Unilateral Head Pain, Ear Symptoms, and Congestion Are Not Complications of Under-Eye PDGF Treatment
The symptoms described—unilateral right-sided head pain with ear symptoms and congestion—are not recognized complications of under-eye Platelet-Derived Growth Factor (PDGF) treatment and instead represent a primary headache disorder requiring neurological evaluation.
Why These Symptoms Are Unrelated to PDGF Treatment
The provided evidence contains no documentation linking PDGF treatments to unilateral headache syndromes with autonomic features. The evidence focuses entirely on:
- Anti-VEGF agents (not PDGF) for diabetic retinopathy, with complications limited to endophthalmitis (0.019-0.09%), retinal detachment, cataract formation, and elevated intraocular pressure 1, 2
- Vertigo treatment with canalith repositioning procedures, where complications include only nausea, vomiting, and canal conversion in 6-7% of cases 1, 3
No guideline or research evidence connects periocular growth factor treatments to headache, ear symptoms, or nasal congestion.
What These Symptoms Actually Represent
Your symptom constellation—unilateral head pain with ipsilateral conjunctival injection, eyelid edema, and autonomic features—matches well-characterized primary headache syndromes:
Short-Lasting Unilateral Neuralgiform Headache Attacks (SUNCT/SUNA)
- Pain characteristics: Orbital, supraorbital, or temporal stabbing pain lasting 1-600 seconds, occurring 2-600 times daily 4, 5
- Autonomic features: Conjunctival injection (100% in SUNCT), tearing (100% in SUNCT), nasal congestion, rhinorrhea, eyelid edema 4, 6
- Triggering: Cutaneous stimuli trigger attacks in 74% of SUNCT patients 4
- Key feature: No refractory period between attacks in 95% of cases 4
Hemicrania Continua
- Pain pattern: Continuous unilateral pain (side-locked in 92%) with exacerbations rated 6.5-10/10 severity 7
- Autonomic features: Lacrimation (73%), nasal congestion (51%), conjunctival injection (46%), ptosis (40%), facial flushing (40%) 7
- Diagnostic hallmark: Absolute response to indomethacin 100-200mg 7
Cervicogenic Headache
- Presentation: Persistent unilateral headache with ipsilateral conjunctival injection, eyelid edema, and ptosis 8
- Diagnostic confirmation: Symptom resolution following greater occipital nerve blockade 8
Critical Clinical Approach
Immediate steps:
Perform indomethacin trial (100-200mg orally or intramuscularly) to rule out hemicrania continua, as this provides both diagnostic and therapeutic benefit 7
Examine for trigger points in the suboccipital region and greater occipital nerve distribution, as tenderness here with symptom reproduction confirms cervicogenic headache 8
Document attack characteristics: Duration (seconds vs. minutes vs. continuous), frequency, and presence/absence of refractory periods between attacks 4, 6
Assess for cutaneous triggers: Chewing, eating citrus fruits, head movement, or light touch precipitating attacks strongly suggests SUNCT 4, 5
Common Pitfall to Avoid
Do not attribute primary headache syndromes to recent cosmetic procedures without documented evidence of causation. The temporal association between a periocular procedure and headache onset does not establish causality, especially when the symptom pattern matches well-defined primary headache disorders with distinct pathophysiology 8, 4, 7.
The absence of any documented complications linking PDGF to these symptoms, combined with the classic presentation of a trigeminal autonomic cephalalgia, makes a primary headache disorder the overwhelmingly likely diagnosis requiring appropriate neurological management rather than concerns about procedural complications.