Neurophthalmologic signs in headache syndromes.

Visual and oculomotor changes may be the only abnormalities in patients complaining of headache. Ocular signs are common during episodes of migraine and cluster headache. Temporal arteritis may be an extracranial cause of ocular signs. Intracranial disorders include painful ophthalmoplegia, pseudotumor cerebri and various causes of increased intracranial pressure. Neurophthalmologic evaluation in headache patients must include assessment of visual acuity and visual fields, examination of pupils (including pharmacologic testing), ophthalmoscopic examination and auscultation for bruits.