pressure on eyeball

[abhi_1122]

hello doctor. Actually I easily self obsess over things and get anxious . I am sorry about that but my mind is a very curious type. I want to know the exact mechanism behind why pressing on the eye with a finger causes the eye to hurt for few days afterwards along with photophobia. I have seen other posts here as well as to how one hairdresser applied pressure on the customer eye accidentally while sorting the eyebrow out and it caused him pain for many days. Similarly in my case i once pressed the eye inwards with my finger and another time also tried using a headphone jack which is not sharp but rather pointed to press on my eye out of curiosity to check how far i can go and releasing it when felt the pain. But the main point is that the pain continues for many days afterwards...There is constant ache along with light sensitivity after pressing incidents which even overlap with symptoms of iritis/uveitis. But on slit lamp, no inflammation was found after pressing( which is a good news although) , but fails to explain the cause of pain. I cannot believe that pressing hard causes corneal erosion or abrasion usually, as abrasion is a scratch and until the fingernail hurts the eye, scratch is not a possibility . The surface of a finger is flat and soft. And inflammation probably results from blunt hit ...thats why probably uveitis shows up from ball hit, punch and not after a press. Now ,could you be able to please clarify as to what changes happen in eyeball from pressing which causes the pain like symptoms. I also want to add that when we lift heavy weights in the gym, our muscles become very sore on the first day and hurt. Is it any similar to eye, that pressing causes strain in the eye muscles resulting in pain. Do eye muscles have the ability to signal pain like other muscles of body . And those would be intraocular or extraocular involvement in cases of pressing? . When we press, the eye only squeezes while remaining fixed in socket. Or rather the entire eyeball moves backwards along with the muscles as if pushed inward in totality . Again, I am sorry I wont try pressing on eyes ever again but done it 3 times in life and now want you to relieve my anxiety with an accurate explanation. thanks so much

[John C Hagan III, MD, FACS, FAAO]

People differ in their sensitivity of pain and pressure.  What one person does not notice could be  moderately or severely painful for others.  Think about how many people have lots of pain at the dentist, and require their teeth to be numbed with anesthetic while other can have a root canal done without anything. Also think about a person playing American football or Rugby.  Some people one tackle or scrum would break their bones or kill them.  You need to mellow out.

[abhi_1122]

thats a great response. Thanks once again . However , one short follow up question please. Is it also possible that poking or pressing the eye with an object may have resulted in inflammation but that inflammation is just too less to be noticed on any slit lamp or cause an extreme red eye. hence treatment may be anti inflammatory drops on empirical basis rather than any diagnostic findings. Just like docs prescribe advil/ibuprofin for pains in body after exertion but x-rays show normal findings. Also if a patient after injury shows you his eye pictures or on a video call, can you assess if the person is having uveitis/iritis just by grossly looking at the eye over the phone without tools like slit lamp, I mean atleast the anterior chamber if something serious is there or not. Forget the retina, as it needs dilation

[John C Hagan III, MD, FACS, FAAO]

At this point we are dealing more with your anxiety than a real medical problem. I'm going to stop this correspondence.