[Headaches in ophthamology].

Purpose: To determine the frequency of ocular abnormalities in patients with headache seen for an ocular examination.

Methods: All 944 consecutive new patients with headache examined during a 3-year period (1984-1986) at the Department of Ophthalmology, University of Kinshasa, Democratic Republic of the Congo, were enrolled in this retrospective study. All patients received an ocular examination which included measurement of visual acuity, refraction, slit lamp examination, and fundoscopy. Other examinations such as measurement of intraocular pressure, neuro-ophthalmological examination, visual field and fluoangiography were performed when needed.

Results: The frequency of patients with headache examined during this period was 15.6% (944 out of 6,066 patients) or one patient out of 16 new patients. Their average age was 30+/-13.5 years. Females (60%) complained more frequently of headache than males (40%) (p<0.05). Migraine was found in 3.9% of patients. Ocular abnormalities were found in 505 (64%) patients and included refractive disorders (44%), lesions of the posterior segment (17%), abnormalities of the conjunctiva (12%), abnormalities of the anterior segment (12%), presbyopia (11%), and ocular motor palsies, heterophoria, convergence insufficiency and other ocular abnormalities (4%). Of 224 patients with ametropia, 154 (69%) were myopic with or without astigmatism. When specified, headache was most often fronto-occipital. Headache was most frequently associated with decreased vision, eye pain, epiphora, foreign body sensation, itching, and photophobia.

Conclusion: Ocular examination could be necessary in cases of patients who complain of headache.