Pain behind eye on accent

[DiveTub]

Hi to all the medical wizards on the board
I have a question about a dive we did on Saturday morning. Just a simple 1hour BT off Harbord in 10M of water.

Anyway after the dive my buddy was describing to me what happened on the accent.

He said at 5m he got an almost blinding pain behind his left eye accompanied by a nervous twitch of his eyelash. Light-headedness and a little dizzy. He descended to about 7m the pain eased slightly but the dizziness and light headiness remained. After the safety stop and surface the pain and symptoms dissipated within a couple of minutes.

He assured me he had no problems equalizing on the dive whatsoever and during accent he felt perfectly fine until the symptoms hit. He also said this had happened a couple of times before on various no deco dives always kicking on at around the 5m mark.

My initial reaction was a blocked sinus maybe pressure building up on a nerve behind the eye.

Anyway an interesting one that I had never heard of before, your thoughts would be most appreciated.

Regards
Chris

 

[BillP]

Sydney_Diver said...


My initial reaction was a blocked sinus maybe pressure building up on a nerve behind the eye.

Howdy Chris:

You're probably right. Eye pain associated with diving is likely due to sinus barotrauma. Pain on ascent would most likely be due to a reverse squeeze. A diver might equalize fine on descent, but on ascent the air expanding in a sinus can be trapped and cause painful pressure. Divers with sinus squeeze frequently have a history of similar problems in the past. Sinus squeeze is usually a mild and self-limiting barotrauma injury, but on rare occasions it can be quite severe.

You can read more about sinus barotrauma on DAN's website at:

http://www.diversalertnetwork.org/medical/faq/faq.asp?faqid=113

And on Scubadoc's site at:

http://www.scuba-doc.com/entprobs.html#Intracranial_Difficulties

The eye twitching is probably different. The nerves that control the muscles of the eye are different from the nerves that give feeling in the sinuses. The facial nerve controls the muscles of the face. It runs right by the middle ear, and if a diver has middle ear barotrauma they can have transient facial nerve paralysis, but eye twitching as a consequence of barotrauma would be a new one on me.

HTH,

Bill

The above information is intended for discussion purposes only and is not meant as specific medical advice for any individual.

 

[DiveTub]

Bill
Thanks for your fast response.
the eye twitching got me as well. I thought the barotruma might be pressing on a nerve... I will question him more and give you an update. He said he had no associated pain with his ears and it was only behind one eye that was causing the problems, a real stabbing pain as he put it.

I am interested as to why there would be Light-headedness and a dizziness, if the pain was only associated with the sinus.

I am going to get him checked by my ENT guy, but what are your thoughts on this condition affecting his diving ?

Chris

 

[BillP]

Sydney_Diver said...


I am going to get him checked by my ENT guy, but what are your thoughts on this condition affecting his diving?

Howdy Chris:

First, I think if I had a blinding stabbing pain behind my eye I might very well get dizzy and lightheaded. But having said that, sinus barotrauma is often associated with congestion. Congestion can be associated with middle ear barotrauma (recognized or not). I suppose that a reverse middle ear squeeze on ascent (perhaps masked by a near-simultaneous blinding eye pain) could convceivably also cause dizziness, lightheadedness, and facial nerve irritation. Dunno if it did happen, but I guess that it could.

Blinding eye pains, dizziness, and lightheadedness can adversely affect one's ability to dive safely. It's particularly concerning that it might happen again on future dives if it has "happened a couple of times before on various no deco dives". If it were me, I'd get that ENT checkup before continuing diving.

HTH,

Bill

As before, the above information is intended for discussion purposes only and is not meant as specific medical advice for any individual.

 

[DiveTub]

I will be making him a booking this week to go see my ENT guy.
Will see what he has to say, and will let you know the results.

Regards
Chris Holman
PADI MSDT
http://homepage.mac.com/sydney_diver