help required.

[nitrox]

whilst descending recently ive suffered a terrible pain in my right eye socket and no pain anywhere else ears or left eye, the problem is with descent only and is intollerable!
and its only happened since a freediving dip to 15metre's about six months ago, the eye is in perfect working condition with no ailments and the pain is in the tissue surrounding the eyeball itself and seems to be coming from behind the eye. any suggestions anyone?? it dont affect my balance or vision once i achieve my TOD but getting there is a f!*king mare to say the least.

regards in advance

nitrox

[andy2tanx]

r u doing something thats known to make you go blind trox old pal?!!!

[Ian Daly]

Hi
I am not a diving medicine doctor, but something that can cause pain similar to that which you are describing (even at the surface) is sinusitis.  You could try simple measures such as menthol/steam inhalation to try and relieve things or a short course of decongestants (avoiding pseudoephedrine of course if you are intending to dive on nitrox during this period). Pain from sinuses can be referred to the orbit and surrounding tissues.
Of course it may well be something else, but it might be worth giving it a try.
Its not clear from your original post whether you are suffering visual problems during descent, while you are having pain.  If you are , then it doesn't sound like a sinus problem.
HTH
Fee

[JohnK]

"(avoiding pseudoephedrine of course if you are intending to dive on nitrox during this period)."

Ian - why is this

[daz]

Decongenstants containing pseudoephedrine have been linked to increased  O2 toxicity..

Daz

[parahandy]

Agree with Ian,on the likelyhood on the Sinus thing having previoisly experienced identical symptoms to those described by Nitrox.
Tony

[John Gulliver]

Ian, Daz, please explain.

[Ian Daly]

Hi there John,

I assume that you are querying the statement refering to the use of nitrox and the use of pseudoephedrine.  Incidently, that post was done by Fee, don't worry she is not too upset :maniac:  as there is only a bit of difference; 10 inches in height, 7 stone in weight and a hairy chest (wont tell you which one has the hairy chest).  I first came across this notion during my PADI basic nitrox course and as I have the view that you should dive as safely as possible I just accepted it and if I have to use a decongestants I use one that doesn't contain pseudoephedrine.  Since then I have had a bit of a literature search and found a study study that does suggest a link between ephedrine and increased utilisation of oxygen and thus a tenuous link to ox-tox, how closely this pertains to diving I wouldn't like to guess but there is a hint that maybe we shouldn't dive nitrox using it.

The study involved bolus doses of ephedrine which are often used by anaesthesetists for intraoperative hypotension. The study was randomized single-blind cross-over study (for all you science monkeys out there) was designed to simultaneously evaluate circulatory, respiratory and metabolic effects of intravenously given ephedrine in 12 healthy male volunteers. Oxygen uptake and carbon dioxide excretion were measured with indirect calorimetry and non-invasive transthoracic electrical bioimpedance was used for cardiac output measurements. The maximum effect on most variables was reached at 4-5 min. At 5 min after the administration of ephedrine 0.1 mg per kilogram body weight, there were significant increases in cardiac index, systolic and mean arterial blood pressure, expired minute volume, oxygen uptake and carbon dioxide excretion rates. There were no significant changes in the quotient between oxygen uptake rate and cardiac index, VO2/CI during the 30 min study period. The O2 saturation was not altered. The present study indicates that ephedrine increases oxygen demand and supply in a similar magnitude.

HTH :umnik: here endeth the lesson :yelclap:

Ian Daly :doctor:

(Edited by Ian Daly at 9:27 am on Feb. 9, 2003)


(Edited by Ian Daly at 11:04 am on Feb. 13, 2003)

[John Gulliver]

Thanks Ian! Interesting per se but we're talking about two different substances (ephedrine versus pseudoephedrine), with different pharmacological and pharmacokinetic properties, and two different routes of administration (intravenous versus oral ). I'm just a humble pharmacist but I'd want more evidence than that to conclude that oral  pseudoephidrine was contraindicated in connection with diving on nitrox. Still, better safe than sorry, I suppose.

(Edited by John Gulliver at 1:49 pm on Feb. 9, 2003)

[Dr Stevil]

That's the second time pseudoephedrine and Sudafed have cropped up recently:as it's a decongestant,if you feel the need for it perhaps it's not a good day to dive? Or try Olbas oil instead.

Ian, you sound like a medical practioner; I'm not (I'm a research scientist) but from previous experience I have a suggestion Re Nitrox's orbit pain, jump in if you've any comments on the medical accuracy; according to one of my old colleagues from Dental Sciences (a consultant in oral-maxillary surgery), it may be related to a problem in another area of the head:  The trigeminal nerve links the areas of ears, eyes, upper and lower jaws, so it's not impossible that e.g. an ear problem can manifest as pain in your eye.

'Trox, perhaps give your diving a rest (heresy!) for a week or two in case you've got some low level infection, if the problem is still there after a break I'd suggest you see a neurologist just to be on the safe side.

Chee-az
Steve