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    What causes severe pain behind the right eye?

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Posted on Fri, 27 May 2016 in Brain and Spine
Question: Hello,

I'm a 32 year old male. Two days ago I began experiencing pain behind my right eye whenever pressure is applied to my right ear. Specifically, the area directly above my tragus. I know this may sound bizarre, but there is definitely a distinct and somewhat sharp pain behind my right eye every time that specific area of my right ear is touched. For example, when washing my face and my fingers slide over that tragus area of my ear it triggers the pain behind my eye. Same when I rest that side of my head on a pillow. The pain goes away immediately once that area of my ear is not being touched. It almost seems as if it is a nerve problem, but is that possible? What would cause it? I didn't hit my head, no injury, this just randomly started happening two days ago. Thanks in advance for any guidance you can provide.
doctor
Answered by Dr. Dariush Saghafi 1 hour later
Brief Answer:
You're not imagining things

Detailed Answer:
What you're describing is not hard to imagine from an anatomical/neurological point of view. You are stimulating sensory nerves that are interconnected through the skin and subdermal structures between the area above the tragus to either the top part or lateral angle of the right eyeball which is why you are experiencing pain BEHIND the eye in all likelihood. In fact, there are multiple cranial nerves that send out and have branches of a sensory nature in that area of the face above the ear so it is possible you are stimulating those nerves that can feed back toward the trigeminal ganglion itself which is certainly capable of causing pain behind the eye. Why is this happening though? That's a more difficult question to ponder and I don't have a XXXXXXX 100% explanation for that. Somehow there is an inflammatory reaction going on over a very specific dermatomal region of the right side and though you cannot recall any trauma to that area...perhaps there is a viral infection or some type of chemical irritation going on causing swelling and irritation of the nerve branches just above the ear. One possible solution to this problem would be to take NSAID types of medication such as ibuprofen, naprosyn, or diclofenac. These medications may help reduce any swelling as well as pain caused by this cranial nerve branch whether it be the 5th or some other nerve in the region. You may also get some relief by place either a cold or warm compress over the area in question for about 15-20 min., several times per day will give some temporary relief.

Now, after all of this rather logical and OBVIOUS explanations talking about cranial nerves and trying to figure out the interconnections between different regions of the face and how they all can lead back to the retro-orbit there is one other explanation which you SHOULD LOOK into that could be a remote possibility and that would be an upper molar (possibly back) infection or small abscess formation that you should look into. Get a start on this first by asking your doctor to consider sending you for what we call a PANOREX of the mouth (x-ray of the teeth). If you have any type of tooth infection on the upper right side then, that may be your problem. The roots of the upper molars go upward toward the top of the tragal region so when you lie on that side you may irritating or compressing infected roots of the tooth.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. If so, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: www.bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

This consult required 83 minutes total time of research, response preparation, and envoy.

Many thanks for using this service to ask your questions. Be well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Dariush Saghafi 12 hours later
Hello,

Thank you very much for that information. A few hours after you responded to my question, the issue suddenly got worse as I was laying in bed doing nothing. I don't know if it's a nerve or a vain, but it bulged out of my head basically in the area of where my temple is. So now when I run my fingers over that area of my right temple, I can feel the nerve (or vain) raised up a bit. And when I press on it, I feel the same pain I was describing in my original question. I am guessing the nerve swelled up in that one spot? Is that possible? It is noticeably raised in that one spot and then it dissapears back under the skin as it continues to run up towards my forehead. The area in which it is raised is still there this morning, sometimes feels warm, and sometimes I can feel it pulsating.

In addition, when I woke up this morning the LEFT side of my jaw was slightly stiff and my left ear was slightly sore when biting down. I must have been clenching in my sleep. Also, approximately a week ago I started having heart palpitations and still have them now. I have had palpitations before, for about 5 months straight leading up to my wedding and then the palpitations went away the day after my wedding. I haven't had palpitations since then until now.

Could everything I'm experiencing be related to stress? There is nothing going on that I feel stressed or anxious about. I'm particularly concerned about what is going on with that nerve around on the right side of head in temple area. I'm not concerned with the palpitations as I've experienced them many times before and they were previously diagnosed as benign.

Thank you!



Thanks again for the information.

Do you think it's okay to wait a few days before I make an appointment with my doctor? The weekend is here now, so they are closed. The pain from that location hasn't gotten any better, but the good news is it hasn't gotten any worse either and is not elevated or warm to the touch anymore like it was yesterday. Maybe it's still slightly elevated, but not nearly as much as before.
doctor
Answered by Dr. Dariush Saghafi 15 hours later
Brief Answer:
Stress always a possible answer to symptoms but must rule other things out

Detailed Answer:
Certainly, many of the symptoms you mention in relationship for example, to your wedding which then, got better after the ceremony and so forth are very likely due to the anxiety and fear you must've felt in that particular situation. However, the rest of the symptoms you are mentioning especially about your ear bothering you and stiffness in the jaw should be imaged as I said in my prior message with some kind of X-ray, CT, or MRI to rule out some type of infectious or other process before being able to say that everything is due just to stress. Your past medical history appears to be no stranger to health related anxiety issues either so I am sure that some part of this story is due to stress and so forth....but we still need better proof that something organic isn't going on before turning around and concluding the opposite....pr somatiform type of problem. If blood vessels are warm to the touch or elevated and tender then, the problem of VASCULITIS should be looked at which would necessitate lab tests such as:

1. ESR
2. CRP
3. Blood cultures x 3 with gram stain and sensitivity.


I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. If so, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: www.bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

This consult required 83 minutes total time of research, response preparation, and envoy.

Many thanks for using this service to ask your questions. Be well.

I hope this addresses your concerns and that you'll keep me in mind for future questions regarding these or other neurological/medical issues. If so, I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to a few words of feedback. In addition, I'd appreciate your CLOSING THIS QUERY if you're satisfied with my response.

Write to me any time at: www.bit.ly/drdariushsaghafi for additional comments, concerns, or to provide status updates if you'd like which I would love to receive from you to see just what has been discovered.

This consult required 98 minutes total time of research, response preparation, and envoy.

Many thanks for using this service to ask your questions. Be well.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
doctor
Answered by Dr. Dariush Saghafi 16 hours later
Brief Answer:
I think that decision is more appropriately YOURS

Detailed Answer:
You are the best person to answer the above question since I've not examined you but if you were to defer action I would simply advise you to keep up with if things were to change such as fever, nausea, sudden feelings of spinning, dizziness, loss of speech or intense headaches, changes in pain settings that you were feeling up to this point. If any of these things were to happen then, I'd recommend heading to your closest ER and presenting for an evaluation.

On that note I'd appreciate your rating this interaction with a HIGH STAR SCORE and look forward to your opinion on how our interaction helped you understand your condition and if it was useful to any intervention you took or intended to take.

In addition, I'd appreciate your CLOSING THIS QUERY at this time with the caveat of being able to open a new one if necessary or to pass on updated information.


Don't forget to look me up any time at: www.bit.ly/drdariushsaghafi for additional comments and concerns.

This consult required 104 minutes total time of research, response preparation, and envoy.

Many thanks for using this service to ask your questions. Be well
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Dariush Saghafi

Neurologist

Practicing since :1988

Answered : 2474 Questions

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