Headaches in optometric practice part 3: Asthenopia or angle closure?

In practice, we regularly deal with patients who have been referred by friends or professional colleagues for an eye examination. These patients invariably have to wait a few weeks for an appointment due to our booked clinics. They are mostly booked in at the end of the day where there is always time pressure to finish the clinics and, typically, these patients have a list of concerns and problems. As a clinician, one has to be focused and treat every patient equally, whether known to one or not.

Case study

A 58-year-old male attended for his first appointment after the recommendation of his sister and mother who had been patients at the practice for 10 years. His mother had been referred by the author a few years ago with a diagnosis of pseudoexfoliative glaucoma. He had previously been assessed by his optometrist near to his workplace for a number of years, and had a long and persistent history of tiredness and soreness of the eyes associated with prolonged computer use.