Headaches are another of those "stress" symptoms and are the primary reason most people seek an eye examination. They are also one of the most difficult problems to diagnose and treat effectively. Headaches are reported at least once a month by 76 per cent of women and 57 per cent of men. There are numerous types of headaches and they can be caused by a number of different conditions.

It is important to distinguish between visual and non-visual origin headaches and what might be the source of the symptom. Visual headaches most often occur toward the front of the head (there are a few exceptions to this); occur most often toward the middle or end of the day; do not appear upon awakening; do not produce visual ‘auras’ of flashing lights; often occur in a different pattern (or not at all) on weekends than during the week; can occur on one side of the head more than the other and other more general symptoms. It is critical to distinguish the type of headache involved. You should be aware of the time of onset, location of the pain, frequency, duration, severity and precipitating factors such as stress, certain foods or medications. Associated signs and symptoms such as nausea, vomiting, light sensitivity and noise sensitivity should also be noted.

I often hear patients say they suffer from ‘migraine’ headaches. However, migraines are a very specific type of headache and have an organic, not visual, cause. There is no clinical diagnostic test to establish the presence of a migraine headache so extensive laboratory tests would be appropriate. You should seek a neurological evaluation after all other variables have been accounted for.

If you work at a computer, you most likely get tension-type headaches. These can be precipitated by many forms of stress, including anxiety and depression; numerous eye conditions, including astigmatism and hyperopia; improper workplace conditions, including glare, poor lighting, and improper workstation setup. These types of headaches are mild to moderate in intensity, often occur on either or both sides of the head, are not aggravated by physical activity, develop during the early to mid part of the day, last from 30 minutes to the rest of the day, and are relieved by rest or sleep. Chronic tension headaches vary somewhat from this but have the same overall symptoms but occur much more frequently.

Visual and environmental conditions are the first places to look for a solution to a headache problem. If all obvious factors have been considered, medical management is in order, often starting with a complete eye examination to rule out the visual cause.