My daughter sees dots and often complains of eye pain and headaches. Please help.

Question

Hello doctor,

Our 10-year-old daughter has been complaining of eye pain or sore eyes for the last six months. She says that she sees dots and often gets headaches. GP suggested a reduction in screen time and possible anxiety. She was referred to an Ophthalmologist, but due to COVID-19, it has been put on hold. However, it seems worse and leaves her often in tears. We reduced screen time, but no changes. She has noted some greyish patches on the whites of her eyes, but honestly, they are not sure if they were always there or are normal. She had her yearly eye test eight months ago. A small change in her prescription, but otherwise, all good. Looking for an opinion as it is starting to become an all-day thing and upsets her massively. Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

Thanks for your query. I understand your concern about eye pain. If you could upload the spectacle prescription and a photo of the grey patches, I can better understand your concern. Eye pain and headache without an associated pink eye might be related to eyestrain either due to overuse of the eyes or if the refractive error is not corrected properly. Occasionally migraine can manifest this way too. Children tend to be hypermetropic or long-sighted, which they grow out eventually, which is why I need to know the prescription. If screentime is unavoidable, I would suggest you train her with the 20/20/20 rule. For every 20 minutes, she should focus on an object twenty feet away for 20 seconds. This gives rest to the eye muscles responsible for accommodation or near vision. Another cause of headaches is, of course, stress or anxiety. Certain personality types are more prone to headaches, which are of a dull aching type and could be located anywhere. Sinus headaches can cause pain around the forehead and occasionally the eyeball if involving frontal sinuses. Does she have a stuffy nose or sinusitis? I recommend using lubricating eye drops, avoiding cell phone and computer games, and encouraging more outdoor activity. If migraine is possible, you might need to consult a pediatrician for the precise and migraine medication dose. I shall await the eye photo and spectacle prescription.

Answer 2

Hello,

Welcome back to icliniq.com.

I had a look at the photo (attachment removed to protect patient identity), and as you said, it is not very clear. It could likely be ocular melanocytosis, which is usually present from birth and darkens with age. It is nothing to be concerned about. It just needs to be monitored. On her next ophthalmologist visit, her eye pressure should be checked. Going by her history of autism and anxiety, it is likely the cause of her headache. It is better to get her eye power checked every six months. Hypermetropia tends to reduce as children grow, and myopia increases. So even a minute change of power can cause eyestrain. Let her start with the lubricating eye drops like Refresh Tears (Carboxymethyl Cellulose) as they are safe to use long term and are available without a prescription. And also make the 20/20/20 rule to reduce eyestrain. I hope this helps.