What are the primary causes of eye pain and soreness. How can you identify different types of eye discomfort. When should you seek medical attention for eye issues. What are effective treatments for various eye conditions.

Understanding Eye Pain: Types and Characteristics

Eye pain and soreness can manifest in various forms, ranging from a mild irritation to severe discomfort. Understanding the nature of your eye pain is crucial for proper diagnosis and treatment. Generally, eye pain can be categorized into two main types:

• Ocular pain: Pain on the surface of the eye
• Orbital pain: Pain within the eye

Ocular pain often feels like a burning, scratching, or foreign body sensation. Orbital pain, on the other hand, may be described as a deep, aching pain behind or within the eye. Recognizing these distinctions can help healthcare providers determine the underlying cause of your discomfort.

Foreign Body in the Eye: Symptoms and Immediate Actions

One of the most common causes of sudden eye pain is a foreign body. This can range from a tiny speck of dust to a larger object like a wood splinter or metal shaving. Symptoms of a foreign body in the eye include:

• A persistent feeling of something in the eye
• Excessive tearing
• Redness and irritation
• Sensitivity to light
• Difficulty keeping the affected eye open

If you suspect a foreign body in your eye, resist the urge to rub it. Instead, try gently flushing your eye with clean water or saline solution. If the object doesn’t dislodge easily or if pain persists, seek immediate medical attention to prevent potential corneal damage.

Bacterial Conjunctivitis: Recognizing the Pink Eye Menace

Bacterial conjunctivitis, commonly known as pink eye, is an inflammation of the conjunctiva – the thin, clear tissue covering the white part of the eye and the inner surface of the eyelid. This condition is highly contagious and can spread rapidly, especially in schools and workplaces.

Key Symptoms of Bacterial Conjunctivitis:

• Redness in one or both eyes
• A gritty, burning sensation
• Thick, yellowish-green discharge
• Swollen eyelids
• Increased tear production

Bacterial conjunctivitis is typically treated with antibiotic eye drops or ointments. It’s crucial to complete the full course of antibiotics as prescribed, even if symptoms improve, to prevent recurrence and antibiotic resistance.

Vernal Conjunctivitis: Understanding This Rare Allergic Condition

Vernal conjunctivitis is a less common but potentially serious form of eye inflammation. It’s an allergic condition that tends to affect children and young adults, particularly those with a history of allergies, asthma, or eczema.

Distinctive Features of Vernal Conjunctivitis:

• Intense itching in both eyes
• Stringy, mucus-like discharge
• Photophobia (sensitivity to light)
• Formation of cobblestone-like bumps on the inner eyelid
• Seasonal recurrence, often worsening in spring and summer

Management of vernal conjunctivitis typically involves a combination of antihistamine eye drops, mast cell stabilizers, and in severe cases, topical corticosteroids. Long-term management and regular follow-ups with an ophthalmologist are essential for preventing complications.

Corneal Abrasion: When Your Eye’s Protective Layer Gets Scratched

A corneal abrasion is a scratch or injury to the cornea, the clear, protective outer layer of the eye. This condition can result from various causes, including contact lens wear, foreign objects, or even vigorous eye rubbing.

Identifying a Corneal Abrasion:

• Sudden, sharp pain in one eye
• A feeling of something stuck in the eye
• Increased sensitivity to light
• Blurred vision or difficulty keeping the eye open
• Excessive tearing and redness

While minor corneal abrasions often heal on their own within a few days, it’s important to have any suspected abrasion evaluated by an eye care professional. They may prescribe antibiotic eye drops to prevent infection and recommend pain relief measures.

Blepharitis: Inflammation of the Eyelids and Its Impact

Blepharitis is a common condition characterized by inflammation of the eyelids, particularly at the base of the eyelashes. It can be caused by bacterial overgrowth, skin conditions like seborrheic dermatitis, or dysfunction of the oil glands in the eyelids.

Common Symptoms of Blepharitis:

• Red, swollen eyelids
• Itchy or burning sensation in the eyes
• Flaky skin around the eyes
• Crusting of the eyelashes, especially upon waking
• Frequent styes or chalazia (blocked oil glands)

Managing blepharitis often involves a consistent eyelid hygiene routine, including warm compresses and gentle cleansing of the eyelids. In some cases, antibiotic ointments or oral antibiotics may be necessary. Addressing underlying skin conditions can also help prevent recurrence.

Chronic Dry Eye Syndrome: More Than Just Occasional Discomfort

Chronic dry eye syndrome occurs when your eyes don’t produce enough tears or when the tears evaporate too quickly. This condition can lead to significant discomfort and potential damage to the eye’s surface if left untreated.

Recognizing Chronic Dry Eye:

• Persistent burning or scratchy sensation
• Stringy mucus in or around the eyes
• Increased sensitivity to light
• Difficulty wearing contact lenses
• Paradoxical watery eyes as a reflex to irritation

Treatment for chronic dry eye may include artificial tears, lifestyle changes, and in some cases, prescription medications to increase tear production. Addressing underlying health conditions and environmental factors can also help manage symptoms effectively.

Contact Lens-Related Eye Infections: Prevention and Early Detection

While contact lenses are a convenient vision correction option for millions, they can increase the risk of eye infections if not handled properly. Understanding the risks and practicing good hygiene is crucial for contact lens wearers.

Signs of a Contact Lens-Related Infection:

• Redness and irritation that persists after lens removal
• Increased pain or discomfort while wearing lenses
• Cloudy or blurred vision
• Unusual discharge or tearing
• Increased sensitivity to light

To prevent contact lens-related infections, always wash your hands before handling lenses, follow the recommended replacement schedule, and never sleep in your lenses unless specifically approved by your eye care professional. If you suspect an infection, remove your lenses immediately and seek medical attention.

Rare and Unusual Causes of Eye Pain: When to Be Concerned

While most cases of eye pain have common causes, there are rare instances where eye discomfort may signal a more serious underlying condition. These situations often require immediate medical attention.

Potential Rare Causes of Eye Pain:

• Optic neuritis (inflammation of the optic nerve)
• Acute angle-closure glaucoma
• Orbital cellulitis (infection of the tissues around the eye)
• Uveitis (inflammation of the middle layer of the eye)
• Ocular herpes (viral infection affecting the eye)

If you experience severe eye pain, especially if accompanied by vision changes, fever, or other systemic symptoms, seek immediate medical care. These conditions can potentially lead to vision loss if not treated promptly.

Eye Pain in Immunocompromised Individuals: Special Considerations

Individuals with weakened immune systems, whether due to illness or medical treatments, may be at higher risk for certain eye conditions and infections. Understanding these risks is crucial for early detection and treatment.

