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    Asking right questions leads to better headache diagnosis

    Ophthalmologists can keep certain queries, mnemonics in mind to track and treat

     

    Tracking down the cause

    Ophthalmologists also can encourage patients to think more closely about their headaches by asking further questions, such as:

    ·      Where is the pain?

    ·      Is it bilateral or unilateral? (“It’s a red flag if it’s always on the same side,” Dr. Gordon said)

    ·      What’s the severity and duration?

    ·      What’s the quality of pain? Is it pulsatile, pressure, or stabbing?

    ·      Are there other symptoms? (this could include nausea, vomiting, and photophobia)

    ·      Do you have any double vision?

    ·      During the headache do you want to rest in a quiet, dark space or do you need to stay active or pace around the room?

    ·      Do you have to miss time from work or other activities due to your headaches?

     

    “You could even have these as a written questionnaire for patients, and hopefully someone else could input the information into your electronic health record,” Dr. Gordon said. This would help save time.

    Editorial: Why pediatric ophthalmologists don't go to late night parties

    If a patient’s headaches or headache history triggers red flags, a physician has an obligation to conduct imaging, blood work, or sometimes a spinal tap. If the physician does not feel comfortable delving further into headache diagnosis and treatment, then refer the patient to another specialist with an interest in the area, she advised.

    “If you don’t get them to the right doctor, they may not get the right workup and diagnosis, and for sure they won’t get the right treatment,” she said.

    Diagnosis is key

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