By Joshua Tucker

Orbital Tendonitis or Trochleitis?

by Laurie H.
(USA)


Can you get tendonitis in the muscles around the eyes? I read there is a trochlea tendon above the eye. I have read of conditions called "Trochleitis" and "Temporal Tendonitis".

Off and on for about 3 years, I get this uncomfortable sensation in my right eye socket & brow bone that occurs for many weeks and then goes away for a couple months. It comes and goes. My eyeball does not have any pain. Just the surrounding tissue above the eyeball.

I feel it when I touch my face. It is underneath the brow bone & at the top of my eye socket. It's a sharp nerve sensation that hurts when I either lightly touch the skin or rub the area. Often it will spread to the area above my outer eyebrow on the forehead. When I push on my brow bone, the sharp nerve sensation will travel in a straight line to the back of my skull on the same side or travel to my ear or jaw on the same side as well.

Sometimes when it gets bad, the pain will shoot to my temple area travel to the back of my head down the back of my neck on that side. Squinting my eyes will also trigger this nerve pain.

If these are real tendonitis conditions, how do you treat it with cold an ice?



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Joshua Answers:


Hi Laurie.

Yikes. That's an odd pain...

So let's just assume that you have ruled out any eye or eye socket issues (medical issues I don't know anything about, nor even what they might be named other than 'tumor').

Who knows what could be going on in there. Make sure you get 'bad' things ruled out by the appropriate doctor.


Technically one could get tendonitis in there. Inflammation and irritation.

Your pain symptoms don't match up like I would expect them to....though there's a lot of nerve in the area, and that can equal a lot of different kinds of pain.



So, it could be Tendonitis, which Trochleitis essentially is.


There are a few options I would start with.

1. Get your Vitamin D levels up. We'll cover our nutritional bases with this and #2.


2. Supplement with Magnesium for Tendonitis and B6 and B12 (methylcobalamin, not cyanocobalamin).


3. Rest a covered ice pack on the eyes for 1-2 minutes, repeat regularly. Don't let the eyes get too cold, obviously.

Not the best option in the world, but...


4. Rest your palms lightly over your eyes. Rest, relax, let the heat of your hands do it's thing.

Either that time or the next, add a little more weight. Again, rest, relax, etc.

This kind of counts as massage, but also calms the nervous sytem.


5. Depending on what happens with the Magnesium, we may have you get some magnesium oil, and rub that on the area. This can have great results, if the spasm/irritation is due to a magnesium issue.




While there may be inflammation, my sense is that icing isn't going to be the answer.

Try the above, and see what happens, and let me know, and we'll go from there if we need to.



Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com
















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Comments for Orbital Tendonitis or Trochleitis?

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Aug 22, 2011
your not alone - Orbital Tendonitis or Trochleitis?
by: Anonymous

Hi laurie. The last couple days i have developed your exact symptoms. Mine is a centralized pain just above my left eye in my brow area. The only time i feel the pain is when i touch right on the spot and the pain shoots behind my eyeiioo. Otherwise there is no pain at all. Again it just popped up the last couple days and i never had it before. Very odd

Sep 01, 2011
pain on and under right brow bone also.... -- Orbital Tendonitis or Trochleitis?
by: candy

Hi guys...I too have the exact pain on and right under my right brow. Had this for about a month now and got to the point that can't sleep in my comfortable position anymore because just the pressure of my brow area on a pillow is excruciating.

I can no longer even wash lightly over that area. Going to the doc soon being it is getting worse.

Totally know what frustration u all are going through with this and will let you know what I find out.



Nov 03, 2011
Bull
by: Anonymous

This in not tendonitis, it's trochleitis. I have it. The solution is to use aspirin or something stronger like dolobid twice a day 500mg each. It may take a few days to feel better so hang in there. Try aspirin (not ibuprophen doesn't work as well) first and see if it relieves the pain if not get Dr. to give dolobid.

Ice won't help reduce swelling to that nerve and may even damage your eyes if not done properly. Now once your eyes feel better you have to be careful not to continue to cause damage because although pain is reduced, the damage still continues from the rubbing/fraying of the nerve.

Hope this helps.


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Joshua Comments:

Hey Guy Who Calls Bull But Won't Leave His Name.

1. Trochleitis is tendonitis. "Trochleitis is inflammation of the superior oblique tendon trochlea apparatus"

So clearly you don't know what's what and shouldn't be calling 'bull' on anything.


2. -IF- a nerve is getting rubbed and frayed, why is that happening? What is the cause? And how is Ibuprofen a fix? Oh, it's not.

How do you know there's actual damage happening? Just because there's irritation doesn't mean there's damage.

How do you even know it's a nerve issue?


