Why does reading cause a headache

An ophthalmological examination can therefore be useful in order to make the correct diagnosis. Ophthalmologists recognize whether the symptoms are caused by the eye or whether the headache is common, such as migraines or tension headaches, and will advise their patients accordingly.

Since the pain triggered by the eye often radiates into its surroundings and manifests itself particularly intensely there, it cannot always be precisely localized for the person affected. A disease of the eye, the eyelids, the lacrimal system or the eye socket often leads to complaints that are perceived as pain in the forehead, temples, ears or teeth. The risk of misdiagnosis is obvious. This can mean that valuable time can elapse before the actual cause is identified. This applies, for example, to glaucoma attacks, which require immediate ophthalmological treatment because undetected, it can lead to irreversible blindness in a very short time.

The area around the eye contains a particularly large number of nerve fibers that are very sensitive to pain. Starting from the first branch of the fifth cranial nerve, the ciliary nerves supply the eye. The pain radiating into the area around the eye is caused by the fact that the irritation of the ciliary nerves (ciliary neuralgia) can also be passed on to other branches of the fifth cranial nerve or the very pain-sensitive meninges.

Eye-related headaches arise
  • with inflammatory diseases of the eyelids, the lacrimal gland, the lacrimal sac and the eye socket,
  • with inflammation of the front sections of the eyeball, especially the leather, cornea and iris and a sudden increase in intraocular pressure (acute attack of glaucoma),
  • in asthenopias. It is typical of asthenopia that those affected are completely symptom-free when they wake up in the morning. Only after increasing stress on the eyes do dull pain appear behind the eyes as well as in the forehead and temples during the day. Sometimes there is even dizziness, nausea and vomiting.
Background knowledge of asthenopia

Asthenopic symptoms can have various causes:

External influences
  • Excessive strain on the healthy eye, for example through long close work at too short a working distance, work at the computer workstation with unsuitable glasses
  • longer work under unfavorable lighting conditions such as
    • insufficient lighting
    • Incorrectly attached filament
    • twilight
    • poor light and shadow contrast
    • exposure to intense light
    • Glare
    • irritating reflexes
Incorrect or insufficiently corrected refractive errors of the eye and muscular asthenopias
  • Uncorrected or insufficiently corrected ametropia or incorrect corrections can lead to cramping of the inner eye muscles. The complaints can be remedied by optimally compensating for the ametropia.
  • Disturbed eye muscle balance (heterophoria) can cause double vision. To avoid double vision, individual outer muscles of the eye are put under excessive strain. Typical for "muscular asthenopia": The symptoms disappear when one eye is temporarily switched off, for example by covering it with a frosted glass film. In the case of muscular asthenopia, correction using prism lenses can be helpful in some cases. Since this involves an intervention in the eye muscle balance, i.e. a therapeutic procedure that can have serious side effects if used improperly, providing a patient with prismatic lenses is reserved exclusively for the ophthalmologist.
Nervous asthenopia

If none of the external causes, caused by refractive errors or a disturbed eye muscle balance, are an explanation for asthenopic complaints, the problem is mostly a purely functional problem, triggered by nervous exhaustion or psychological stress. Only the ophthalmological diagnosis can provide information about this, in which organic causes have been ruled out.

To examine the symptoms, an examination in cycloplegia can be useful. To do this, the ciliary muscle is temporarily relaxed with medication. This widening of the pupil leads to a temporary impairment of reading ability and driving ability.

More data on headache and eye:

According to a survey of German ophthalmologists, an average of 12.9 patients per week come to the ophthalmologist exclusively or primarily because of headaches - extrapolated to all ophthalmologists in Germany that is 2.5 million headache patients per year.

According to a survey in France, patients go with daily headaches
19 percent to the ophthalmologist,
13 percent to the neurologist,
11 percent to the gynecologist,
9 percent to the ENT doctor.


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