HomeAnswersNeurologymigraineI am experiencing severe pain behind my left eye. Why?

I have a pain behind my left eye and a headache in the base of the skull. What could it be?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At July 7, 2017
Reviewed AtFebruary 6, 2024

Patient's Query

Hello doctor,

I do not know if you would be able to help. I just want to be pointed in the right direction. I am 25 years old. My height is 5 feet and 2 inches. I weigh about 279.98 lb. I have underactive thyroids, but they are not treatable by national health service (NHS) standards. I have a mixed connective tissue disorder. Currently, I have a contraceptive implant and constant vitamin D deficiency. I am fairly active, as I have to run around for my disabled mother, as well as lift a 121.25 lb mobility scooter in and out of a car daily. Also, my thyroid stimulating hormone (TSH) was 3.25 and my thyroxine (T4) was 13.5. But, for the last two to three years, I have been getting a lot of pain behind my left eye, to the point that I feel like taking it out would be the only release of pain. However, putting pressure on it helps a little. I also tend to get a dull pain or a headache in the base of my skull, at the top of my neck. But that may be due to a bad bed and pillows. I have had it tested by two opticians. One of them said that I should get checked for multiple sclerosis (MS), which my doctors and neurologist scoffed at, and the other said he could not see any symptoms of a tumor. The only thing that seems to take the edge off the pain is strong co-codamol 30/500. I have also noticed recently that sometimes I do lose grip in my dominant hand, and sometimes struggle to put sentences in the right order, or just lose my balance. I also struggle to eat and sometimes feel sick after eating, even more so if I eat in the morning. But, my doctors do not seem to care about my eye at this point. And, I am worried it might be something serious. I would just like some advice.

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com. I would like to know further details about your symptoms: 1. Since when do you have theseheadaches? 2. In which areas of the head do you feel the headache? From where does it originate? Is it limited to the area behind the left eye alone? 3. What kind of a headache would you describe it as - heaviness, throbbing, stretching, bursting, shooting pain, electric currents like pain or something else? 4. Is it severe, moderate or mild? 5. Is the headache episodic or persistent? If it is an episodic headache, how long does one episode last? That is, from onset to complete relief without medication? 6. How frequent are these headache episodes before and now? 7. Do you have any vomiting, nausea, watering from eyes, eye redness or nasal congestion during the headache? 8. Have you noticed anytrigger factors for this headache? 9. How is your sleep? 10. How is your mood in general? 11. Have you ever undergone investigation for this headache like magnetic resonance imaging (MRI) brain? Had you taken any medicines for the headache? 12. Are you taking any medications for the mixed connective tissue disorder? If yes, please tell with their dosage. 13. Do you have a fever?

Patient's Query

Hello doctor,

Thanks for answering. I am experiencing these headaches from about two years ago. It is limited to the left eye. I would describe it as a heavy pain, which is moderate to severe. On some days, I can carry on with my daily life. On others, it stops me from doing anything till it is gone, which can take the whole day.The headache is episodic, I suppose. And, it can last the entire day, unless I sleep or take the pain medication. I get it two to three times a week.I have vomiting, but that seems to be triggered by eating. I have noticed a redness in the eye when I have an episode. My nose seems to be congested most of the time. I have not noticed anything that particularly triggers it. I can have either very good sleep, or very broken sleep. It changes daily. I have a generallylow mood every day. I have not undergone any magnetic resonance imaging (MRI) as my local doctors seem to be reluctant to send me for one. I am taking Co-codamol 30/500 mg, and that is the only thing that helps me. However, that was prescribed for a torn ligament in my ankle a year ago, not for the headache. I was not prescribed any medications for the mixed connective disorder. My temperature can spike sometimes.

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com. Your headache seems like a migraine headache or a vascular headache with some anxiety and a depressive element associated with it. But before labeling it, we have to rule out other secondary causes of such a headache. I suggest the following tests: 1. MRI brain with contrast. 2. ESR (erythrocyte sedimentation rate). 3. ANA (antinuclear antibody). 4. Serum vitamin B12. 5. Ophthalmology examination to look for refraction, intraocular pressure, and the fundus. I do not understand if the mixed connective tissue disease is a confirmed diagnosis or a probable diagnosis? If it was a confirmed diagnosis, possibly some disease-modifying medications might be helpful. Meanwhile, I suggest you start on: 1. Tablet Etizolam 0.5 mg twice a day. 2. Tablet Propranolol 20 mg twice a day. 3. Tablet Amitriptyline 10 mg at bedtime. 4. For a severe headache, you can take tablet Naproxen 500 mg as and when required. Revert with the above-mentioned reports, as well as your previous reports, in two weeks.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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