3. You still have whatever is bothering you? And your only option is pharmaceuticals? And you don't know how to prevent it's return?

I don't know that you're the best person to be offering any kind of advice, since you can't fix your own issue.


4. So people shouldn't use ice for short periods, but pharmaceuticals are ok? As if they don't have any possible down sides (They do, look up the side effects of doloboid)? Come on.

Yes one can hurt your eyes by applying ice on them for too long and past any point of common sense.

So don't leave it on for too long. And make sure your eyes are closed. And if it hurts, remove it and/or use a less cold cold pack.

Easy.


5. Normally I would just delete a comment like this, but it was an opportunity to address a couple of points, and it was too fun to pass up. So thanks for that.



Jan 04, 2012
Answer
by: Bull

My nickname is Bull - justed probably typed in wrong place, I wasn't calling bull lolll. Relax! I do realize that trochleitis involves tendonitis but it also has other symptoms that are caused by additional swelling in other areas when it gets really, really bad. I ended up with symptoms that minicked TMJ, I lost my sense of salt taste for a few days and I woke up dizzy from swelling around ears several times. I was diagnosed by an opthalmic neurologist and meds were given by a rheumatologist. I know what I'm talking about.

The ice does not help and so far, with all the treatments out there, the only thing that did help was the dolobid (diflunisal) is all that is avail now. Please don't discount a solution for this person because you took an attitude to my response. Try a strong anti-inflammatory and you will get relief.


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Joshua Comments:

Hi Bull.

Yeah, that's kind of funny.

Here's my beef.

There's a difference between 'solution' and 'relief'.

If a person wants to take an anti-inflammatory or pharmaceutical to get them through the day, great. They should.

But if it's not a fix, it's not a solution. It's at best a band-aid.

When someone offers a band-aid as a solution (whether it's a doctor or a doctor's patient that still has pain/problem, I don't get offended, but I do point out the difference. It's an important difference.

If the eye problem isn't gone and you have to take meds to keep it away, you have not found a solution.

Maybe it's semantics, but it is my humble opinion that accuracy is pretty important when it comes to health care.

And don't get me wrong. I'm ALL FOR you trying to help. I very much appreciate that quality in people.


In your case specifically, how did the doctor determine that your nerve is getting damaged?






Jan 09, 2012
Trochelitis in both eyes for over two years
by: Anonymous

I have been suffering from trochelitis in both of my eyes for over two years. My left eye is worse than my right. I am currently seeing an eye doctor in Houston, Texas who is one of the few docs in the country who treat this condition.

Most eye docs haven't even heard of this condition. She performs eye scans on me periodically to measure the inflammation with an ulrasound-like machine. She has me on oral predizone and, so far, that has worked for me.

I am tappering off of it slowly. She recommends oral Prednizone before the shot.



May 24, 2012
There is help
by: Anonymous

I have suffered for about 4-5 yrs with sinuis and migraines issues. I've had 2 sinuis surgeries which have helped but I continued to suffer from the migraines.

I have taken numerous types of medications. The best being indomycin but I had to stop because of GI upset. But it did work for nine months. As stated before I've taken many meds including oral prednisone.

I finally be came so fustrated and begged my neurologist for other solutions, some were invasive and I decide to seek another option. Which lead me to The Headache Clinic in Philadelphia. Very hard to get apt. But they have been great today i I had my first injection of decadron and lidocaine into to trochlear tendon. Yes, I was diagnosed with trochleitis by getting a ct scan of my orbit. This is the true way to diagnose.

Hoping for good results won't know for a few days and may need another injection but for now one day at time, hoping to regain my life back with my family. Best of luck to all you suffers keep fighting for answers don't settle.


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Joshua Comments:

Ultimately it's a quest to find what works....

1. What is your Vitamin D level?

2. Have you ever gone completely off Gluten for 2 months?

3. Ask the clinic about Magnesium, I'm curious what they have to say.






Jun 26, 2012
Help with tight eye muscle feeling and pain after lasik eye surgery
by: Denise

I think ive been dealing with this condition as well. I had lasik 9 months ago and have suffered with this tight eye muscle feeling and pain ever since.

What type of doctor diagnoses this, and what tests should be performed? My eye feels like its constantly flickering. Its torture.


Please help with any more info or advice. Thank you.


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Joshua Comments:

I'd think you're be looking for a doctor that specializes in issues of the eye.

?





