Pain Behind the Eyes (Retro Orbital Pain)

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Patients suffering from the commonly known TMJ syndrome (technically termed cranio-mandibular dysfunction or CMD) often complain of pain behind the eyes.  How is it possible that pain behind the eyes can be connected to TMJ?  A further question to consider is it possible that retro orbital pain (pain or pressure behind the eyes) can  originating from strained muscles that attach hyperactive muscles between the sphenoid bones that make up the cranial bones and mandible?

Retro Orbital Pain and TMJ Pain

The Eye Connection
The retro-orbital bony complex contains the greater and lesser wings of the sphenoid.  Since the lateral and medial pterygoid muscles insert into the medial and pterygoid plates, chronic contracture of these muscles can result in the torquing action of the sphenoid.  Strained internal muscles of mastication due to abnormal jaw positioning (posterior relationship) and unsupportive occlusion of the bite can trigger pressure feelings behind the eyes.  Some have reported a dagger like pain and ice pick feelings behind the eyes.

Muscles Associated with the Sphenoid Bone and Mandible

1.Sphenomandibularis muscle
2.Superior head of lateral pterygoid
3.Inferior head of lateral pterygoid
4.Medial pterygoid

Treatment Remedy to Consider
It has been noted that when a physiologic mandible to maxillary relationship exists with calm relaxed muscles supported with a properly designed anterior repositioning appliance (e.g., lower removable orthosis) that allows the mandible to relax and function physiologically (unstrained) the pressure behind the eyes often go away.

An unreported muscle observed in 25 cadavers and MRI scans of clinical patients that may have clinical implications regarding retro-orbital pain.  Origin – maxillary surface of sphenoid bone.  Insertion – Internal crest (Internal oblique line of the mandible.  (Dunn, Hack, Robinson & Koritzer, CRANIO  – Journal of Craniomandibular Practice. April 1996, Vol. 14 No. 2, pp 97-103).

Disorders of the temporomandibular joint can mimic other dental and medical problems.  A proper diagnosis regarding head and neck pain is very important because serious medical problems such as vascular disorders, brain tumors, aneurisms, cervical disc disorders, throat and oral cancer, etc. can produce similar symptoms of TMJ disorders.  Check with your medical  doctor to rule out other medical problems.

For more information contact: Dr. Clayton A. Chan at or (702) 271-2950.  Las Vegas, NV .

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The Originator of the Chan Optimized Bite™. He is considered by many to be the authority on Neuromuscular Occlusion and its application to Clinical Dentistry. Dr. Chan is a general dentist, clinician, teacher, educator and leader .

Director, Occlusion Connections™ Center for Gneuromuscular Dentistry & Orthopedic Occlusal Advancement
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