Eye pain

Introduction There are two pains. One is the eye, white eye pain. One said that the eyes are black and white. Covering eyes and white eyes are yang. Therefore, it hurts a lot. Point bitter cold medicine is effective. According to the so-called white-eye red vein method, Yu Yang is also. The black eye pain of the eyeball is yin. It hurts at night. Point bitter cold medicine counter drama. The so-called scorpion black eye method is also used in Yin.

Cause

(1) Infectivity

1. Eyelid pain, mumps, eyelid skin disease, eyelid abscess.

2. Eyelid pain Acute dacryocystitis, acute lacrimal gland inflammation, periostitis, orbital cellulitis, ocular fasciitis, eyelid pus, orbital pseudotumor.

3. Good globular pain keratitis, ulcer scleritis, iridocyclitis, endophthalmitis, total ocular inflammation.

4. Post-ball pain sphenoid sinusitis, posterior optic neuritis.

(two) allergic

Follicular keratoconjunctivitis, scleritis, acute iridocyclitis.

(3) Mechanical stimulation

Inversion, trichiasis, conjunctival stones.

(4) Glaucoma

(5) Traumatic

Various foreign bodies such as eyeballs and eye appendages.

(6) Tumor oppression

(7) Neurological

Trigeminal neuralgia (eye branch), supraorbital neuralgia.

(8) Refractive error and adjustment of fatigue, anisometropia.

an examination

Related inspection

Ophthalmic examination

1, physical examination

Pay attention to the signs of systemic acute infection, body temperature and pulse, and whether there are brain and paranasal sinus diseases.

Eye examination attention to vision, with or without eyelid swelling, varus, trichiasis, periorbital mass, fistula, sinus, ocular dyskinesia, redness of the lacrimal sac, overflow secretion of conjunctiva, conjunctival hyperemia or ciliary congestion, Scleral congestion, nodular cornea, foreign body infiltration, ulcerated corneal posterior anterior chamber exudation, empyema, hemorrhage, anterior and posterior adhesion atrophy, nodular pupil size, shape, photoreaction and fundus changes, if necessary, optometry and intraocular pressure.

2, laboratory inspection

Attention should be paid to blood test for infectious diseases. For some of the above diseases, the cause of erythrocyte sedimentation rate, blood immunoglobulin, lymphocyte transformation rate, and tuberculin test should be determined.

3, device inspection

Slit lamp microscopy, except keratitis, ulcers, foreign bodies and iridocyclitis, glaucoma and other diseases, fundus examination of vitreous, fundus changes, anterior chamber gonioscopic examination for glaucoma type diagnosis, visual field examination for glaucoma and ball Posterior optic neuritis has diagnostic significance, and imaging examination can determine whether there is abnormal change in the humerus and the eyeball.

Differential diagnosis

Differential diagnosis

Mumps

It is a very common clinical glandular purulent inflammation in the clinic. It is clinically classified as mumps and mumps. The former is the inflammation of the Zeis gland in the root of the eyelash sac. The general yellow pus is located at the root of the hair follicle; It occurs in the meibomian glands in the deep part of the eyelids. The pus is located on the conjunctival surface. When the mumps is not purulent in the early stage, it often shows conjunctival congestion and edema. At this time, it should be differentiated from acute conjunctivitis. Mumps has eye pain, redness and swelling of the eyelids, and it is not difficult to identify the hard block of tenderness. Mumps and acute lacrimal gland inflammation have eye pain, but the inflammation of the latter is obvious in the upper part of the iliac crest, and it can be indurated between the gingival margin and the gingival margin. There is tenderness, and the eyeball rotates outward when it is turned downward. The lacrimal gland is prominent in the ankle.

Second eye periostitis

The anterior humeral periostitis lesion is located at the temporal margin, with severe radiation pain and obvious tenderness. The conjunctiva of the adjacent eyelid is obviously congested and edema, the eyeball is displaced to the opposite side, and the fistula can be broken to form a fistula. The probe can touch the back of the rough bone surface. . Periostitis is often spread by paranasal sinusitis, and the lesion invades the apex of the sac and causes the eyeball to protrude straight forward. It is accompanied by conjunctival edema of the eyeball and ophthalmoplegia. It is often diagnosed as supracondylar syndrome. Those with visual impairment are diagnosed with apex syndrome. Sometimes the diagnosis is difficult, and the imaging examination shows that bone changes are helpful for diagnosis.

Three acute dacryocystitis

Acute dacryocystitis essentially includes cellulitis around the lacrimal sac, the pain radiates to the forehead and the redness of the teeth, and the lacrimal sac area along the inferior iliac ligament can spread to the base of the nose, the lymph nodes in the ear, the mass of the mass and The lacrimal duct obstruction is its identification point.

diagnosis

Eye pain is often accompanied by other eye symptoms. The medical history should be asked in detail. Pay attention to the location and nature of eye pain. For example, the pain of corneal lesions is painful, like the feeling of sand in the eyes, accompanied by irritation; acute iris ciliary The eye pain of dermatitis is eye acid, eye pain, ipsilateral migraine, and obvious tenderness in the ciliary area. The eye pain of acute angle-closure glaucoma is severe eye pain with ipsilateral migraine and visual impairment. Afterwards, rainbow vision, nausea, vomiting and other posterior optic neuritis is the deep pain in the eye, eye movement or oppression of the eye when the ball feels dull pain in the posterior; supraorbital neuralgia is severely painful, heavy at night, and there is a scar on the sac Obvious tenderness point, refractive error, eye pain when adjusting fatigue is more related to near-neighbors, closed eyes and better after rest; full eyeball inflammation, sputum cellulitis, etc. for the whole eye and eyelid pain, eye movement pain and severe Headache and symptoms of acute infection.

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