Factors That Can Compromise Immune Function:

• Chemotherapy for cancer treatment
• HIV/AIDS
• Organ transplant recipients on immunosuppressive drugs
• Chronic corticosteroid use
• Certain autoimmune disorders

Immunocompromised individuals should be particularly vigilant about eye health, as common infections can progress more rapidly and potentially lead to severe complications. Regular eye check-ups and prompt attention to any eye discomfort are essential for these patients.

When to Seek Immediate Medical Attention for Eye Pain

While many causes of eye pain can be managed at home or with routine medical care, certain symptoms warrant immediate medical attention. Recognizing these red flags can help prevent serious complications and protect your vision.

Signs That Require Urgent Eye Care:

• Sudden vision loss or significant changes in vision
• Severe eye pain, especially if accompanied by nausea or vomiting
• Eye injury involving chemicals or foreign objects
• Sudden onset of flashes of light or floaters
• Persistent eye pain that doesn’t respond to over-the-counter treatments

If you experience any of these symptoms, don’t hesitate to seek emergency eye care. Many eye conditions are time-sensitive, and early intervention can make a significant difference in outcomes.

Preventive Measures and Eye Health Maintenance

Maintaining good eye health and preventing eye pain often comes down to simple, everyday practices. By incorporating these habits into your routine, you can significantly reduce your risk of eye discomfort and potential complications.

Tips for Optimal Eye Health:

• Practice good hygiene, especially when handling contact lenses
• Wear protective eyewear during sports or hazardous activities
• Take regular breaks when using digital devices (follow the 20-20-20 rule)
• Maintain a healthy diet rich in vitamins A, C, and E
• Stay hydrated to support tear production
• Get regular eye exams, even if you don’t wear glasses

Remember, many eye conditions are preventable or can be managed effectively if caught early. Don’t ignore persistent eye discomfort or changes in your vision – consult with an eye care professional to ensure your eyes remain healthy and comfortable.

10 Causes of Pain in One Eye | Eyeball Pain

A flare-up of the virus that causes chickenpox.

• If this occurs near the eye, it can interfere with vision.

Rare and unusual causes:

• Immunocompromised cases, such that person’s immune system has been weakened due to illness or treatments such as:
• Chemotherapy.
• Radiation therapy.
• Acquired immune deficiency syndrome (AIDS) or HIV.

This list does not constitute medical advice and may not accurately represent what you have.

Foreign body in the eye

Foreign bodies like windblown grit, wood or masonry, or flecks of metal can land in the eye and get stuck there, causing extreme discomfort.

Rarity: Uncommon

Top Symptoms: feeling of something in the eye

Symptoms that always occur with foreign body in the eye: feeling of something in the eye

Urgency: In-person visit

Bacterial conjunctivitis

Bacterial conjunctivitis, or pinkeye, is an inflammation of the clear membranes covering the eye. It causes redness, pain, and irritation of one or both eyes.

Staphylococcus or streptococcus bacteria are often involved, and anything that brings bacteria to the eye can cause conjunctivitis. Touching the eyes with unwashed hands; sharing eye makeup, washcloths, or towels; or improperly cleaning contact lenses are common causes. The same bacteria that cause the sexually transmitted diseases chlamydia and gonorrhea can also cause conjunctivitis.

Most susceptible are children, but anyone can be affected.

Symptoms include a gritty, burning feeling in the eye; discharge or tears; swelling; itching; pink discoloration due to dilated blood vessels; and sensitivity to light.

Diagnosis is made through patient history, physical examination, and careful eye examination. Smears may be taken from the eye for testing.

Treatment involves a course of antibiotic eyedrops. It is important to use all of the drops as prescribed, even when the infection seems to improve. Warm compresses over the eyes can help ease the discomfort.

Rarity: Common

Top Symptoms: sore throat, eye redness, eye itch, watery eye discharge, eye redness

Symptoms that always occur with bacterial conjunctivitis: eye redness

Urgency: Primary care doctor

Vernal conjunctivitis

Vernal conjunctivitis is long-term (chronic) swelling (inflammation) of the outer lining of the eyes due to an allergic reaction. Vernal conjunctivitis often occurs in people with a strong family history of allergies, such as allergic rhinitis, asthma, and eczema.

Rarity: Ultra rare

Top Symptoms: wateriness in both eyes, eye itch, eye redness, sensitivity to light, feeling of something in the eye

Urgency: Primary care doctor

Corneal abrasion

Corneal abrasion is a wound to the part of the eye known as the cornea. The cornea is the crystal clear (transparent) tissue that covers the front of the eye. It works with the lens of the eye to focus images on the retina.

Rarity: Common

Top Symptoms: blurry vision, sensitivity to light, constant eye pain, moderate eye pain, pain in one eye

Symptoms that always occur with corneal abrasion: pain in one eye, wateriness in one eye, constant eye pain

Urgency: Phone call or in-person visit

Inflamed eyelid (blepharitis)

Inflamed eyelid, or blepharitis, is a bacterial infection of the skin at the base of the eyelashes.

If the oil glands around the eyelashes become clogged, normal skin bacteria will multiply in the oil and cause infection. The glands can become blocked due to dandruff of the scalp and eyebrows; allergies to eye makeup or contact lens solution; or eyelash mites or lice.

Symptoms include red, swollen, painful eyelids; oily, dandruff-like flakes of skin at the base of the eyelashes; and eyelashes that grow abnormally or fall out.

If the symptoms do not clear with hygiene, see a medical provider. Blepharitis can become chronic and lead to infections of the eyelids and cornea; dry eyes which cannot take contact lenses; and scarring and deformity of the eyelids.

Diagnosis is made through physical examination of the eyelids, under magnification and through skin swab of the eyelashes.

Treatment includes warm compresses and careful washing of the eyelids; antibiotics in pill or cream form; steroid eyedrops; and treatment for any underlying condition such as dandruff or rosacea.

Rarity: Common

Top Symptoms: eye itch, sensitivity to light, eye redness, feeling of something in the eye, dry eyes

Symptoms that never occur with inflamed eyelid (blepharitis): severe eye pain

Urgency: Self-treatment

Chronically dry eyes

Chronically dry eyes are a relatively common condition, especially in older adults, that can be very uncomfortable and lead to damage of the surface of the eye. They are caused by a decrease in the tear production of the eye or an increase in tear evaporation. Risk factors inc.

Contact lens-related eye infection

Millions of people wear contact lens daily without issue; however, there is a risk of infection. Often, infection is avoidable by keeping lenses clean.

