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Old 05-31-2009, 10:21 AM
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Fever and eye pain -- urban legend?

So, for a while I have been hearing that you can check whether or not you have a fever if you move your eyes to the extreme outward positions, as if straining to see something just outside your field of vision without turning your head. The story is, if this hurts, you have a fever (or at least high temperature).

The problem is that this seems just like the kind of folk wisdom and 'things granny knew' that may or may not have some kernel of truth to them, but I haven't been able to either find a conclusive refutation or something that corroborates this factoid. So, is there something to it, or not?
Old 05-31-2009, 11:01 AM
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Quote:
Originally Posted by Half Man Half Wit View Post
So, for a while I have been hearing that you can check whether or not you have a fever if you move your eyes to the extreme outward positions, as if straining to see something just outside your field of vision without turning your head. The story is, if this hurts, you have a fever (or at least high temperature).

The problem is that this seems just like the kind of folk wisdom and 'things granny knew' that may or may not have some kernel of truth to them, but I haven't been able to either find a conclusive refutation or something that corroborates this factoid. So, is there something to it, or not?
Pain and/or difficulty with lateral gaze can be a sign caused by underlying infectious processes as well as a number of other mechanical dysfunctions involving the orbit, the rectus muscles of the eye or their innervations. Infection can be associated with fever.

I am not otherwise aware of any connection and I have never heard this association, even as a lay notion. Over the years I've seen thousands of patients presenting with fevers and I do not recall ever hearing (as a primary unsolicited complaint) an association with discomfort on lateral gaze. While an elevated temperature can cause general myalgia (including achiness in the eye muscles), and while many infectious syndromes are associated with things such as conjuctivitis or mild encephalopathic or meningeal symptoms, the obverse--that lateral gaze discomfort is a indication of fever per se--is not born out by my experience.
Old 05-31-2009, 06:22 PM
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Thanks for a very informed and informative answer. As for the notion in general, maybe it's a local thing (I'm in Germany), and it's probably not very common even over here -- I've only heard it a couple of times, and brought it up myself in conversation a few days ago, with somebody else claiming to have heard the same thing.
Old 05-31-2009, 08:16 PM
Just Lovely and Delicious
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For what it's worth, my mom always says if I don't feel well and I roll my eyes upwards and it hurts, I have the flu (or maybe a fever...pretty sure she said flu.) We're from the Cleveland area but she may have gotten it from her mom who is from Slovakia.
Old 06-01-2009, 03:38 AM
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My brother the optometrist tells me that painful eye movement often results from inflammation of the nerve sheaths. This can have many causes, most of which are not associated with fever (not high fever, anyway). John J. Bonica's Management of Pain mentions this, as well as muscular inflammation from anterior sinusitis.
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