Jul 05, 2012
Thought I was crazy
by: Brian

I am glad that I searched Google and found this page. I have the same exact pain that Laura describes in her first post and have basically dealt with it for years, but I have had enough and needed to know what type of doctor deals with this.
Anytime I have a headache I know that all I have to do is touch or push into the area around my brow bone in order to feel the sharpest and most excruciating pain I have ever felt in my life. It is always associated with a headache that progressively gets worse until it reaches a migraine unless I take prescription strength ibuprofen to get rid of the inflammation and headache before it gets that bad.
I normally take my knuckle or use my thumb and rub under the brow bone to try and massage the area. That can help sometimes, but it's also like torturing myself because the pain resonates through my eye into my skull and can even reach my neck at times. I can only rub the area for so long, because if I put too much pressure directly on it, then I wouldn't be surprised if that pain makes me pass out. I was hoping for some other relief from this other than more medicine, but from the responses here it looks like that's how most people have gotten relief.


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Joshua Comments:

I wonder...if you regularly rub that spot, instead of waiting till it's excruciating, if that would help keep it from getting to that point.




Oct 06, 2012
Laughable
by: Kim

I have trochleitis and this made me laugh:
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Joshua Comments:

Ultimately it's a quest to find what works....

1. What is your Vitamin D level?

2. Have you ever gone completely off Gluten for 2 months?

3. Ask the clinic about Magnesium, I'm curious what they have to say.

-

I ALSO have myasthenia gravis, which means NO magnesium!!! And I have been gluten free for over 3 years due to celiac! And yes, my vit D is good. And these are your "solutions"?? Really? Thanks for a good laugh.


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Joshua Comments:

Hello Kim. I'm confused.

1. Nobody on this thread has mentioned Myasthenia Gravis, so nothing I've said on the thread could possibly be refferring to that. You've never posted here, so to somehow think that anything I've said correlates to you or your situation is...well....weird.

2. In fact, I asked three questions, as opposed to any 'solutions' you seem to think are 'mine'.


Normally I wouldn't publish a crazy post like yours, but I am just so anyone reading this thread that has Myasthenia Gravis that doesn't know that they need to be very aware of their body's relationship with Magnesium might start asking the right questions.

So thanks for sharing. Hopefully it will make a difference for someone.





Mar 28, 2014
Same issues... post Cipro dosage.
by: M W

Just wanted to check in on this thread to see if anyone started having these symptoms after being prescribed Cipro.

I recently had a small procedure and 2 day dose of 500mg Cipro and this happened to me... I have read innumerable reviews of the drug's effects on people's tendons and muscles and my assumption is that my incidence of tendonitis/trochleitis is related.

I am trying a food based anti-inflammatory regimen in hopes of easing some of the pain.




Mar 29, 2014
Orbital tendinitis, eye sags and waters when it hurts
by: Rosie

I am just searching for answers myself. I gave had pain above my eye brow and inner eye off and on for years. I am troubled by it so much. The eye sags when I experience the pain and waters so much. The skin Below my eye becomes very dry from the watering .. Painful dryness.

I have massaged the area and it really doesn't help. Is surgery the only real solution.


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Joshua Comments:

Hi Rosie.

Are you sure it's tendonitis, as opposed to a bunch of other possibilities?



Nov 12, 2014
Trochleitis vs Something more serious
by: Siobhan

Last night while driving I experienced sharp pain behind my left eye. I had a dull ache while looking forward but if I looked up or down or to the side the pain became sharp. My vision was okay but the area closest to my nose and below my brow is now swollen and tender to touch. I'm out of town attending a conference so I can't just go to a doctor easily.

I'm a little worried... Sounds like trochleitis to me. What do you think?


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Joshua Comments:

That sounds like something you should see a doctor about to rule out anything bad.

Sudden onset of pain (anywhere in the head) followed by swelling and tenderness (Meaning inflammation meaning possible damaged artery), is serious enough to get thee to a doctor asap.

It doesn't have to be a terrible thing and it very well could not be a horriblething as there's various non-horrible things it could be, but it definitely falls in the category of "I'd be worried about it enough to go to the hospital at some point soon ESPECIALLY if it recurrs at all, gets worse, or other symptoms show up."

And if you're flying before you see a doctor? I'd rather err on the side of caution and see a doctor before going into a high altitude/pressurized cabin with no doctor on board scenario.



Nov 17, 2014
Eye pain when moving eye and nerve pain
by: Anonymous

So I suffer from migraines to the right side and te last month.

I have had severe eye pain only when I move my eyes in
Other directions I get pulsing pain and when I touch my brow bone and upper nose area between the eyes it hurts causes a sharp nerve pain all on the right side.

I'm waiting on dr appt but super concerned cuz the pain gets worse also when I put my contacts on which I stopped for now until I know what's going on.


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Joshua Comments:

It's definitely a good idea to see a doctor to rule out anything 'bad'.

Is this a new thing for you?

Do you have a history of migranes?

Any historical issues with your eyes?

Any trauma to the head/face ever?


Let us know what the doctor says.




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