By Dr. Charles J. Bock

Headaches

Most children with chronic headaches are referred for an eye examination to determine if there is an ocular cause for the headaches. Some common types of ocular and non-ocular headaches are described below.

Holding reading material too close

As children progress through school, the size of the print in their books becomes smaller and the number of pictures in the books decreases. This creates fewer breaks for the child while reading. More difficult vocabulary and sentence structure force the child to concentrate, and the result is that many children begin to hold their books closer to their eyes. This forces their eyes to increase their focus, and this can induce eyestrain headaches.

Refractive error

Refractive error is the term used to describe a patient's glasses prescription. Children who get headaches may have nearsightedness, farsightedness, or astigmatism. Nearsighted children tend to complain of blurred vision at distance and may squint to the board in school. They frequently have headaches as a result of the eyestrain they cause by squinting. Farsighted children often complain of headaches with reading, because they need extra help for focussing at near. Farsighted children often have severe eyestrain and headaches after prolonged reading. Children with astigmatism may have headaches due to blurred vision at all distances.

A complete eye examination will determine if your child needs glasses.

Convergence insufficiency

This problem is uncommon, but children who complain of headaches after reading for 15 to 20 minutes, especially when accompanied by blurred or double vision, sometimes have a problem holding their eyes together at near for prolonged periods. In this problem, called convergence insufficiency, one eye actually drifts outward, creating the blurred or double vision. This is only eye problem for which eye exercises are considered to helpful.

Pediatric migraine

Migraine is an under-diagnosed problem in children. Not all people who suffer from migraines complain of seeing blurred spots or bright lights prior to the onset of the headache. You should suspect migraine if nausea or vomiting, sensitivity to light or sound, or the need to lie down or sleep in a dark room accompanies your child's headaches. One of the easiest things your child can do to decrease the frequency of migraine headaches is to drink plenty of water each day; mild dehydration is now known to be responsible for headaches in many children and adults. Other important factors include getting plenty of sleep, eating at regular times each day, and limiting caffeine.

Brain tumors

Many parents are concerned about the possibility of headaches in their child being a sign of a brain tumor. Fortunately, this is extremely uncommon, but a thorough examination of your child's eyes after the eyes are dilated will include an examination of the optic nerve. A swollen optic nerve is cause for concern and requires additional evaluation.

If you have questions

Feel free to call our office at any time 503-656-4221. Our goal is that you understand completely your child's condition and treatment.