Blurred or double vision with headache pain is very common. I have experienced this first hand during a headache. I had pain and tension around the left eye as well. It felt like someone with long finger nails was holding onto the back of my left eye. Our theory is that there is likely a communication issue between the upper neck and the muscles that control the eyes. There is a condition that is common where we can develop ocular or eye muscle trigger points causing abnormal tension and weakness. Trigger points or knots in our eye muscles will cause our visual system to work harder. Tension in the eye muscles can pull one or both eyes off of the midline. This is even more obvious when we try to focus on anything up close.
Your vision or eye muscle strain may be part of the reason for your headache pain. A difficulty focusing or looking down and reading is a common sign that you are having trouble bringing your eyes inward. Try this out! Hold a finger up in front of your nose and slowly bring it toward you. Keep your eyes focused as you go “cross eyed”. Doing this slowly and with some repetition should not be a problem. If this is difficult, causing you to close your eyes or look away, or causes pain, your eye muscles could be part of the problem. A common finding after a head injury, concussion or even whiplash is a nerve injury affecting the eye muscles of one or both eyes. This creates a continued strain and eye muscle pain. This can be treated with Physical Therapy and is not usually something that requires an optometry assessment. Most people with this problem have had a normal eye exam. The problem is not with the eye itself but the muscles and nerves that control the eye.
The problem is not with the eye itself but the muscles and nerves that control the eye.
Our theory is that this can occur with clenching and tension to the cranial sutures, most commonly the sphenoid bone. Tension and changes to motion of the upper neck including loss of proprioception or head and joint position sense can also affect the eye muscles.
Eye fatigue by the end of the day or with increased reading and activity
Pain around or behind your eye or eyes
Dizziness or feeling off
Depth perception issues, driving is more difficult and can be more stressful
Walking grocery aisles, especially the cereal aisle or large stores such as Costco.
Muscle trigger points in the eye muscles can be felt next to the edge of the orbit along the bone. We do not recommend pushing on the eye itself. Supporting next to the eye where the muscle attachments are and adding head motion can bias the cranial nerves of the eye. Increased pain with testing suggests a cranial nerve entrapment as part of the underlying problem.
The most common muscle involved is the superior oblique muscle of the eye. It is easier to feel this muscle as it goes through a sling on the inside of your eye. It is responsible for inward motion with the other eye muscles as well as rotating the eye inward.