“I pray each night to be able to fall asleep and never wake up”, ‘Jane’ whispered after describing the burning, sharp, cutting and needle-like piercing pain that had found a home in her eyes during the past 4 years. The constant headaches that travel to her ears, face and occasionally to her jaws were almost an afterthought. Medicines took the “edge off” the pain but the cost they extracted in making her feel sick and clouding her thinking was too high to bear. She admitted that being the single parent of 2 young children was the only reason she was able to keep “the terrible thoughts” from taking root. I examined her in almost total darkness to minimize her eye pain and what I found was not surprising: Her eyes looked perfectly normal — which explained why she had been followed by a private detective hired by her disability insurance company.
How can such devastating eye pain be invisible? It turns out that its perceived location is an illusion. It is not produced in the eyes (or face, or head). The pain is generated in the wiring of her brain that normally carries the pain messages from her eyes. In effect, they are like short-circuits causing pain that is projected to her eyes although they feel as though they are coming from her eyes.
But nature has played another cruel trick on Jane and people like her. The malfunctioning area of her brain also controls tear production and disturbances here can reduce the tears. This means that the less tears and the eye pain are both caused by the same disease rather than dry eyes causing the eye pain. In medical/scientific terms we have been confusing association with causation. The eye pain can be made worse by reduced tears but it has a life of its own which is nurtured in the unseen depths of the brain.