Retro orbital pain, or pain behind the eye, is a frequently reported symptom by patients who have TMJ/TMD. This type of pain is often not perceived to be related to TMD by the patient or the doctor. Patients may have often been convinced that the pain is due to eyestrain or even an undiagnosable or untreatable condition, which only increases their anxiety or depression. It is well known that retro orbital pain can be referred from a trigger point. A trigger point is a hyperirritable spot in a muscle that is painful to palpation. It is called a trigger point because it “triggers” a painful response. A trigger point is more than a tender nodule. It affects not only the muscle within which the trigger point is located, but also causes “referred pain” to distant and seemingly unrelated sites. Trigger points are located in a taut band of muscles fibers. The trigger point is the tenderest point in the band. In the case of eye pain, trigger points are known to be located in at least eight muscles of the head and neck (sternocleidomastiod m., temporalis m., splenius cervicus m., masseter m., suboccipital group, occipitalis m., orbicularis oculi m., and trapezius m.).
The majority of TMD complaints are of muscle dysfunction origin and every patient should be carefully examined of myofascial trigger points, which can be associated with their symptoms. Of course, these muscles are all paired and therefore the muscle on the affected side will refer the pain. The majority of TMD complaints are of muscle dysfunction origin and every patient should be carefully examined for myofascial trigger points, which could be associated with some of their symptoms. Following a comprehensive diagnostic evaluation, if trigger points are identified, these areas should be treated and eliminated prior to any significant surgical or medication intervention.