Question

A 45-year-old man is admitted in the ward with complaints of headache. You are called to do an assessment of the eye.
What relevant history would you like to ask related to the eye?

Hint:

When evaluating a headache, always consider whether it is primary or secondary to an eye condition. Key symptoms like visual disturbances can help narrow down the cause.

Answer 1

Step 1: Onset and Duration of the Headache.
- Ask the patient when the headache started, how long it lasts, and its frequency. A recent onset of headache may suggest acute issues such as acute angle-closure glaucoma or temporal arteritis.

Step 2: Associated Visual Symptoms.
- Inquire about any visual disturbances associated with the headache, such as blurred vision, diplopia (double vision), scotomas (blind spots), or flashes of light. These symptoms may indicate ocular causes such as optic neuritis or retinal conditions.

Step 3: Past Medical History.
- Hypertension: A common risk factor for conditions like hypertensive retinopathy or retinal vein occlusion.
- Diabetes: Can lead to diabetic retinopathy and other ocular complications.
- Head Injury or Trauma: Any recent history of head injury or trauma should be asked, as it may cause conditions like retinal hemorrhage or optic nerve damage.

Step 4: Family History.
- Ask if there is a family history of eye diseases such as glaucoma, macular degeneration, or retinal disorders, which could predispose the patient to similar conditions.

Step 5: Conclusion.
A detailed history, including headache characteristics and visual symptoms, is crucial for determining the potential ocular cause.