Rarity: Rare

Top Symptoms: eye redness, wateriness in both eyes, sensitivity to light, constant eye redness, eye redness

Symptoms that always occur with contact lens-related eye infection: eye redness, constant eye redness

Urgency: In-person visit

8 Common Causes of Eye Pain

Eye Pain: Causes, Home Remedies & When to See a Doctor

What is Eye Pain?

Eye pain, also known as ophthalmalgia, is a common eye condition.

However, eye pain is rarely a symptom of a serious disease or condition. Usually, the pain clears without medicine or treatment.

Depending on where you feel the discomfort, eye pain can fall into one of two categories. These include ocular pain, which occurs on the eye’s surface, and orbital pain from within the eye.

Pain that develops on the surface of the eye may involve a scratching, burning, or itching feeling. Surface pain typically results from irritation from a foreign body or object, infection, or trauma. Usually, this form of eye pain is treated with eye drops or rest.

Ophthalmalgia that occurs deeper with the eye may include an aching, stabbing, or throbbing sensation. This type of eye pain may need more in-depth treatment. 

Eye pain that comes with vision loss may be a symptom of an emergency medical problem. Speak with your ophthalmologist, eye doctor, or health care provider immediately if you lose vision while experiencing eye pain.

Other Symptoms that Might Accompany Eye Pain

Eye pain may occur with other symptoms including:

• Blurred vision
• Crusting on the eyelid margin 
• Eye discharge
• Dry eyes 
• Heightened light sensitivity
• Increased tear production 
• Itchy eyes 
• Loss of vision
• Changes in vision 
• Red eyes (bloodshot eyes) 
• Seeing floating objects or spots 
• Watery eyes
• Tiredness
• Fever 
• Flu-like symptoms, including fatigue, fever, sore throat, headache, cough, aches, and pains
• Migraine headache

What are the Potential Causes of Eye Pain?

There are various potential causes of painful eyes.

Here are some of the most common causes:

Conjunctivitis

The conjunctiva is the tissue that borders the front of the eye and the underside of the eyelid. The conjunctiva can become infected and inflamed. Usually, this occurs from an allergy or infection.

While the pain of viral conjunctivitis is typically mild, the inflammation leads to itchiness, redness, and discharge in the eye. Conjunctivitis is also known as pink eye.

Contact Lens Irritation

People who wear contact lenses overnight or do not disinfect their lenses thoroughly are more likely to experience eye pain resulting from irritation or infection.

Corneal Abrasion

The cornea is the clear surface that covers the eye. It is prone to injuries. When you experience corneal abrasion, you will feel like there is a foreign object in your eye. 

However, treatments and methods that usually remove irritants from the eye, like flushing with water, will not ease any pain or discomfort if you have a corneal abrasion.

Eye Injury

Chemical and flash burns to the eye can lead to significant pain and eye injury. These burns are usually the result of exposure to irritants like bleach or intense light sources. These light sources may include the sun, tanning booths, or the materials used in arc welding.

Blepharitis 

Blepharitis develops when oil glands on the eyelid’s edge become inflamed or infected, leading to eye pain.

Stye

A blepharitis infection can form a nodule or raised bump on the eyelid. This is known as a stye or hordeolum. A stye can be extremely painful.

The part of the eye near to the stye is typically very tender and sensitive to touch. However, a chalazion isn’t usually painful.

Glaucoma

Glaucoma occurs when there is damage to the optic nerve. Some types of glaucoma are associated with high eye pressure. Typically, glaucoma has no symptoms early on. However, if there is a drastic increase in eye pressure, you may notice headache, loss of vision, and nausea.

A sudden boost in eye pressure is an emergency. Immediate treatment is necessary to prevent permanent vision loss. This sudden rise in eye pressure is called acute angle-closure glaucoma.

Optic Neuritis

You may have eye pain and loss of vision if the nerve that links the back of the eyeball to the brain becomes inflamed. This nerve is known as the optic nerve.

An autoimmune eye disease or a viral or bacterial infection may produce the inflammation.

Sinusitis

A sinus infection can lead to pressure behind the eyes. As it builds up, the pressure can lead to pain in one or both eyes.

Migraines

Eye pain is a common side effect and symptom of a migraine headache or cluster headache.

Iritis

Iritis is uncommon. However, inflammation in the iris can lead to pain deep inside the eye.

Can Eye Pain Indicate Something Serious?

Depending on the cause, eye pain may resolve without treatment. Or the problem may require medical attention. 

You should contact your doctor if you experience severe eye pain or any discomfort that persists for more than a few hours. These symptoms can suggest a more serious underlying health condition.

When is Eye Pain an Emergency?

If you start experiencing vision loss with eye pain, this may indicate an emergency.

Other symptoms and side effects that require immediate medical attention include:

• Severe eye pain
• Eye pain resulting from trauma or exposure to a chemical or light
• Abdominal pain
• Vomiting
• Dramatic vision changes

Most eye discomfort will fade with no or mild treatment. Eye pain and the underlying conditions that lead to it rarely cause permanent damage to the eye. However, this is not always the case.

Some conditions that lead to pain may also result in more severe eye problems if they are untreated. For example, the pain and symptoms resulting from glaucoma are an indication of an upcoming problem. If glaucoma is not diagnosed and treated, it can lead to vision problems and eventually complete blindness. 

When to See a Doctor for Eye Pain

Speak with your eye doctor or surgeon if you are experiencing eye discomfort and you have had surgery in the past or if you have recently had eye surgery or an eye infection.

Seek medical attention if you experience painful eyes, and you wear contact lenses. You should also look for medical help if you have eye pain and a weakened immune system or if your eye pain does not improve following two to three days of medication.

Professional Treatment Options 

The professional treatment options for eye pain depend on the cause of the discomfort.

Some common professional treatment options for eye pain include:

Glasses

If you often wear contact lenses, allow your corneas time to heal by wearing glasses instead.

Antibiotics

Antibacterial drops and oral pills can help treat eye infections causing pain, including conjunctivitis and corneal abrasions.

Corticosteroids

Your doctor may provide corticosteroids for more severe infections like optic neuritis and anterior uveitis (iritis).

Pain Medications

If the pain is severe and leads to an interruption to your daily life, your doctor may prescribe a medication to help reduce the discomfort until the underlying condition is treated.

Eye Surgery

Surgery is sometimes necessary to repair damage from a foreign object or burn. However, this is rare. Those with glaucoma may require laser treatment for drainage in the eye.

Home Remedies for Eye Pain 

There are also home remedies for eye pain, including:

Rest

The best way to treat many of the conditions that lead to eye pain and improve your eye health is to allow your eyes to rest. Staring at a television or computer screen can lead to eye strain, so your doctor may ask you to rest with your eyes covered for a day or more.

