Sensitivity to light: Some FMS people can't go anywhere unless they wear dark glasses. Some of us have Seasonal Affective Disorder (SAD), and need light to prevent depression. Part of this problem in FMS may be due to the hypothalamic-light connection. People with FMS often have too little of the neurotransmitter melatonin, which helps to regulate sleep. This may be also connected to light. People with SAD have too much melatonin, and they don't always have a night/day fluctuation of melatonin production.
Dry eyes, nose and mouth: This is called sicca syndrome, which simply means that you have dry eyes, nose and mouth. All the mucous membranes can dry, including the lining of the vagina, and the GI tract. It is very hard for us to wear contact lenses. The dryness, the irritation and sensitivity, and the allergies prove too much for most of us. After a regimen of eye exercises and medication (especially guaifenesin), some people with FMS&MPS Complex have been able to wear contact lenses for the first time.
Red eyes, tearing eyes: These symptoms can be caused by the sternocleidomastoid (SCM)TrPs, along with hearing impairment, and a disturbed sense of weight perception.
Eye pain: Cutaneous facial TrPs can cause pain in ear, eyes, nose and teeth. These TrPs are shallow, and can occur in many places on the face. Try some pressure-point work on the face. If the TrPs are there, they will let you know. At times, deposits form in the corners of the eyes. This is fairly common in FMS&MPS Complex.
Double vision, blurry vision, changing vision: In order for vision to be clear, both eyes must take the same picture at the same time. When this doesn't happen, vision problems result. I believe that misalignment of eyes can be caused by TrPs contracting the muscles that hold the eyeballs in place. If these muscles are being contracted to different tensions, that could cause all of the vision irregularities mentioned. Muscle fatigue and lack of sleep would make things worse. Check the internal eye muscles, temporalis, SCM, trapezius, cutaneous facial muscles for TrPs. To check the inner eye muscles, stretch them. Put one hand on your head, above your forehead. Then try to look at your hand. This shouldn't hurt. If it does, it's the TrPs in the muscles telling you they are there. With your eyes still looking upward at your hand, look from one upper corner of your eye to the other. This will probably hurt too, which is a good sign. The TrPs are there, and that's at least part of what is causing your eye problem. The eye-exercises stretch out those TrPs. Once your patient does this simple eye exercise regularly, the mysterious changing vision problem usually disappears. Splenius cervices TrPs can also cause blurring of near vision. This will also cause pain inside of the head to the eye on the same side, and in the eye orbit. Floaters are common, and may go along with the overgrowth or dysregulation of connective tissue growth so common in FMS&MPS Complex. Words jump off the page or disappear when you stare at them: Orbicularis oculi TrPs will refer pain to your nose, cheek, above your eye, and cause "jumpy pages" when you try to read. Try putting clear plastic over the page to decrease print contrast. Asymmetry is a common perpetrator of TrPs. Check to see if your patients have ears that are misaligned. Ensure the glasses fit well.
Motor coordination problems: The sternocleidomastoid is much of the problem here. SCM TrPs can cause dizziness, imbalance, neck soreness, swollen gland feeling, runny nose, maxillary sinus congestion, "tension" headaches, eye problems (tearing, ptosis, blurred or double vision, inability to raise the upper lid, and a dimming of perceived light intensity), spatial disorientation, postural dizziness, vertigo, sudden falls while bending, staggering walk, impaired sleep, nerve impingement, and disturbed weight perception. People with SCM TrPs often have trouble glancing downward -- they can fall forward. They can get so disoriented that there is nausea and vomiting. Chronic dry cough, pain deep in the ear canal, pain to the throat and back of the tongue and to a small round area at the tip of the chin can be part of the SCM TrP package. Localized sweating and vasoconstriction can be a problem, as well as pain in a "skull cap" area of the head. What SCM TrPs don't cause is a pain in the neck, although they figuratively become one due to their wide-ranging symptoms. A feeling of continued movement in car after you've stopped, and feeling of tilted "banking" as your car corners are also part of the SCM TrP gifts to us. The perceptual changes can be very hard to explain to a doctor. Ask your patient.
Bump into doorjambs, walls and other stationary objects, knock things over often, clumsiness: If "klutziness" were an Olympic event, my closet would be filled with gold medals. They'd have to bar people with SCM TrPs from entering -- they'd have an unfair advantage . All of us go tripping through life, cleaning up one mess after another. We learn to keep our sense of humor and a good supply of absorbent paper towels. The combination of SCM TrPs and extrinsic eye muscle TrPs seem to be chiefly responsible for visual perception problems.
"Fibromyalgia and Chronic Myofascial Pain Syndrome: A Survival Manual" by Devin Starlanyl and Mary Ellen Copeland M.S., M.A., New Harbinger Publications Oakland CA 1996 800-748-6273 $19.95 400 pages
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