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Migraine and Reduced Binocular Vision in Adolescents: A Cross-Sectional Study
Hanne Mari Schiøtz Thorud1, Cecilie Onshuus Bjørset2, Inger Helene Hallan Minsås2
1Department of Optometry, Radiography and Lighting Design, National Centre for Optics, Vision and Eye Care, University of South-Eastern Norway, Kongsberg, Norway. hannemt@usn.no.
Purpose:
Headache disorders and untreated vision problems are both common among adolescents. This study aimed to examine headache characteristics in adolescents and potential associations with untreated vision problems.
Methods:
As part of a school vision testing programme, 230 Norwegian adolescents aged 15.5 ± 0.5 years (mean ± SD) completed a structured questionnaire including questions that allowed for classification according to The International Classification of Headache Disorders, 3rd edition. The Wong-Baker FACES Pain Rating Scale was used for registration of pain intensity. The questionnaire also registered general health, pain/discomfort in the upper body, screen time and physical activity.
Results:
A total of 190 (83%) adolescents reported experiencing headache, while frequent tension-type headache was classified in 42 (18%) and migraine in 25 (11%) of the adolescents. Adolescents with an untreated vision problem [n = 74 (32%)] were more likely to be classified with a migraine diagnosis (20 vs. 8%, p = 0.009) and reported more arm pain/discomfort (68 vs. 49%, p = 0.007) compared with adolescents with normal vision. Adolescents classified with migraine more often had an untreated vision problem due to reduced binocular vision (37 vs. 16%, p = 0.008), reduced accommodation amplitude (15 vs. 2%, p = 0.009) and reduced near point of convergence (19 vs. 2%, p < 0.001), compared with adolescents without a migraine diagnosis. Adolescents who reported arm pain/discomfort more often had reduced near point of convergence (12 vs. 3%, p = 0.02), compared with adolescents without arm pain/discomfort.
Conclusions:
The results of this study indicate an association between migraine characteristics, upper body musculoskeletal pain and reduced near visual function. However, as the study design prevents causal interpretation, further research is needed. A comprehensive eye examination may offer significant benefits and should be considered an integral part of the management strategy for patients with headaches.
