design to be *SIGNIFICANTLY* better than the Biofinitys. incrementally better: maybe. exponentially better: no.

    it is what it is haha...contacts have their problems

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  8. Thanks for the super-fast and detailed response!
    Two follow up questions:

    1. So it seems I am never going to be completely happy with soft contacts. What about RGPs or Hyrbids like Synereyes? Can I expect *SIGNIFICANT* vision quality improvement with those? It seems they are healthier options too (?). Currently it would cost me ~$600 to try them.

    2. The ortho-k + CXL combo you mentioned seems promising. Do you know if that combo is currently being practiced, or it’s still undergoing clinical trials. You said ortho-k in general sucks with astigmatism. Will it work OK with my (relatively slight) prescription?

    Thanks Again

    Steven

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  9. 1) sure GP's would be better vision...yes. so would Synergeyes..but those are pretty expensive

    2)no cross linking any time soon. plus ortho-k isn't any better VA than soft lenses

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  10. Final question...

    1. I have super small eyes, like beyond small. Sometimes it's difficult to remove the toric from my left eye. Can I use one of those plunger to take my soft contacts out? They are designed for RGPs, but they should work just fine with soft CLs right?

    ReplyDelete
  11. that also makes you not a great Synergeyes candidate...b/c all of them are 14.5 diameter (i.e. huge) and difficult to remove

    ReplyDelete

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