“Severe Eye Pain and Extreme Light Sensitivity Despite Normal Eye Tests” - #20232

Hello dear I think it is either photosensitivity or chances of migraine or sinusitis Iam suggesting some tests. Please share the result with neurologist or opthalmologist for better clarity. Please donot take any medication without consulting the concerned physician Esr Photopatch test Pmle Ct scan Mri Photo testing Crp B3 serum level Regards

Hello,

Severe eye pain with extreme light sensitivity despite normal eye tests is not normal and needs further evaluation.

Even if slit-lamp and pressure tests are fine, it may still be due to:

Possible causes: Severe dry eye / neuropathic eye pain Early uveitis/inflammation Migraine or neurological causes Sinus-related pain Rarely optic nerve or brain-related issues

Recheck with ophthalmologist (preferably cornea specialist)

If eye exam still normal → neurologist evaluation; MRI may be needed depending on findings

Meanwhile Sunglasses, reduce screen light Preservative-free artificial tears Avoid steroid drops unless prescribed

This problem should not be ignored.

Thank you

Please tell me:

Age of the patient

Has any rash, redness, or tiny blisters appeared on:

Forehead

Eyelid

Nose tip or side?

Is the pain constant or comes in attacks?

Hello MD, thank you for sharing your concern. Her issues are alarming and need prompt evaluation and treatment.

Kindly get an MRI Brain + Orbit with contrast done. Also get a Slit Lamp examination with Fluorescein by a certified Ophthalmologist. Review with reports.

Till then, take this prescription - - Eye drop CMC 1 drop in each eye 2-3 times a day. - Tab. Pregabalin 75mg at night × 5 days. - Tab. Amitriptyline 25mg at night × 5 days. - Sunglasses, even indoors.

Go to a tertiary eye center or neuro-ophthalmologist urgently if: Pain is worsening, Vision decreases, Eye redness appears, Nausea/vomiting or severe headache starts.

Regards, Dr. Nirav Jain MBBS, DNB D.Fam.Medicine

Hello MD Thanks for sharing these details. Severe eye pain with light sensitivity and burning, especially when all eye tests are normal, can be very frustrating. Since she’s already seen multiple doctors and tests are normal, it’s less likely to be a common infection or injury.

Possible Causes - Migraine or cluster headache: Sometimes, these can cause severe pain around the eye and forehead, along with light sensitivity, even if eye tests are normal. - Neuropathic pain: Nerve-related pain (like trigeminal neuralgia or post-herpetic neuralgia) can cause burning and severe discomfort without visible changes in the eye. - Dry eye or ocular surface disorder: Sometimes, severe dryness or sensitivity can cause burning and pain, but usually some findings are seen on tests. - Rare causes: Sinus issues, referred pain from nearby structures, or even psychological stress can sometimes present this way.

What Can Be Done - Keep a symptom diary: Note when the pain starts, what triggers it, and any other symptoms (like headache, nausea, tearing, or vision changes). - Protect from light: Use sunglasses or stay in dimly lit rooms to reduce discomfort. - Avoid eye rubbing or frequent washing: This can worsen irritation. - Consult a neurologist: Since eye tests are normal, a nerve or headache specialist may help identify the cause. - Gentle eye care: Use preservative-free artificial tears if dryness is suspected (after doctor’s advice).

Rx- tablet naproxen sodium+ domperidone (napra-d 500mg) - take it after food for 5 days

Thank you