Ear and Eye problems (new diver)

[DizzyWizard]

Hey! First whenever I go diving I seem to equalize fine (ears pop as I descend), but farther down to about 20ft when I pop my ears it sounds like rice crispy treats (crackling after it pops). I almost always get barotrauma in my ear due to it and 2 weeks ago this caused me to have a middle ear infection. Is there anything I can try to help this?
Second off yesterday I had a stabbing pain (starting from my forehead, behind my eye, and down my cheek all on the same side) on decent about 50mins into our dive around 25ft. I went up to 20ft and it went away and about 10 mins later it came back. I've read it could be sinus barotrauma but I wasn't too sure since that was the last tank I used for the day (refilled twice)
Any help is appreciated!

 

[Duke Dive Medicine]

Hey! First whenever I go diving I seem to equalize fine (ears pop as I descend), but farther down to about 20ft when I pop my ears it sounds like rice crispy treats (crackling after it pops). I almost always get barotrauma in my ear due to it and 2 weeks ago this caused me to have a middle ear infection. Is there anything I can try to help this?
Second off yesterday I had a stabbing pain (starting from my forehead, behind my eye, and down my cheek all on the same side) on decent about 50mins into our dive around 25ft. I went up to 20ft and it went away and about 10 mins later it came back. I've read it could be sinus barotrauma but I wasn't too sure since that was the last tank I used for the day (refilled twice)
Any help is appreciated!

Your latest event does sound like sinus barotrauma, and your description of your ears makes me wonder whether you're either not equalizing frequently enough or you have a chronic inflammatory process in your upper respiratory mucous membranes. Have you seen an ENT physician?

Best regards,
DDM

 

[RobPNW]

I had the sinus pain during a dive trip before and it can be painful. After that experience I researched nasal irrigation and did about a week of cleaning and never had the issue again. I know many people here who use the spray bottles but I wanted something more thorough so I got a Waterpik and bought a couple nasal tips off Amazon.

I make my own saline solution by heating up 2 1/2 cups of distilled water in the microwave for a minute. I then mix a teaspoon of sea salt and 1/2 teaspoon of baking soda in it until completely dissolved. Don’t forget the baking soda because it cuts the burn at least in half.

Turn the Waterpik on the lowest setting and press the nasal tip on one nostril until half the water is gone and then switch to the other nostril. The flow washes through the nose and sinuses and out the other side. It will flush out mucus and such and it will burn a bit, especially if there’s significant gunk in there. Just man up and deal with it. After done don’t blow your nose. Let it marinate in there and do the post nasal drip thing.

After about a half hour the drainage will stop. After about a week, things will be clear in the sinuses. After this experience, I do this now every time I start getting cold symptoms also and it helps with that too.

 

[DizzyWizard]

Your latest event does sound like sinus barotrauma, and your description of your ears makes me wonder whether you're either not equalizing frequently enough or you have a chronic inflammatory process in your upper respiratory mucous membranes. Have you seen an ENT physician?

Best regards,
DDM

I haven't seen an ENT I will be asking my primary care to see a ENT this week though. My ears are weird usually when I go down after every inhale on the way down I equalize and then if I'm at 20ft they're fine and equalize on their own (they'll randomly pop with no pain) I usually notice the pain after diving. I wouldn't say my buoyancy is perfect but I'm able to control my ascent and decent with my breathing.

 

[DizzyWizard]

I had the sinus pain during a dive trip before and it can be painful. After that experience I researched nasal irrigation and did about a week of cleaning and never had the issue again. I know many people here who use the spray bottles but I wanted something more thorough so I got a Waterpik and bought a couple nasal tips off Amazon.

I make my own saline solution by heating up 2 1/2 cups of distilled water in the microwave for a minute. I then mix a teaspoon of sea salt and 1/2 teaspoon of baking soda in it until completely dissolved. Don’t forget the baking soda because it cuts the burn at least in half.

Turn the Waterpik on the lowest setting and press the nasal tip on one nostril until half the water is gone and then switch to the other nostril. The flow washes through the nose and sinuses and out the other side. It will flush out mucus and such and it will burn a bit, especially if there’s significant gunk in there. Just man up and deal with it. After done don’t blow your nose. Let it marinate in there and do the post nasal drip thing.

After about a half hour the drainage will stop. After about a week, things will be clear in the sinuses. After this experience, I do this now every time I start getting cold symptoms also and it helps with that too.

I will for sure try this! thanks

 

[LI-er]

Not an eye problem.

 

[DizzyWizard]

Your latest event does sound like sinus barotrauma, and your description of your ears makes me wonder whether you're either not equalizing frequently enough or you have a chronic inflammatory process in your upper respiratory mucous membranes. Have you seen an ENT physician?

Best regards,
DDM

Just an update I had a middle ear infection I didn't have enough reason to see an ENT. It resolved itself with meds and I went diving Saturday from 8am-5pm now I have issues chewing and clenching my jaw. The pain shots up to my ear but no hearing loss. Doc said the eardrum is red but couldn't tell if it was trauma or getting infected so he's giving me meds. I finally can see and ENT and waiting for a scheduling call. I did take Sudafed, ibuprofen, and citrizine a day prior and day of diving. Saturday I didn't feel like I had issues equalizing and I always tell new buddies I equalize slower than normal so I don't usually rush. When I'm going to depth I usually equalize with every breath. Inhale, exhale slightly with my nose plugged and release the air through the regulator then repeat.

 

[Duke Dive Medicine]

Just an update I had a middle ear infection I didn't have enough reason to see an ENT. It resolved itself with meds and I went diving Saturday from 8am-5pm now I have issues chewing and clenching my jaw. The pain shots up to my ear but no hearing loss. Doc said the eardrum is red but couldn't tell if it was trauma or getting infected so he's giving me meds. I finally can see and ENT and waiting for a scheduling call. I did take Sudafed, ibuprofen, and citrizine a day prior and day of diving. Saturday I didn't feel like I had issues equalizing and I always tell new buddies I equalize slower than normal so I don't usually rush. When I'm going to depth I usually equalize with every breath. Inhale, exhale slightly with my nose plugged and release the air through the regulator then repeat.

It sounds like there's still some inflammation in the Eustachian tube, and good technique and caution enabled you to clear your ears despite that. Continuing to dive could result in lengthening your recovery time and/or injury. I would avoid recommend you diving until that pain goes away, which is a slow process. Inflammation in the mucous membranes of the upper airway can take weeks to resolve.

Best regards,
DDM

 

[doctormike]

As usual, @Duke Dive Medicine has given you great information. If you want some more background reading about different ear equalizing techniques to try, I have an online resource you could look at:

Michael Rothschild: Ear Equalization Techniques

Most people who come to see me for ear equalization problems don't have any anatomic or other medical issues, and it's just a technique issue. Generally, if you have significant ear disease which could complicate diving, you would know it.

Sinus squeeze, on the other hand, can be very serious and there can be some rare but very scary complications of sinus barotrauma involving the orbits or even the central nervous system. And unlike problems equalizing the ears, it is very common to have some sort of physical obstruction - for example, a polyp in the outflow tract of the frontal sinus. This could be completely asymptomatic until you try to dive.

For anyone having significant sinus squeeze that isn't simply related to diving with a cold, it usually makes sense to see an ENT doc and get a CT scan.