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For ophthalmologists

We need your exclusion before we start

This page promises you little – for a factual reason: there are no robust data for a coupling between bite position and visual function. What does exist is a well-described pathway for 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 were unremarkable each time.

The connection

What has been measured

  1. 01Measured / described

    What is described: referred pain from the masticatory muscles

    The myofascial trigger point is defined by four criteria – palpable taut band, localised tenderness, pain recognition and referred pain into an area typical of the muscle. For the temporalis muscle, the peri- and retro-orbital region is part of this pattern. This explains pressure behind the eye without anything being wrong with the eye.

  2. 02Measured / described

    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.

  3. 03Where the evidence ends

    Where the evidence ends

    There is nothing robust in the literature for a coupling between occlusion and visual function – refraction, accommodation, convergence. We do not claim it. What we claim concerns pain only, and there too as an association, not causation.

Indication

When a referral is worthwhile

First, and without exception: red flags and unclear findings belong in specialist work-up, before any functional diagnostics. The CMD perspective complements, it does not replace.

Worthwhile

  • Pain near the eye without ophthalmological findings, together with jaw or neck signs
  • Tenderness over the temporalis muscle that reproduces the familiar complaints
  • When your work-up is complete and unremarkable

Not worthwhile

  • Visual disturbances of any kind – these are your responsibility, not ours
  • Before your work-up; retro-orbital pain belongs with you first
  • With the expectation that a splint replaces optical correction

Your patient remains yours.

After the assessment or after regulation is complete, we always refer back to you. We only provide further treatment at your explicit written request.

In all our questionnaires, every vision and eye topic includes the question about glasses and contact lenses. We do not want someone with uncorrected refractive error to end up with us and have their headache attributed to the jaw.

Next steps

Three routes – your choice

  • 01

    I want to know more

    The full-text sources, our measurement protocols and the clinical explanatory model with its level of evidence disclosed.

    Request documents
  • 02

    I have a question about a case

    Call-back from the CMD specialist, not from reception.

    Ask a question
  • 03

    I would like to refer

    By phone, email or letter – whatever suits you. The findings report comes back to you.

    Referral

Other specialties

To the overview