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Headaches in Children

Why do children get headaches?

Headaches in children have many causes including sinus disease, brain tumor, migraine headache, tension headache and eye problems. Eye related headaches in children are caused by 1) need for eye glasses (glasses for children), 2) eye muscle imbalance (strabismus), and 3) eye disease.

Should children have eye exams if they have headaches?

Yes.

The eye examination is an important part of headache evaluation. The entire visual system should be examined, with special emphasis on the aspects used for reading tasks. This includes refractive error (need for glasses), eye alignment, and binocularity (ability to use the eyes together).

Can eye problems cause a headache during or after reading?

Yes.

Excess farsightedness requires extra effort to focus clearly when reading and sometimes causes a headache. Glasses can reduce the effort required to see clearly at near and improve the headache.

The decreased ability to pull the eyes toward each other when viewing near objects (particularly while reading) may cause headaches. Doubling of images or words, blurred vision, and eye fatigue are all symptoms of convergence insufficiency. Exercises to improve convergence can help with headache caused by convergence insufficiency.

How do eye diseases in children cause headache?

Acute infections and inflammatory diseases of the eyes can cause headaches. These problems are usually accompanied by red eye and/or eyelid and light sensitivity (photophobia). Some inflammatory conditions, such as Juvenile Idiopathic Arthritis (JIA), can unknowingly affect the eyes thus requiring periodic exams by an ophthalmologist.

Acute glaucoma (angle closure glaucoma) can cause headaches, but rarely affects children. Intraocular pressure checks are indicated for children who are at increased risk to develop glaucoma. This includes use of systemic or nasal steroids, history of trauma or surgery to the eye, and the diagnosis of uveitis (inflammation inside the eye).

Do brain tumors cause headaches?

They can.

Fortunately, childhood headaches are rarely caused by brain tumors. Although the ophthalmologist checks for eye signs of brain tumor (paralysis of an eye muscle, nystagmus, loss of vision in one or both eyes and swelling/paleness of the optic nerve) these findings are not always present. An evaluation by the primary care physician is indicated if a brain tumor is the suspected cause of the headache.

What other headaches are associated with eye symptoms?

Migraine headaches are not common in children but may cause eye symptoms including blurred vision, perception of jagged lines, or partial loss of vision. Evaluation by the primary care provider and/or a neurologist is advised.

Sinus disease can cause pain perceived to be around or behind the eye. The primary care provider and/or otolaryngologist diagnose and treat this problem.

Tension headache is rarely associated with eye abnormalities.