Warm Compress

Doctors may tell patients with blepharitis or a stye to apply a warm, moist compress to their eyes. A warm compress helps clear the clogged oil gland or hair follicle.

Flushing

If a foreign object or chemical enters your eye, flush it with water or a saline solution to clear the irritant out.

Antihistamines

Over-the-counter eye drops and oral medications can help reduce the pain occurring from allergies in the eyes.

How to Prevent Eye Pain

Eye pain prevention begins with eye protection. Here are some ways you can prevent eye discomfort.

Protective Eyewear

Wear protective eyewear to prevent many of the causes of eye pain, including scratches and burns. Put on goggles or safety glasses when exercising, playing sports, mowing the lawn, or handling hand tools.

Construction workers, welders, and individuals who work around flying objects, chemicals, or welding gear must always wear protective eye gear.

Handle Chemicals with Caution

Handle chemicals and potent agents like household cleaners, detergents, and pest control with care. Always spray away from your body when using them.

Exercise Caution with Children’s Toys

Toys featuring spring-loaded components, toys that shoot, and play swords, guns, and bouncing balls can all hurt a child’s eye. Avoid giving your child these types of toys.

Contact Lens Hygiene

If you wear contact lenses, clean them thoroughly and routinely. Wear your glasses occasionally so your eyes can rest. Do not wear contacts for longer than directed.

Eye Pain – Eye Disorders

Doctors ask the person to describe the pain, including when it started, how severe it is, and whether it hurts to look in different directions or blink. They ask about whether the person has ever had eye pain and whether the person is sensitive to light, has blurred vision, or feels as if the eye contains a foreign object.

During the physical examination, doctors check for the presence of fever or a runny nose. They check the face for tenderness.

Most important is the eye examination, including the entire eye, eyelids, and the region around the eye. Doctors check

• Whether the eyes are red or swollen

• How clearly a person can see using a standard eye chart (visual acuity)

• Whether the person can see in each part of the field of vision (visual field testing)

• How the pupils react to light

• Whether shining a light into the unaffected eye causes pain in the affected eye when the affected eye is closed (called true photophobia)

If doctors suspect a foreign object but do not see one, they turn the eyelids inside out to search for hidden foreign objects.

Doctors usually do a slit-lamp examination What Is a Slit Lamp? A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2… read more . A slit lamp is an instrument that enables a doctor to examine the eye under high magnification. Doctors place a drop of fluorescein stain on the cornea to show scratches or certain kinds of infection, including ulcers. Doctors use tonometry Tonometry A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2… read more to measure the pressure inside the eye (intraocular pressure). They use a slit-lamp and/or an ophthalmoscope Ophthalmoscopy A person who has eye symptoms should be checked by a doctor. However, some eye disorders cause few or no symptoms in their early stages, so the eyes should be checked regularly (every 1 to 2. .. read more (a light with magnifying lenses that shines into the back of the eye) to examine the lens and use an ophthalmoscope to examine the vitreous humor (the jellylike substance that fills the eyeball), retina (the light-sensing structure at the back of the eye), optic nerve, and the retinal veins and arteries.

Sometimes findings are helpful in making a diagnosis. Particular findings or combinations may point to particular disorders.

Findings may also help suggest or eliminate certain types of disorders.

• Corneal disorders, among other disorders, tend to cause eye redness, tearing, and pain. If those symptoms are absent, a corneal disorder is very unlikely.

• Pain on the surface of the eye, a foreign body sensation, and pain with blinking suggest a foreign object.

• People who wear contact lenses may have a corneal scratch, a corneal ulcer, or contact lens keratitis.

• When measuring eye pressure, doctors put a drop of anesthetic into the eye. If pain then disappears, the cause of pain is probably a corneal disorder.

• Deep, aching, throbbing pain often indicates a possibly serious disorder such as acute closed-angle glaucoma, anterior uveitis, scleritis, endophthalmitis, orbital cellulitis, or orbital pseudotumor. If, in addition, there is eyelid swelling, bulging of the eye, or inability to move the eye to look in all directions, the most likely disorders are orbital pseudotumor, orbital cellulitis, or possibly severe endophthalmitis.

• Fever, chills, and tenderness suggest infections such as orbital cellulitis or sinusitis.

Eye Pain – Clinical Methods

Definition

Ocular discomfort and pain are symptoms that can be distressing to the patient and physician alike. An awareness of the various types of eye symptoms, their pathogenesis, and clinical significance allows the examiner to narrow the diagnostic possibilities and focus the remainder of data gathering.

The following types of eye discomfort have considerable diagnostic importance (see ):

Technique

Too often, the patient with ocular symptoms will state that an eye hurts, and the examiner will be unable to help the patient to be more specific in expressing symptoms. This is unfortunate because a great deal of information is lost in not pursuing the ocular history in such cases.

To elicit the symptom of foreign body sensation, the following questions can be asked: Do you feel as if there is a grain of sand or eyelash in your eye that you can’t blink away? Are you much more comfortable with your eyes closed? Does it bother you a lot when you open and close your eyes? Similarly, it is useful to ask the patient whether the eye discomfort is more like an eyelash in the eye or a headache around the eye. The answer to this question will often differentiate conditions involving the ocular surface from those associated with deeper intraocular inflammation.

When a patient complains of itching, burning, and tearing, it is helpful to ask: What is your most disturbing symptom? If the answer is itching and the patient states that he cannot stop rubbing his eyes, useful information has been obtained.

Photophobia, or painful spasm with bright light, is usually obvious when speaking to the patient in a bright room where the patient will display discomfort and guarding ptosis. A confirmatory yet nonleading question might be, Are your eyes noticeably more comfortable in the light or dark?

Basic Science and Clinical Significance

Foreign body sensation can occur when nerves within the tarsal conjunctiva are stimulated by an irregular ocular surface such as an actual foreign body. More often, however, with a corneal abrasion as an example, foreign body sensation is caused by breaks in the conical epithelial layer exposing sensitive sensory nerves that are painfully stimulated with normal blinking. The purpose of a pressure dressing for a corneal abrasion is to splint the eyelids shut, preventing pain caused by eyelid excursions over exposed corneal nerves.

Itching often suggests Type 1 hypersensitivity with an cosinophilic response and should be separated from other, less specific ocular surface symptoms such as burning and tearing.

Significant photophobia is usually associated with more severe ocular surface disease or, more likely, intraocular inflammation. The pain induced by exposure to bright light represents ciliary muscle spasm and explains the use of parasympatholytic drops such as atropine in iridocyclitis; painful spasm is prevented by pharmacologically paralyzing the ciliary muscle.

