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Sleep Disorders

Painful Eyes

12/18/2008

Question:

Hi, For about 10 years I have had problems sleeping with any form of lught, i wear an eye patch and have dark curtains. Even so I wake up very early when the light comes through the curtains (even though my friends tell me its very dark). My eyes are very painful and cold. Recently it has gotten worse and I`m also sweating alot in the night even though my sleeping environment is not hot. I`m a very light sleeper and wake up wide awake at 3/4 times every night.

It`s making me feel tired and my painful eyes effect my day. I know it sounds like a strange question but is there anything you can suggest? It would be amazing if you have any advice for me.

many thanks

Answer:

As best I can tell from your question, the symptom you are reporting is either intolerance to light (photophobia) or pain inside the eye (Opthalmalgia) or both. You could also be referring to pain in the head behind the eyes. I am also assuming that this condition is present to some extent during the daytime. Given these assumptions, it is unlikely that this is a primary sleep disorder and more likely that it represents an eye problem and therefore I strongly recommend that you start the evaluation by seeing an eye specialist (ophthalmologist).

Not being an eye specialist, I will not be able to provide you with all the possible explanations for your problem. Notwithstanding that, your symptoms could be due to any of several eye or nerve problems. Increased eye pressure (glaucoma), chronic inflammatory disorders of the eye, such as scleritis, episcleritis, or uveitis (which can be associated with some types of autoimmune disorders), chronic sinusitis, and inflammation of the optic nerves are all conditions that may cause this type of presentation. We would also need to consider a group of disorders called neurologias, in which some of nerves of the eye or the face muscles produce painful signals. Another possibility, but less likely is that you may have a variety of migraine.

You are also reporting insomnia that appears to be secondary (induced by) the eye problem. However, it is possible that, with the relatively fragmented or interrupt sleep you report, you have another sleep disorder such as sleep apnea or periodic limb movement of sleep contributing to the problem. These conditions would not cause eye pain or light sensitivity though. As far as the insomnia, it is likely to improve significantly once your eye problem is taken care of.

You should discuss your problem with your primary care physician. Specific factors in your history and/or examination are likely important and referral to an ophthalmologist should be considered.

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Response by:

Rami N Khayat, MD Rami N Khayat, MD
Clinical Assistant Professor of Pulmonary, Allergy, Critical Care & Sleep
College of Medicine
The Ohio State University