Eye pain

Introduction Eye pain is often a complaint of symptoms in patients with eye diseases. Many lesions of the eyeball and its appendages can cause significant eye pain. Because of the different diseases, the location and nature of the pain are different, so it is necessary to combine other signs to further confirm the diagnosis. The sensory nerves of the eyeball and the eye appendage are dominated by the second branch of the trigeminal nerve, except for the second branch of the trigeminal nerve. The rest of the tissue is dominated by the first branch of the trigeminal nerve. The eyeball is innervated by the ciliary nerve and is divided into a ciliary long nerve and a ciliary short nerve. The former is the branch of the nasal ciliary nerve of the first branch of the trigeminal nerve, which enters the eyeball. The ciliary short nerve originates from the ciliary ganglion. The preganglionic fibers are composed of three roots, and the long roots are sensory roots, which are emitted by the nasal ciliary nerve. The other two are the root of motion and the sympathetic root. The post-ganglionic fibers form a short ciliary nerve. The ciliary long and short nerves enter the ciliary body to form a nerve plexus, which branches to dominate the iris. Perception of the ciliary body, cornea, and sclera. When these anatomical sites are stimulated by the above causes, they will feel eye pain.

Cause

The cause of eye pain:

The sensory nerves of the eyeball and the eye appendage are dominated by the second branch of the trigeminal nerve, except for the second branch of the trigeminal nerve. The rest of the tissue is dominated by the first branch of the trigeminal nerve. The eyeball is innervated by the ciliary nerve and is divided into a ciliary long nerve and a ciliary short nerve. The former is the branch of the nasal ciliary nerve of the first branch of the trigeminal nerve, which enters the eyeball. The ciliary short nerve originates from the ciliary ganglion. The preganglionic fibers are composed of three roots, and the long roots are sensory roots, which are emitted by the nasal ciliary nerve. The other two are the root of motion and the sympathetic root. The post-ganglionic fibers form a short ciliary nerve. The ciliary long and short nerves enter the ciliary body to form a nerve plexus, which branches to dominate the iris. Perception of the ciliary body, cornea, and sclera. When these anatomical sites are stimulated by the above causes, they will feel eye pain.

(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, orbital pus, orbital pseudotumor.

3. Good ball pain: keratitis, ulcers, 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:

Inverted eyelashes, conjunctival stones.

(4) Glaucoma.

(5) Trauma:

Trauma, foreign bodies, etc. of various eyeballs and eye appendages.

(6) Tumor compression.

(7) Neurological:

Trigeminal neuralgia (eye branch), supraorbital neuralgia.

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

an examination

Related inspection

Ophthalmic examination of anti-triiodothyronine (T3, anti-T3) triiodothyronine (T3) anti-triiodothyronine (T3, anti-T3) eye function test

Physical examination :

Pay attention to systemic examination, body temperature, pulse, etc., with signs of acute infection. Whether there is a craniocerebral and paranasal sinus disease. Eye examination pay attention to eyesight, with or without eyelid swelling, varus and eyelashes, periorbital mass, fistula, sinus, eyeball protrusion, movement disorder, redness and swelling of the lacrimal sac, pressure secretion, conjunctival hyperemia or ciliary congestion, Scleral congestion, nodules, corneal foreign bodies, infiltration, ulcers, posterior corneal deposits, anterior chamber exudation, empyema, hemorrhage, adhesions before and after iris, atrophy, nodules, pupil size, shape, photoreaction, and fundus changes. If necessary, optometry is the intraocular pressure.

Laboratory inspection :

For infectious diseases, pay attention to blood tests. For the above-mentioned diseases, the etiology should be determined, and the erythrocyte sedimentation rate, blood immunoglobulin, lymphocyte transformation rate, and tuberculin test should be determined.

Device inspection :

Slit lamp microscopy, except for keratitis, ulcers, foreign bodies, and iridocyclitis, glaucoma and other diseases. The fundus is used to check the vitreous and fundus changes. Anterior chamber keratoscopy is helpful in the diagnosis of glaucoma types. Visual field examination has diagnostic significance for glaucoma and retrobulbar optic neuritis. Imaging examination can determine whether there are abnormal changes in the humerus, sacral and eyeballs.

Differential diagnosis

Symptoms of eye pain and confusion:

Eye irritation: There are many causes of eye irritation. Corneal diseases can be caused. The normal eye surface is covered with a tear film, which is the basis for maintaining healthy and comfortable ocular surface. White-collar workers are staring at the computer for a long time, their concentration is high, their eyelids are wide open, and the tear evaporation increases more than usual. At the same time, the number of blinks is greatly reduced, resulting in insufficient moisture on the surface of the eyeball, and the radiation of the screen light is easy to appear. The eyes are dry and stinging.

Medical history :

Eye pain is often accompanied by other eye symptoms, and the medical history should be asked in detail. Pay attention to the location and nature of eye pain. The pain of a corneal lesion is a pain, like the feeling of sand in the eye, accompanied by irritation. The eye pain of acute iridocyclitis is eye pain, accompanied by ipsilateral migraine, and obvious tenderness in the ciliary body. The eye pain of acute angle-closure glaucoma is severe eye pain, accompanied by ipsilateral migraine, visual disturbance, rainbow vision, fog vision, nausea and vomiting. Posterior optic neuritis is a dull pain in the posterior part of the ball when the eye is deep in pain, eye movement or oppression of the eye. The pain in the supraorbital nerve is severe, and the night is heavy. There is obvious tenderness at the incision. When the refractive error is correct and the fatigue is adjusted, the eye pain is mostly related to the near object, and the eye is closed after the break. Total ocular inflammation, sputum cellulitis, etc. are painful eyes and eyelids, pain during eye movement and severe headache and acute infection symptoms.

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