Causes of Headache

by Dennis
(Arizona)

I was given my first pair of glasses when I was 12. I had developed headaches on a regular basis and my teacher suggested getting my eyes checked. My new eye doctor soon became my best friend, I would pop in and see him at least twice a week. That's how often I needed to get my glasses straightened.

The glasses cured my headaches, sort of. If they were out of adjustment in any way, the headaches were back. The Optometrist said I had good eyes and did not need to wear the glasses all the time. But it was not that simple for me, when I wore them my headaches were gone, when I took them off they were back in minutes.

We went to Florida on vacation the next year and I was splashing in the Gulf of Mexico. A wave came in, over my head, and knocked my glasses off. For at least the next hour my sisters and my parents were searching the ocean floor for the glasses that were not to be found.

My mom had an idea, we bought a pair of sunglasses to see if they would help. They did, and for the next two weeks I must have looked like a pretty goofy 13 year old, because I never took them off.

Shortly after high school I had a job working outdoors. The constant sweat made wearing glasses very uncomfortable and I found my self going without them for longer and longer periods of time. While working outdoors I was also wearing a cap. In a few months time I was wearing a cap all the time instead of the glasses. I have not worn glasses in forty years but my cap goes on first thing in the morning and off the last thing at night.

Occasions where I need to be without my cap can still be very hard on me, especially if it is outdoors or under bright lights. So I have thought I have light sensitive eyes and let it go at that for all this time.

Just a few minutes without my cap reminds me that whatever my condition is, it is still with me. Changing caps is even something I dread doing. My loved ones remind me from time to time that my cap is getting dirty, so I find a clean one, and usually after the third day the cap feels comfortable and the headaches go away. There have been times when after a week the cap was not comfortable and I had to try a different one.

There is one positive to this long story. I am one easy guy to shop for on special occasions. Buy me an Arizona D-backs cap or a Phoenix Suns cap and I am a happy camper.

So, any idea that's the matter with me?

Answer:

Hi Dennis,

Your headaches may have been migraine since photophobia or light avoidance is part of the symptoms. However, chronic tension headache may also cause photophobia.(although a bit rare.)

At this point if you are still having chronic daily headaches you should consider seeing a headache specialist. This would be a neurologist who specializes in headache and migraine.

The chronic photophobia is caused by central sensitization of the brain...what that means is the optic nerves and other parts of the brain are overly sensitive due to the chronic pain state. Not unusual with chronic migraines and headaches. Thus the need for the hat and/or sunglasses to avoid bright light.

If you have not had an MRI of the brain, this should be considered, in addition to other medical causes of headache that could be influencing or worsening the problem.

You do not mention any other treatments, but if you are using OTC meds or anti-inflammatories to treat these headaches, please stop. This is common in headache for patients to do this but unfortunately results in analgesic rebound headaches.

You do not say where you live in Arizona, but I can tell you there are many headache specialists listed by the National Headache Foundation for your state. Start with your primary care MD and ask who in your area is the headache specialist.

Good luck!
Mary Kay Betz MS RPA-C