When the right glasses bring no relief
We say it right at the start: there are no robust data for a link between bite position and visual function. What there is concerns the pain – and you see that regularly.
You know these clients
Persistent headaches, eye pressure, “strenuous” vision or neck and shoulder tension despite a correctly determined and well-fitted correction. Frequent changes of glasses without relief.
What has been measured
Referred pain from the masticatory muscles
The myofascial trigger point is defined by four criteria; for the temporalis muscle, the peri- and retro-orbital region is part of the typical referral pattern. That explains pressure behind the eye with a flawless correction.
Head posture and jaw are connected – in both directions
The association between malocclusion class and head posture has been measured at 1.3 to 2.9 degrees; the anatomical pathway via the supra- and infrahyoid muscles, platysma and neck extensors is undisputed. A conspicuous head or gaze posture is therefore a finding that concerns both sides.
Where the evidence ends
For refraction, accommodation and convergence there is no proven connection with bite position. Anyone who tells you otherwise has no source for it. Our statement concerns pain and muscle tension exclusively – and even there as an association.
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
- persistent asthenopic complaints or tension headaches despite correct correction
- additional jaw, neck or posture signs
- once the ophthalmological work-up is complete and unremarkable
Not useful
- before the refraction and ophthalmological work-up are complete
- with the expectation that a splint replaces or changes the correction
Your client 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.
The same applies the other way round: in all our questionnaires, every vision and eye topic includes the question about glasses and contact lenses – so that we do not attribute to the jaw a headache that comes from uncorrected refractive error.
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.