re: Headache + one tiny pupil & one huge one. Docs seem stumped! What gives??

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Yet, if we consult with the internet they get butthurt

If I were you, I would search for the best ophthalmologist in your area and get in ASAP.

I will never understand how we are suppose to have the best health care in the world and yet, if you go to an ER an ophthalmologist could not have seen you. In every other profession you would think one of each speciality should be on duty.

Does the percocet alleve the headache? Take 800 mg of motrin.

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I wouldn't characterize swelling around my ocular nerve as something "simple"

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did you say you got hit by a rock?

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What are cluster headaches?

Cluster headache is pain that occurs along one side of the head. It's frequently described as pain that occurs around, behind, or above the eye and along the temple in cyclic patterns or clusters. The pain of a cluster headache is very severe. Many patients describe a “drilling” type of sensation. For classification as a true cluster headache, associated autonomic features such as tearing/watering of the eye, redness of the conjunctiva, rhinorrhea or nasal stuffiness, eyelid drooping, sweating on one side of the face, or changes in pupil size (with the pupil on the affected side becoming notably smaller) are usually present. The headache lasts from 15 minutes to a maximum duration of about 3 hours. However, the headache can recur up to eight times daily. Cluster headache was originally described in the 17th century, but it wasn't until the mid- 20th century that it became known by this name.

Who gets cluster headaches?

Males are two to four times more likely to develop cluster headache than females; however, the overall frequency is quite low, with a prevalence rate of about 1 per 1,000. Because of the rarity of the condition, limited information is available.

Although the vast majority of patients are adults, cluster headache has been reported in children as young as 6 years of age.

What are the symptoms and signs of cluster headaches?

Cluster headache is always unilateral, or one-sided. However, some patients may experience some variability of the side on which their headache occurs. Most patients describe their pain as occurring around or behind the eye. Pain is also described as radiating along the forehead, into the jaw or along the gum line and into the teeth, or across the cheek of the affected side. Infrequently, pain may extend into the ear, neck, or shoulder. Although watering (tearing) of the eye is frequently identified, some patients may only experience some redness of the conjunctiva. Eyelid drooping or swelling and a runny nose (rhinorrhea) are often associated with the pain of a cluster headache. Symptoms more commonly identified with migraine headaches, including sensitivity to light, sounds, or odors may occur. However, unlike migraine headache, movement does not worsen the pain of a cluster headache. In fact, many patients describe a sense of restlessness during their pain.

The headaches associated with cluster occur in groups. While the headaches themselves may be brief (as short as 15 minutes), the headaches can recur up to eight times in 24 hours. Headaches may last as long as 3 hours. Cluster cycles may last for only a single day, or may linger for many weeks.

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Anisocoria. I have it too and went as far down the line of specialists as a neuro-ophthalmologist. My eyes reacted appropriately and equally to light and every test they ran came back normal, so she diagnosed me with physiological anisocoria- meaning that it's benign and not indicative of stroke, brain tumor, or aneurism like I'm sure you've read it can be linked with. Get an appointment with an ophthalmologist and go from there, but I wouldn't worry too much about it if the scan came back ok

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That sounds like a classic cluster headache. The CT was warranted based on the sudden onset and severity to rule out something like a bleed or a mass. The treatment is typically 100% oxygen by face mask, which is really effective for that type of headache. You probably don't have access to an oxygen mask, so the next best thing is imitrex (or another triptan), which you need a prescription for.

I would still recommend you get the MRI done to rule out anything more sinister, especially if it doesn't resolve over the next day or so.

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