Suggest Treatment For Persistent Sharp Pain In The Eyes
Orbital Pain
Detailed Answer:
Good afternoon. I'm sorry to hear that your uncle is experiencing these difficulties.
I am a neurologist at the XXXXXXX VA and know the system well. I'm sure there must be neurologists in your uncle's VISN (VA designation for different regional territories) and if I were in his position I would go to get checked out. Although, it may not turn out to be anything significant I would want him checked out for a possible dilatation or abnormal connection of some sort of blood vessels that lie behind the right eye or globe. Symptoms as you describe (if not sinus) certainly can be something more significant such as an aneurysm or fistula which can detour blood flow and cause problems.
I don't think the leukemia has much to do with his presentation and I don't think he necessarily has anything such as temporal arteritis although that specter is always raised when discussing sharp and painful sensations in the area of the eyeball. So I'm sure a good neurological evaluation will take that very low probability differential into consideration.
The pain is much too prolonged for this to be a trigeminal neuralgia but there could be an entrapment of a twig of the ophthalmic nerve which is in that area which upon changes in posture incites or increases compression which upon changing position takes time for the nerve to quiet down....so that could be a possibility as well.
Bottom line is I think a good neurological examination would do your uncle well and if the neurologist can't particularly find anything then, you can have him check with ophthalmology where they can check intraocular pressures and test the integrity of the contents of the globe and make sure his thyroid hormones are in line, etc.
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