A11.3.5 Headache attributed to heterophoria or heterotropia


Headache caused by latent or persistent strabismus (squint), usually occurring after prolonged visual tasks.

Diagnostic criteria:
  1. Headache fulfilling criterion C
  2. Heterophoria or heterotropia has been identified, with at least one of the following symptoms:
    1. blurred vision
    2. diplopia
    3. difficulty switching from near to far focus and/or vice versa
  3. Evidence of causation demonstrated by at least two of the following:
    1. headache has developed in temporal relation to the onset of heterophoria and/or heterotropia, or led to its discovery
    2. headache has significantly improved after correction of the heterophoria and/or heterotropia
    3. headache is aggravated by sustained visual tasks
    4. headache is alleviated by closing one eye and/or discontinuation of the visual task
  4. Not better accounted for by another ICHD-3 diagnosis.

There are a number of supportive cases for A11.3.5 Headache attributed to heterophoria or heterotropia but otherwise little evidence for this cause of headache. It has therefore been moved to the Appendix pending more formal study.

Patients with 11.3.5 Headache attributed to heterophoria or heterotropia , if it exists, are likely to seek advice from an ophthalmologist.