Abnormal eye sensations can encompass a range of symptoms including pain, itching, burning, grittiness, or the feeling of something in the eye. These sensations are often indicative of underlying ocular or systemic conditions.
Causes of Abnormal Eye Sensation
- Dry Eye Syndrome: Insufficient tear production or poor tear quality.
- Conjunctivitis: Inflammation or infection of the conjunctiva, often viral or bacterial.
- Corneal Abrasion: Scratch on the cornea.
- Foreign Body: Presence of a foreign object in the eye.
- Blepharitis: Inflammation of the eyelids.
- Allergies: Allergic reactions affecting the eyes.
- Contact Lens Complications: Overuse, poor fit, or reaction to lens solutions.
- Glaucoma: Increased intraocular pressure causing pain and potentially vision loss.
- Uveitis: Inflammation of the middle layer of the eye.
- Scleritis: Inflammation of the sclera, often related to autoimmune disorders.
- Computer Vision Syndrome: Eye strain from prolonged screen use.
Diagnosis
- History
- Symptoms Description: Nature, onset, duration, and progression of the sensation.
- Associated Symptoms: Redness, discharge, vision changes, light sensitivity.
- Environmental Factors: Exposure to allergens, chemicals, or foreign bodies.
- Medical History: Including systemic diseases (like rheumatoid arthritis), recent infections, and eye history.
- Lifestyle: Screen time, use of contact lenses, and hygiene practices.
- Physical Examination
- Visual Acuity Test: To check if vision is affected.
- External Eye Examination: Inspect the eyelids, conjunctiva, and cornea.
- Slit Lamp Examination: Detailed examination of the anterior eye structures.
- Intraocular Pressure Test: Especially if glaucoma is suspected.
- Pupil Examination: Size, shape, and reaction to light.
- Investigations
- Fluorescein Staining: To detect corneal abrasions or ulcers.
- Schirmer’s Test: For dry eye diagnosis (uses filter paper under lower lid for 5 minutes to test for moisture production)
- Allergy Testing: If an allergic cause is suspected.
- Blood Tests: If a systemic condition is suspected (e.g., rheumatoid factor for rheumatoid arthritis).
Differential Diagnosis (DDx)
- Migraine or Cluster Headaches: Can cause referred pain to the eye.
- Optic Neuritis: Inflammation of the optic nerve, often associated with multiple sclerosis.
- Sinusitis: Sinus infections can cause pressure and pain around the eyes.
- Trigeminal Neuralgia: Facial pain affecting the ophthalmic branch of the trigeminal nerve.
- Temporal Arteritis: Inflammation of the temporal arteries, which can affect vision.
Management
- For Dry Eye: Artificial tears, lifestyle modifications like reducing screen time, and humidifiers.
- Infections (Conjunctivitis, Blepharitis): Antibiotic or antiviral eye drops or ointments.
- Foreign Body Removal: With need to remove rust ring for steel FB
- Allergic Reactions: Antihistamine eye drops or oral antihistamines.
- Contact Lens Issues: Review of lens care, fitting, or temporary cessation of use.
- Glaucoma: Eye drops to reduce intraocular pressure, laser treatment, or surgery.
- Uveitis or Scleritis: Steroid eye drops, systemic immunosuppressive agents.
- For Corneal Abrasions: Antibiotic eye drops and pain management.
- Lifestyle and Ergonomic Adjustments: For computer vision syndrome.
Conclusion
Management of abnormal eye sensations depends on identifying and treating the underlying cause. A thorough ocular examination and patient history are crucial. In some cases, referral to an eye specialist may be necessary for further investigation and treatment, especially if there’s a risk of vision loss or if symptoms are persistent and unexplained. Regular eye check-ups can help in early detection and prevention of complications related to these conditions.