Iridocyclitis is diagnosed by the ophthalmologist with the use of the slit lamp biomicroscope. With this instrument, the presence of inflammatory cells in the anterior chamber and other evidence of increased vascular permeability of the anterior segment of the eye can be appreciated. Photophobia, like perilimbal conjunctival hyperemia, suggests the presence of intraocular inflammation. This must be differentiated from burning and diffuse conjunctival hyperemia, a combination associated with ordinary conjunctivitis.

Pain on extraocular movement is an unusual but highly suggestive symptom of retrobulbar optic neuritis. It is caused by irritation of the extraocular muscles surrounding an inflamed intraorbital optic nerve.

Sore eyes a significant ocular manifestation of COVID-19

January 14, 2021

2 min read

Source/Disclosures

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Disclosures:
Pardhan reports no relevant financial disclosures.

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Sore eyes represent a significant ocular symptom in patients with COVID-19, according to a study published in BMJ Open Ophthalmology.

Of 83 participants with COVID-19 who self-reported anterior segment symptoms, 18% had photophobia, 16% had sore eyes, and 17% had itchy eyes.

The frequency of sore eyes was significantly greater during a COVID-19 state than a pre-COVID-19 state (P = .002). Frequency of other symptoms associated with conjunctivitis, such as mucus discharge and gritty eyes linked to bacterial infection, did not reach statistical significance.

Shahina Pardhan

Healio/OSN spoke with Shahina Pardhan, PhD, director of the Vision and Eye Research Institute, Anglia Ruskin University School of Medicine, Cambridge, U.K., about the research she co-authored.

Question: Why is this research important?

Answer: It is known that the eye can be involved during COVID-19 infection. The term “conjunctivitis” has been used frequently, but conjunctivitis is a broad term, and it can represent many symptoms in the eye, some of which are not shown at all with COVID-19 infection. Our research specifies which eye symptoms were experienced during COVID-19 infection.

Q: Do your findings meaningfully affect current treatment?

A: Yes, as other symptoms of the eye, such as mucopurulent discharge, are not associated with virus infection and need different type of treatment as it is linked to bacterial conjunctivitis needing antibiotics.

Q: Can “sore eyes” be characterized?

A: Sore eyes are when the eyes feel uncomfortable or sore. The eye symptoms linked to COVID-19 are not mucus discharge or dry eyes or lumps and bumps on the eyelid. Our research showed that light sensitivity and watery eyes were also important.

Q: Why are light sensitivity and watering important?

A: They suggest viral infection rather than bacterial infection.

Q: How do your findings inform future research?

A: We need to ascertain how exactly the eye transmits the virus, what pathways are involved in the transmission, and why it affects some people and not others. Could it be that people who did not have the eye symptoms were spectacle wearers, for example, offering some protection?

Q: What else would you like to say?

A: We know that around 16% of people have ocular symptoms, and our research suggests that these are felt by people at around the same time as other COVID-19 symptoms, and they last for just as long. It is therefore important that, in addition to a mask, eyes should be protected as well to reduce the risk of the virus entering the eye.

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COVID-19 Resource Center

Sore eyes as the most significant ocular symptom experienced by people with COVID-19: a comparison between pre-COVID-19 and during COVID-19 states

Introduction

SARS-CoV-2 is the cause of COVID-19, which has been shown to be primarily a respiratory illness, with the most common symptoms being a new continuous cough and high temperature. Further symptoms have been added to this list, and the WHO added conjunctivitis a less common symptom.1 Ocular manifestations of COVID-19 have not been at the forefront of substantial research, possibly due to the life-threatening nature of the other more serious respiratory symptoms which have resulted in high numbers of mortality around the world. This might have resulted in other non-life-threatening symptoms not given importance in the presence of other life-threatening conditions. However, the type, frequency and ocular transmission of the virus must not be ignored, especially as the eye has been recognised as one of the organs through which the virus might enter the body.

Reports on ocular manifestations are varied and show a wide range in terms of prevalence, varying from 4% to 31% of ocular symptoms among those with a confirmed case of the virus.2–4 A systematic review and meta-analysis of 15 studies involving 1533 patients reported conjunctivitis as the most common ocular finding. 5 It is likely that ocular manifestations were not given consideration in the presence of other more critical symptoms when patients were admitted to hospital.2 3 One study of 56 patients with COVID-19 reported that 15 people (27%) had ocular symptoms that included sore eyes, itching, foreign body sensation, hyperaemia, floaters and/or secretions (although the type of secretions was not noted), with six patients reporting ocular symptoms prior to other respiratory or fever symptoms onset.6 A larger study in China, on 534 confirmed COVID-19 cases, reported a much smaller percentage (5%) of people with ocular manifestations.7 The three main ocular symptoms noted were dry eye, foreign body sensation and blurred vision. A small number of patients (n=3) had reported ocular symptom(s) as their first symptom. In both studies, a positive association was reported between the disease severity and the prevalence of ocular manifestations.6 7 Further, late-onset (>2 weeks after initial influenza symptoms) ocular manifestations were reported in a patient who had a confirmed COVID-19 in France, as pseudomembranous and haemorrhagic conjunctivitis. 8 However, conjunctival swabs were returned as negative for both bacterial and viral manifestations in this patient. Other studies have reported the presence of SARS-CoV-2 virus in conjunctival swabs in people suffering from ocular manifestations, and also in those who did not manifest with any ocular symptoms.9 10 It is further possible that under-reporting might have occurred in the absence of any ocular signs and no conjunctival swabs were considered necessary.10 One study even suggested ocular symptoms may be the sole symptom of COVID-19.11 As ocular manifestations are not considered as serious as the other life-threatening symptoms of COVID-19, it is possible that they were under-reported in the light of other more serious symptoms.12

Early in the pandemic, ocular transmission of SARS-CoV-2 was not thought to be a possibility. However, a study investigating a previous coronavirus outbreak (Middle East respiratory syndrome coronavirus) suggests that people who wore full protective wear, including eye protection, showed no evidence of serum antibodies. 13 In contrast, people who wore full personal protective equipment but no eye protection were infected with SARS-CoV-2.10 14

It would be important to ascertain which ocular conjunctival symptoms are reported most frequently. Conjunctivitis manifests with different aetiologies and ocular symptoms, including mucopurulent discharge and itchy eyes associated with bacterial and viral conjunctivitis, respectively. In addition, it would be useful to know how these ocular manifestations compare with other known COVID-19-like symptoms (such as fever and dry cough), how long they last for and when do they manifest when compared with the other COVID-19 symptoms. In addition, as a number of people are known to suffer from other chronic ocular symptoms, it would be useful to compare ocular symptoms before and during COVID-19 state. The aims of the study were to examine the above points.

