Headache is rarely due to the eye, with the exception of obvious ocular pathology. Photophobia, associated with migraine, is rarely caused by diseases of the eye, eye muscles, or the optic nerves. Reading, eye strain, eye muscle imbalance, or refractive errors are rare causes of headache.
The pain of glaucoma is due to an increased intraocular pressure within the globe. The severity is more directly related to the rate of increase of the intraocular pressure rather than the absolute pressure. Glaucoma can be easily classified as: (i) open if the anterior angle filtration is patent, (ii) closed if the chamber is blocked, or (iii) combined if the chamber is patent and blocked. The type of glaucoma with the most severe pain is caused by acute closure ofthe angle in the anterior chamber. On exam, the orbit is "rock hard'' and immediate ophthalmologic referral is necessary.
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