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    AAO 2015
    Intracranial Pressure/Headache , Neuro-Ophthalmology/Orbit

    History questions key to patients with headache:

    • Do you have a history of headaches? If yes, is this headache similar?
    • Are your headaches associated with specific triggers or do they occur at specific times?
    • Does the headache interfere with your usual activities?
    • What is the location and character of the headache?
    • Does eye movement aggravate the pain?
    • Do you have any nausea or vomiting, light or sound sensitivity?
    • Does any activity make the headaches worse?
    • Have you had any cancer, autoimmune disease, immunosuppression, or seizures?
    • Could you be pregnant?
    • Have you had weight loss, fever, scalp pain, jaw or tongue pain, or temporary vision loss?

    Exam keys in patients with headache:

    • Examine lids and orbit for ptosis, proptosis, displacement, and lid retraction.
    • Palpate the trochlea.
    • Examine pupil for anisocoria and relative afferent pupillary defect.
    • Do a motility exam to detect subtle signs of cranial nerve involvement.
    • Slit lamp and dilated fundus exam will identify any inflammatory or infectious involvement of the eye or ocular adnexa, and if present, will identify papilledema.