Fluids Hypertension Syndromes: Migraines, Headaches, Normal ...

Fluids Hypertension Syndromes – Dr. Leonardo Izecksohn – page 38
V) Migraines Intensities linked with Intraocular Pressures and other conditions:
V-a - We classified the Migraines intensities (Graph V-1) as:
0: No Migraine.
1: Small Migraine, well tolerated, only confirmed when asked about.
2: Moderate Migraine, complained by the patients amongst other symptoms.
3: Strong Migraine, many times spontaneously complained about during the first examination.
4: Very strong Migraine, intolerable.
The intensity of the Ocular Migraine was consequent from a mild and evanescent rise of intraocular
pressure, as we see in the Graph V-1, published at the year of 2002 (Izecksohn L and Izecksohn C.).
Other authors also found similar relations between Migraines and intraocular pressure rise:
“Pain in migraine attacks including occipital and nape discomfort reflects selective involvement of
the Ophthalmic nerve. Photophobia is largely a retinal reflex involving the Ophthalmic division of the
trigeminal nerve. Key clinical features of the migrainous scintillating scotoma are consistent with retinal
origin. ... Several first-line migraine prophylactic agents lower the intraocular pressure.” (Gupta, V
K).
Graph V-1 (schematic): Intensities of Migraines, Headaches and Migraine variants (vertical from
0 to 4) linked with their Intraocular Pressures (horizontal from 14 to 26 mmHg). Modified from
Izecksohn L and Izecksohn C.
As shown by Liu and others, the average intraocular pressure of healthy eyes, on diurnal period, on the
sitting position, is between 15.9 to 16.7 mmHg.
We conclude that the patients feel higher ocular aches intensities when presenting intraocular
pressures between 17 to 21 mmHg. The intraocular pressures lower than 17 mmHg do not ache
because they are physiologic; those pressures higher than 21 mmHg ache very little, if at all. The
patients feel the eye aches mainly as Cluster Migraines, but they can feel other migraines or variants.