Results

Box 1 shows the questions and summary data of the participants (n=83) who completed the survey.

Box 1

Date of survey: 16 April to 20 July 2020

Participants (n=83) reported being infected by COVID-19 as confirmed by a healthcare provider

1. What is your age group?

• Summary data: 18–29 years (14%), 30–39 years (21%), 40–49 years (36%), 50–59 years (15%), 60–69 years (11%), 70–79 years (3%), over 80 years (0%).

2. What is your gender?

3. What symptoms indicative of COVID-19 did you experience?

Summary data:

• Fatigue (90%), fever (76%), dry cough (66%), loss of smell/taste (70%).

• Others included sore throat (53%), diarrhoea (28%), headaches (19%), shortness of breath (15%), myalgia/other pain (12%).

4. Do you suffer from any systemic diseases?

• Summary data: hypertension, diabetes, asthma, lung disease (24%), no systemic disease (76%).

5. How long did you experience the symptoms indicative of COVID-19?

6. If you had eye symptoms during COVID-19, how long did they last for?

7. When did you experience the eye symptoms (compared with other symptoms indicative of COVID-19)?

• Summary data: after all other symptoms (11%), within 1 week (65%), within 2 weeks (16%), 3 weeks or more before COVID-19 onset (8%).

8. If you self-isolated, how long did you isolate for?

• Summary data: 1 week (19%), 2 weeks (43%), longer than 2 weeks (36%), did not isolate/did not respond (2%).

Statistical analysis

Associations between categorical variables (ie, gender) were assessed using the χ² test. McNemar’s test compared the difference between paired nominal data for individual eye symptoms before and during COVID-19.

COVID-19 symptoms

One hundred per cent of the participants who had been infected with COVID-19 experienced at least one of the four most common COVID-19 symptoms (fatigue, fever, dry cough, loss of smell/taste) (box 1). It should be noted that more than one symptom was experienced by 82% of people.

Ocular symptoms

The most frequent ocular symptoms reported by participants were photophobia (18%), sore eyes (16%) and itchy eyes (17%). Table 1 compares ocular symptoms before and during COVID-19 using McNemar’s test for paired comparisons. Sore eyes was reported significantly more during COVID-19 (p=0.002) compared with pre-COVID-19 state.

Table 1

Data showing different ocular symptoms before and during COVID-19 in confirmed cases. Bonferroni correction was applied

Duration of time frame for COVID-19 and eye symptoms

The χ² analysis showed no significant difference in the duration of eye symptoms and the other symptoms of COVID-19 (p=0.147).

Differences between males and females

An independent t-test showed no significant difference between males and females for sore eyes (p=0.43), watery eyes (p=0.91) and itchy eyes (p=0.72).

Age groups

There was no significant effect of different age groups on ocular symptoms (p<0. 05).

Discussion

The four most reported COVID-19 symptoms in our study were fatigue (90%), fever (76%), loss of smell/taste (70%) and dry cough (66%). These agree with data from studies carried out on larger samples.

In people with confirmed COVID-19, a number of ocular symptoms indicative of viral conjunctivitis were reported. Of these, sore eyes was reported by 16%, and this was significantly higher from pre-COVID-19 state. Although dry eye was reported by more people before COVID-19 state (23%), the prevalence decreased during COVID-19 state (14%), as did changes in the eyelids. This change was surprising. However, it did not reach statistical significance. It is possible that this non-significant decrease might have been influenced by environmental conditions including lack of exposure to dry eye determinants such as pollution, and so on, as participants would have stayed at home during their infection state. The change in eyelids was also non-significant (2% to 0%).

Mucopurulent discharge, indicative of bacterial infection, showed low prevalence rate, which did not change significantly during COVID-19 state. Although other ocular symptoms such as watery eyes, itchy eyes and photophobia were relatively high, these did not reach statistical significance when compared with pre-COVID-19 state. While it is important that ocular symptoms are included in the list of possible COVID-19 symptoms, we argue that sore eyes should replace ‘conjunctivitis’ as it is important to differentiate from symptoms of other types of infections, such as bacterial infections, which manifest as mucous discharge or gritty eyes.1

Our data show that 81% of participants reported to have experienced ocular symptoms within 2 weeks of other COVID-19 symptoms, and 80% reported that they lasted for less than 2 weeks. The timing when ocular symptoms occur in comparison to other COVID-19 symptoms varies widely. Literature suggests that this ranges from around 8 days before other COVID-19 symptoms (cough/fever, and so on) to 43 days after. 6–11 16–29 The reasons as to why this occurs are not obvious and further work is required to explore the reasons for this.

The potential mechanism for SARS-CoV-2 infection in the eye is important. SARS-CoV-2 invasion of healthy human cells is reliant on the host receptor, ACE2, hypothesised to infect cells using two potential routes.30 The traditional route of entry is through the spike (S) protein of the virus, which binds to the ACE2 receptor as a homodimer.31 The S protein is then cleaved by the transmembrane protease, TMPRSS2, into S1 and S2 subunits.32 The latter is responsible for membrane fusion to allow entry into the cell via cathepsin L and cathepsin B-mediated endocytosis.33 34 An alternate hypothesised route for SARS-CoV-2 infection into human cells is the ability to bind to the ACE2-B^oAT1 heterodimeric complex at the human cell surface.31 B^oAT1 (SLC6A19), traditionally considered to be an amino acid transporter in the small intestine, has gained significant interest as ACE2 is also responsible for the membrane trafficking of B^oAT1. 35 While ACE2 and TMPRSS2 expression has been studied in the eye, given the early stage of studies on B^oAT1 in relation to SARS-CoV-2 infection, the protein has not yet been identified in the eye.

