Association of Binocular Anomaly with Headache

Pragati Garg, Aleem Siddiqui, Smriti Misra, Aditi Gupta


AIM: To study various binocular attributes associated with headache, in absence of refractive error and other ocular inflammatory diseases.

METHODS: Study comprised of 199 emmetropic patients of headache after all non-ocular causes of headache were ruled out and after getting the ethical clearance and proper consent. Detailed ocular evaluation was done including visual acuity, refraction, binocular assessment like convergence insufficiency and excess, accommodation excess and insufficiency and AC/A ratio, anterior and posterior segment examination. Data was collected and analysed using SPSS software.

OBSERVATIONS: 45.22% patients were young adults of 21-30 years. The female: male ratio was 2:1. Frontal headache was the commonest presentation (34.7%). Precipitating factor for headache was inadequate or irregular sleep in young patients (p < 0.07) and smoking in older patients (p < 0.0001). An altered AC/A ratio was found in 74.9% patients. Direct proportion was seen between convergence insufficiency and low AC/A ratio and between convergence excess and high AC/A ratio (p = 0.000). Accomodation showed inverse relationship with AC/A ratio (p = 0.0001). Reduced negative fusional vergence was commonly associated with high AC/A ratio while, reduced positive fusional vergence was more common with low AC/A ratio (p = 0.03).

CONCLUSION: Ocular anomalies other than refractive error may coexist with headache complaints. Therefore thorough investigation should be done for refractive and binocular vision abnormalities in all patients suffering from headache.

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