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Information for Eye Care Professionals

©Devin Starlanyl, MD 1995-1998

Two excellent medical texts are available on MPS, "Myofascial Pain and Dysfunction: The Trigger Point Manual Vol. I and II" by Janet G.Travell M.D. and David G Simons M.D. The first volume is important to you, as it deals with upper body TrPs. This is but an introduction to them. The manuals show the referred patterns, tell what causes them, and how to relieve them. You can find specific information in regards to focal length and TrPs.

Common Vision-Related FMS&MPS Complex Symptoms

Check the internal eye muscles, temporalis, SCM, trapezius, cutaneous facial muscles for TrPs. To check the inner eye muscles, stretch them. Put one hand on your head, above your forehead. Then try to look at your hand. This shouldn't hurt. If it does, it's the TrPs in the muscles telling you they are there. With your eyes still looking upward at your hand, look from one upper corner of your eye to the other. This will probably hurt too, which is a good sign. The TrPs are there, and that's at least part of what is causing your eye problem. The eye-exercises stretch out those TrPs. Once your patient does this simple eye exercise regularly, the mysterious changing vision problem usually disappears.

Splenius cervices TrPs can also cause blurring of near vision. This will also cause pain inside of the head to the eye on the same side, and in the eye orbit.

Floaters are common, and may go along with the overgrowth or dysregulation of connective tissue growth so common in FMS&MPS Complex.

Words jump off the page or disappear when you stare at them: Orbicularis oculi TrPs will refer pain to your nose, cheek, above your eye, and cause "jumpy pages" when you try to read. Try putting clear plastic over the page to decrease print contrast.

Asymmetry is a common perpetrator of TrPs. Check to see if your patients have ears that are misaligned. Ensure the glasses fit well.

Motor coordination problems: The sternocleidomastoid is much of the problem here. SCM TrPs can cause dizziness, imbalance, neck soreness, swollen gland feeling, runny nose, maxillary sinus congestion, "tension" headaches, eye problems (tearing, ptosis, blurred or double vision, inability to raise the upper lid, and a dimming of perceived light intensity), spatial disorientation, postural dizziness, vertigo, sudden falls while bending, staggering walk, impaired sleep, nerve impingement, and disturbed weight perception. People with SCM TrPs often have trouble glancing downward -- they can fall forward. They can get so disoriented that there is nausea and vomiting. Chronic dry cough, pain deep in the ear canal, pain to the throat and back of the tongue and to a small round area at the tip of the chin can be part of the SCM TrP package. Localized sweating and vasoconstriction can be a problem, as well as pain in a "skull cap" area of the head. What SCM TrPs don't cause is a pain in the neck, although they figuratively become one due to their wide-ranging symptoms.

A feeling of continued movement in car after you've stopped, and feeling of tilted "banking" as your car corners are also part of the SCM TrP gifts to us. The perceptual changes can be very hard to explain to a doctor. Ask your patient.

Bump into doorjambs, walls and other stationary objects, knock things over often, clumsiness: If "klutziness" were an Olympic event, my closet would be filled with gold medals. They'd have to bar people with SCM TrPs from entering -- they'd have an unfair advantage . All of us go tripping through life, cleaning up one mess after another. We learn to keep our sense of humor and a good supply of absorbent paper towels. The combination of SCM TrPs and extrinsic eye muscle TrPs seem to be chiefly responsible for visual perception problems.

"Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual" by Devin Starlanyl and Mary Ellen Copeland M.S., M.A., New Harbinger Publications Oakland CA 1996 800-748-6273 $19.95 400 pages

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