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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Suggest treatment for eye pain

Answered by
Dr.
Dr. Ilir Sharka

Cardiologist

Practicing since :2001

Answered : 7025 Questions

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Posted on Mon, 7 Dec 2015 in Hypertension and Heart Disease
Question: gmorn,Dr Sharka. the pains are still coming.what do I do?
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would recommend consulting with the GP and perform some tests

Detailed Answer:
Hello !

Welcome back to HCM and thank you for asking!

Could you please tell me more about her pain?

Is it constant or its shock like?

How much does it go on? minutes or seconds or hours?

Can she see with the eye?

Can she open the eyelid?

What are her blood pressure values actually?

What type of drugs did she take?

I recommend consulting with the GP for a careful physical examination and some lab tests ( complete blood count, PCR, sedimentation rate, blood electrolytes).

An opthalmologist consultation and a brain CT scan should be done is suspicions for a possible stroke or other intracranial lesions are raised.


Hope to have been helpful!

Feel free to ask any other questions whenever you need!

Greetings!

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 16 minutes later
we talked yday and u gave me some medications. u advice I give her gabapentine 300mg for the pain.told u she sees with the eye and all.the pain is like an electric shock.comes every 10mins.she screams whenever the pain starts .
doctor
Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
I recommend as follows:

Detailed Answer:
Hello again!

Her symptoms are very typical of a trigeminal neuralgia.

You should know that gabapentine is used to treat this condition as a preventive therapy.

This means that it needs some days to show its effect, which means a decrease in the pain attacks frequency an severity.

You should increase the dose and take this drug for a long period (months).

That is why I recommended you to consult with a neurologist or with the GP for a careful physical examination (if the neurological consult is not possible).

A brain CT scan or MRI is needed to exclude an intracranial cause. You should know that trigeminal neuralgia can occur without an evident cause in old patients, or after herpes zoster infection. But sometimes an intracranial lesion could cause this symptomatology. That is why I recommend performing imaging test like CT scan or MRI.

Meanwhile, I recommended you to give her indomethacine. Did you try it? Did it help relieve the pain?

You should give her indomethacine orally twice daily, if she has no stomach problems and you should closely monitor her blood pressure, because it can increase blood pressure. This will help reduce her pain.

She should also avoid opening the eyes, as it may trigger the pain attacks.

Hope to have been helpful!

Best wishes!

Dr. Iliri

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 3 hours later
U recommended gabapentine. and I gave her tis morn and last nyt.tday is better than yday though.less pain tday.should I still go ahead with the indomethacin drug?
doctor
Answered by Dr. Ilir Sharka 3 hours later
Brief Answer:
I recommend taking indomethacine for some days.

Detailed Answer:
Hello again!

I am glad she is getting better!

Nevertheless I recommend taking indomethacine too, for some days, when the effects of gabapentine will be more obvious.

It will help her during these days.


Best regards!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 41 minutes later
Dr, u talked abt the indomethacin triggering the BP. am scared.u still tink I should add it to the gabapentine?
doctor
Answered by Dr. Ilir Sharka 30 minutes later
Brief Answer:
Blood pressure monitoring is necessary.

Detailed Answer:

Hi,

Indomethacin may increase BP values, but remember that severe pain is a much potent trigger of hypertension.

By relieving the pain, indomethacin may counterbalance its BP increase trend.

Meanwhile I recommended you (please review our previous thread) to double the dose of Amlodipine and increase also beta-blocker dosage.

Hope to have been helpful to you!

In case of any further uncertainties do not hesitate t ask me directly on the link below:

http://doctor.healthcaremagic.com/Funnel?page=askDoctorDirectly&docId=69765

Regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 8 hours later
hi doctor good morn. Tnk u for all the assistance. my mum is better tday.pain has relieved her .she ears well now.opens the eye and just took a bath.but her BP is 113/68.hope is kk.what do u advice next?
doctor
Answered by Dr. Ilir Sharka 38 minutes later
Brief Answer:
I recommend as follows:

Detailed Answer:
Hello again!

I am glad that she is on now!

I recommend continuing gabapentine 300 mg 3 times daily for some months.

Regarding her blood pressure, it seems to be just OK. Nothing to worry about it!

I recommend consulting with a neurologist and performing a brain MRI, just to be sure that everything is all right.

Hope to have been helpful!

Best wishes!

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 9 minutes later
kk Dr. will see a neurologist and perform a ct scan by tmwr.tnk u
doctor
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
You are welcome.

Detailed Answer:

Hi,

Wishing a fast recovery, I hope that everything will conclude OK.

If you have further uncertainties, do not hesitate to ask me!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 1 hour later
kk doctor tnk u again.
doctor
Answered by Dr. Ilir Sharka 23 minutes later
Brief Answer:
You are welcome!

Detailed Answer:
You are welcome!
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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