SARS-CoV-2 is typically considered to be transmitted by airborne dissemination of respiratory droplets through direct or indirect contact. Many viruses, such as avian influenza virus H7, have been shown to cause highly infectious viral conjunctivitis, and conjunctiva is hypothesised to be an important entry point for the infection.36 Murine coronavirus has been shown in previous studies in China to demonstrate that up to a third of patients with COVID-19 have suffered from ocular conditions associated with conjunctivitis, such as watery and sore eyes.6 7 37 While there are no studies, as yet, that have determined conclusively the mechanism through which SARS-CoV-2 can infect the conjunctiva, the eye is known to have an internal (aqueous humour, iris, retina) and external (conjunctiva, cornea) intraocular renin-angiotensin system.38 There is still controversy in the literature regarding the presence of the machinery needed for SARS-CoV-2 infection in the conjunctiva. Some studies have reported an expression of ACE2 and TMPRSS2 in the human conjunctival and pterygium cell lines and tissue.39 40 Others show negligible ACE2 expression in the human conjunctiva.41 There is, therefore, a great need to further investigate the possibility that SARS-CoV-2 can directly infect the conjunctiva and cause the ocular symptoms we observe in participants in this study. Another possibility is that the cornea is the site of SARS-CoV-2 infection. In cornea limbal stem cells from healthy human participants and murine cornea, high mRNA expression of ACE2 and TMPRSS2 has been identified, suggesting that SARS-CoV-2 may infect the ocular surface via the cornea using the traditional ACE2-TMPRSS2-mediated mechanism of cell entry.39 40 42 It is, therefore, possible that SARS-CoV-2 can infect the ocular surface via the cornea using the traditional ACE2-TMPRSS2-mediated mechanism of cell entry. Given the neuronal expression of ACE2 and TMPRSS2, it is possible that this type of infection may allow the spread of the virus through the nose, lungs, bloodstream, and through the nervous system (via the trigeminal nerve) to potentially cause the COVID-19 symptoms documented in participants.43

There is a strong association between the neuroinvasive potential of SARS-CoV-2 and the onset of respiratory failure in patients with COVID-19.44 In both symptomatic and asymptomatic patients with SARS-CoV-2, nasal swabs have a significantly higher viral load than throat swabs. Indeed, Hu et al found that SARS-CoV-2 was identified in eye swabs for 2 weeks after the nasopharyngeal swabs turned negative.45 In addition, viruses similar to SARS-CoV-2 have been found in tears of patients infected with the virus.46 As dry cough is one of the predominant observed symptoms in participants, and that ocular manifestations occur simultaneously with other COVID-19 symptoms, another possibility is that lacrimal drainage from the conjunctival sac into the nasal cavity allows the spread of SARS-CoV-2 into the upper respiratory tract as a potential mechanism of virus spread. By using a murine coronavirus, it was identified that the virus has specific retinotropism, irrespective of whether administered via intranasal, intravitreal or intracerebral route.47 48 In addition, in keeping with other studies, we demonstrate a large number of participants with COVID-19 symptoms indicate a loss of smell and taste.49–51 This is not surprising given the association between viral infection and/or upper respiratory tract infections and ageusia and anosmia.52 Interestingly, the machinery for the main route of entry for SARS-CoV-2, ACE2 and TMPRSS2, has been identified to colocalise with the epithelium in the oral and nasal cavities where taste and smell are governed respectively.53 54 It is, therefore, possible that the spread of SARS-CoV-2 through lacrimal drainage of the tears enables the virus to bind to ACE2 in the oral and nasal cavities to blunt taste and smell.

Our findings suggest that ‘sore eye’ should be used to ascertain ocular symptoms linked to COVID-19. The study has a few limitations. Although the number of people in this study sample is relatively small, the prevalence of other symptoms of COVID-19 agrees with those in the literature. This should be confirmed with a larger scale study. We did not collect data on health literacy apart from participants’ self-reporting on any systematic diseases. It is also important to note that ocular symptoms might have been under-reported in the presence of other more serious manifestations of the disease. We also did not collect data on prior eye disease or collect any further data on self-reported vision loss or the presence of any other complicated eye diseases. In addition, it is possible that the online questionnaire and social media approach may have biased responses from digital literate participants. It is possible that people who are not digital literate were excluded from the study. It is also possible that these people might be older and may indeed have presented with different prevalence rates of ocular symptoms before and during COVID-19. This would require face-to-face or telephone interviews and would form the basis of a future study.

In conclusion, this is the first study to investigate the various eye symptoms indicative of conjunctivitis in relation to COVID-19, their time frame in relation to other well-known COVID-19 symptoms and their duration. We show that sore eyes was the most significant ocular manifestation of COVID-19 (compared with pre-COVID-19 state) and that ocular symptoms manifest at the same time as other COVID-19 symptoms. Our data agree with the fact that there has been an increase in ‘sore eyes’ as increasing trending Google search term over the past 10 months.55

The term ‘conjunctivitis’ does not differentiate between its different types which manifest as different ocular symptoms, including mucopurulent discharge, and may mislead. It is therefore important the clinicians ascertain the correct symptoms that manifest in the eye due to COVID-19 infection.

90,000 Eye pain – causes, symptoms, treatment

Eye pain is a symptom that accompanies some diseases. It can also be accompanied by sensations of pressure, puncture, burning, constriction, tearing from the inside of varying degrees of intensity, strength and repetition.

It can be felt (localized) in different parts of the eye, be spilled or focal, accompanied by other symptoms, or be the only sign of trouble. The feeling of pain can arise acutely (“penetrate”), grow slowly or spasmodically – it appears, then disappears.

Classification of pain by location and type. Possible Causes

Depending on how it hurts (character and type) and on the place where the intensity of the sensation is more pronounced, it can be roughly assumed what cause it is caused.

Sharp pain

Sharp pain, like a needle prick – typical for retinal detachment ^[3] , trauma, foreign body ingress, ocular surface burns, astigmatism, herpes.

Eyes hurt, as if the eye sockets are pressing

Dull pain characteristic of conjunctivitis, allergies, blepharitis. Often occurs with ARVI, sinusitis (sinusitis, ethmoiditis) ^{[1] [3] [4]} .

Sudden pain

Typical for erosion of the cornea, barley, diseases of the lacrimal system, volvulus of the eyelids, scleritis, conjunctivitis, retinal detachment, foreign body ingress, burns of the organ of vision, neuritis of the facial and trigeminal nerve, stroke ^{[1] [2] [3] [4]} .

Pulsating pain

Typical for headaches, migraines, glaucoma, eye fatigue, improper use of lenses, dry eye syndrome.

Severe pain

As a rule, it speaks of serious problems, for example, retinal detachment, hemorrhage in the eye, herpes ^{[1] [2] [3] [4]} .

Pain in the eyes when moving

If an attempt to move the eyeball causes pain, this may indicate uveitis, iridocyclitis, corneal inflammation, trauma, dryness of the mucous membrane ^{[1] [2] [3] [4]} .

Eye hurts when blinking

Very common in conjunctivitis and foreign body in the eye.

Eye hurts when pressed

If pressure through the eyelid causes pain, it may be a foreign body, trachoma, cataract, volvulus, dryness syndrome, overwork from computers and gadgets. (2.5) ^{[2] [5]} .

Discomfort in the corner of the eye

Most often worried about conjunctivitis and inflammation of the lacrimal canals.

