We need your exclusion before we start
This page promises you little – for a factual reason: there are no robust data for a link between bite position and visual function. What there is, is a well-described pathway for the pain. The difference matters, and we make it here.
You know these patients
Retro-orbital pressure or pain, asthenopic complaints, “strenuous” vision without an ophthalmological correlate. People who have been to you several times and whose findings remained unremarkable each time.
What has been measured
What is described: referred pain from the masticatory muscles
The myofascial trigger point is defined by four criteria – a palpable taut band, circumscribed tenderness, pain recognition and referred pain into an area typical of the muscle. For the temporalis muscle, the peri- and retro-orbital region belongs to this pattern. That explains pressure behind the eye without anything being wrong with the eye.
What is also established: trigeminocervical convergence
The trigeminal nucleus caudalis converges functionally with the dorsal horns of C1–C3. This is the anatomical basis of referred pain between neck, face and head – and thus also the reason why pain near the eye can change with neck strain.
Where the evidence ends
There is nothing robust in the literature for a link between occlusion and visual function – refraction, accommodation, convergence. We do not claim it. What we claim concerns the pain exclusively, and even there as an association, not as causality.
When a referral is useful
First and without exception: red flags and unclear findings belong in a specialist work-up, before any functional diagnostics. The CMD perspective is complementary, not a substitute.
Useful
- pain near the eye without ophthalmological findings, together with jaw or neck signs
- tenderness over the temporalis muscle that recognisably reproduces the complaints
- once your work-up is complete and unremarkable
Not useful
- visual disturbances of any kind – that is your field, not ours
- before your work-up; retro-orbital pain belongs with you first
- with the expectation that a splint replaces the correction
Your patient remains yours. After the assessment, or after the regulation is complete, we always refer back to you. We take on any treatment beyond this exclusively at your express, written request.
In all our questionnaires, every vision and eye topic includes the question about glasses and contact lenses. We do not want anyone with uncorrected refractive error to end up with us and have their headache attributed to the jaw.
Three routes – you choose
I want to know more
The sources in full text, our measurement protocols and the clinical explanatory model with the level of evidence disclosed.
I have a question about a case
A call back from the CMD specialist, not from reception.
I would like to refer
By phone, e-mail or letter – whichever suits you. The findings report comes back to you.