Headache attributed to disorder of the eyes is one of the headache syndromes recognised in internationally agreed diagnostic criteria (International Headache Society Classification Subcommittee 2004). Inflammation, infection, trauma and acute glaucoma may cause headache which usually has obvious accompanying ocular signs. Only a very small percentage of headaches are thought to be due to refractive error or muscle imbalance. Nonetheless, the eyes are often blamed for headache amongst the lay community, and ‘eye strain’ may prompt a visit to the optometrist. Headache is reported to be a common complaint seen by eyecare practitioners: although definitive figures have not been found, articles promoting awareness of headache have appeared in the optometry press (Adamczyk 1999, Charlesworth & Harvey 2004, Giovanonni 2000). However, the views of optometrists were not represented among the interested parties drawing up guidelines for the management of headache in primary care under the auspices of the British Association for the Study of Headache (BASH: 2000).