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Headache associated with refractive errors: Characteristics and risk factors - 20/01/21

Doi : 10.1016/j.neurol.2020.10.008 
H. Lajmi , R. Choura, B. Ben Achour, M. Doukh, Z. Amin, W. Hmaied
 Internal Security Forces Hospital, rue Mohamed Fadhel Ben Achour, 2078, Marsa Safsaf, Tunis, Tunisie 

Corresponding author.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Wednesday 20 January 2021

Highlights

Headaches due to ametropia were mainly chronic, progressive, daily predominantly during the second half of the day. They were moderate, with a fronto-orbital topography.
Prolonged screen working, combined ametropia, moderate hyperopia and astigmatism were the risk factors of these headaches.
Headaches induced a substantial to major impact on the quality of life, the latter is significantly influenced by the presence of high myopia.
Optical correction and orthoptic treatment lead to headache improvement.

Le texte complet de cet article est disponible en PDF.

Abstract

Introduction

The purpose of our work was to study the characteristics of Headache associated with refractive errors (HARE)1 , and to search for the correlation between headaches characteristics and some risk factors. We aimed also to assess the impact of these headaches on the quality of life of patients.

Methods

A cross-sectional, retrospective, comparative study including 90 patients followed between August 2019 and January 2020. These patients were divided into two groups: Group 1 including patients presenting headaches due to uncorrected ametropia, and group 2 including control subjects. We studied HARE characteristics, the influence of certain risk factors (profession, triggers factors, characteristics of ametropia, and orthoptic abnormalities) on them, their evolution after one month of treatment, and their impact on patients’ quality of life with the HIT-6 score.

Results

Headaches due to ametropia were mainly chronic (20.9±15.76 months on average) progressive (100% of cases), daily (90% of cases) predominantly during the second half of the day (82% of cases). They were moderate (64% of cases), with a fronto-orbital topography in 52% of cases. Headaches were compression-type in 36% of cases (18 patients) and pressure-type in 64% (32 patients). The multivariate study retained prolonged screen working (P=0.013), combined ametropias (P=0.001), moderate hyperopia (P=0.01) and astigmatism (P=0.03) to be risk factors of HARE. Headaches induced a substantial to major impact on the quality of life in 68% (34 patients had a score greater than 55), the latter is significantly influenced by the presence of high myopia. After optical correction and orthoptic treatment, we noted an improvement in headache in 100% of cases. The multivariate analysis did not identify any independent factor that impact the evolution of headache at one month.

Conclusion

HARE may influence life quality; it needs an appropriate treatment based on risk factor management. A healthy lifestyle in addition to adequate refractive error correction is essential in children and, sometimes in adults. Oculomotor abnormalities treatment leads to improve long term results.

Le texte complet de cet article est disponible en PDF.

Keywords : Headache, Refractive errors, Asthenopia, Accommodation


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