Ocular and Dental Causes of Headaches Among School-Age Children in Jordan: A Retrospective Study

Abstract

IntroductionHeadache disorders are becoming increasingly prevalent among the younger population. In this study, we aimed to explore the varying causes of headaches among school-age children in Jordan. MethodologyThis was a retrospective observational study conducted at the Queen Rania Hospital for Children between June 2019 and June 2020. All the data of the patients were extracted from the patient files with the permission of the administration. All children who were referred to the ophthalmology and dental clinic with headaches as the presenting complaint were included in the study. A detailed history was initially obtained regarding age, gender, medical history, as well as the duration and characteristics of headaches. The patients underwent detailed ocular examination including best-corrected visual acuity (BCVA) using the Snellen chart, anterior and posterior eye segment examination, and intraocular pressure measurement. Refraction under the effect of cyclopentolate was performed for all patients. A detailed dental and oral exam was performed on all children at the dental clinic by the same dentist. ResultsA total of 712 patients aged between five and 13 years (mean ± SD: 9.3 ± 2.86 years) presented with headaches during the study period. Headaches were more frequent in males [n=441 (61.9%)], but a slight female predominance was found among patients aged 11 years and older. At the ophthalmology clinic, 230 (32.3%) patients with headaches had positive findings; the majority of these patients [n=228 (32%)] had refractive errors with astigmatism as the most common type. Of note, 515 patients (72.3%) had dental caries with a Decayed, Missing, and Filled Permanent Teeth (DMFT) score ranging from 1.5 to 4.3. ConclusionRefractive errors, particularly astigmatism, were found at higher rates among children with headaches. Also, temporomandibular disorders were more prevalent among children with headaches, particularly those aged between 11 and 14 years. Routine ophthalmic and dental assessment is recommended for children presenting with chronic headaches.