Pain at night or in the morning after sleep

Typical for dry eye syndrome, fatigue, conjunctivitis.

90,000 Photophobia – causes and treatments

What is photophobia?

Squinting from the bright sun or closing your eyes for a few seconds when leaving a dark room on the street is a normal reaction of the body. Typically, a few minutes are enough to adapt to different lighting conditions. But people with photophobia do not get used to bright light even after a while.Discomfort can be caused not only by the sun, but also by the light from fluorescent and other lamps, as well as normal lighting, in which the eyes of a healthy person feel comfortable.

Sensitivity to light can be chronic, or it can be temporary, associated with some phenomenon, such as trauma.

Contrary to the opinion of many patients, photophobia is not an eye disease as such, but a signal that a person has an eye pathology or diseases of the nervous system.

Often the following symptoms can occur with photophobia:

1. Cutting, burning, pain or other discomfort in the eyes.
2. Lachrymation.
3. Desire to squint even in dim light.
4. Increase in the diameter of the pupils.
5. Redness of the eyes.
6. Decreased visual acuity.
7. Dry eye syndrome.
8. Eye fatigue.
9. Flashes, flies, floating dots, a veil before the eyes.

Fear of light can also be accompanied by other symptoms (they depend on the disease that provoked the photophobia). Among them:

• headache, migraine, dizziness;
• shortness of breath;
• nausea;
• pressing chest pain;
• mood swings, irritability, depression, aggressive behavior.

Regardless of the number of symptoms, we recommend that you see a doctor.Only a specialist can make the correct diagnosis, find the cause of photophobia and prescribe the correct treatment for the disease that provoked it.

Causes of photophobia

Fear of light can be caused both by any pathology and by external conditions. The reasons are as follows:

1. Congenital features of the eyes. For example, the lack of coloring pigment in the iris, which occurs in albinism.
2. Taking medication, for example, treating eye diseases with drops that dilate the pupils.
3. Hours of work at the computer, especially without interruptions. Additional symptoms include dry eye syndrome, eye pain, decreased visual acuity, lacrimation, etc.
4. Regular and / or prolonged work in a poorly lit room.
5. Injuries to the organs of vision. Sensitivity to light after injury develops only in the damaged eye. Often the situation is not limited only to this symptom, it all depends on the type of injury.
6. Heliophobia. It is a panic fear to go outside when the sun is shining there. This is a psychological problem in which patients consider the sun to be the cause of skin cancer, fires, burns and various diseases, so they do not go out into the sun without a hat, sunglasses, short sleeves, etc. Heliophobia often turns into social phobia, as patients can go out on the street only at night and are forced to be alone for a long time.
7. Work indoors with air conditioning or simply with dry air.As a rule, patients note in these cases not only photophobia, but also symptoms of dry eye syndrome.
8. Prolonged eye strain. This usually happens if the work is related to reading, construction, the need to consider small details.
9. Keratitis (inflammation of the cornea), keratoconjunctivitis, inflammation of the iris and other ophthalmic diseases. Usually, the fear of light in this case is accompanied by lacrimation, redness, pain and pain in the eyes or other symptoms characteristic of each specific diagnosis.
10. Infectious diseases: influenza, enterovirus, encephalitis, meningitis, measles, etc. These infectious diseases can be accompanied by symptoms of body intoxication: lacrimation, fever, nausea, vomiting, etc.
11. Damage to the nervous system and various diseases of the central nervous system: depression, chronic fatigue syndrome, psychosis, bipolar disorder, panic attacks, etc.
12. Anomalies of the development of the eyeball.
13. Other pathologies: cerebral stroke, abscess, etc.With such a pathology, in addition to photophobia, there is an increased body temperature, headaches, nausea, etc.

Photophobia can be eliminated simply by removing the cause that caused it, for example, sometimes it is enough to start using computer glasses, remove a particle of dust, a grain of sand or something else that comes into contact with the eye from the eye, regularly humidify the air in the room, etc. If the cause of the pathology is deeper , then the treatment of fear of light is directly related to the treatment of the disease that caused it.

Diagnostics and treatment of photophobia

It is impossible to treat eye photophobia without identifying and eliminating its cause. Ophthalmological specialists do not recommend self-diagnosis and self-medication, since the source of photophobia can be a serious illness that requires specialist intervention.

Diagnosis of fear of light

1. Diagnostic conversation. The doctor determines at what moments the photophobia of the eyes manifests itself, whether this lesion is associated with exposure to sunlight, whether the eyes react to artificial lighting.In addition, the ophthalmologist clarifies the presence of concomitant diseases, finds out whether the patient is taking medication, instills drops, etc.
2. Ophthalmic examinations. Depending on the symptoms and general health of the patient, the doctor performs biomicroscopy, ophthalmoscopy, tonometry, gonioscopy. The specialist can prescribe additional examinations: ultrasound of the eyes, culture for bacteria, etc. Thanks to thorough diagnostics, he can detect the source of the infection, assess the condition of the anterior segment and fundus, patency of the retinal vessels, etc.
3. Neurological examinations. If photophobia is not associated with ophthalmic diseases, the patient is advised to visit a neurologist, who can refer the patient for an MRI, Doppler or other examination.

Additionally, the ophthalmologist may recommend that the patient be examined by an endocrinologist, phthisiatrician or other specialist.

Treatment of fear of light

Photophobia can be treated immediately after diagnosis.Therapy usually includes:

1. Treatment of the underlying disease. For example, a specialist can select medicines for the treatment of migraines, panic attacks, etc., prescribe drops to combat conjunctivitis, scleritis, dry eye syndrome, etc.
2. Refusal from drugs that provoked the fear of light, if it does not harm health.
3. Wearing sunglasses or photochromic lenses. The optometrist may recommend wearing them until the treatment is effective.

How to avoid fear of light?

Hypersensitivity can develop for a number of reasons. If you want to reduce your risk of photophobia, follow these simple guidelines:

• Wear sunglasses to protect your eyes from bright light, while choosing optics, trust only an ophthalmologist and give preference to high-quality lenses;
• Wear a hat with a large brim, it will also help hide your eyes from the sun;
• eye drops will help to avoid dry eye syndrome;
• also use computer glasses and do not forget to take breaks while working at the computer;
• Wet cleaning also helps to cope with photophobia: it is noted that if there is little dust in the house, then the light does not scatter, the likelihood of developing allergies and dry eye syndrome is reduced.

Pain in the corners of the eyes. Causes, treatment of pain in the corner of the eye.

Pain in the corners of the eyes

This symptom refers to unpleasant or painful sensations in the inner or outer corner of the eye. The pain can be persistent or intermittent. As a rule, it is necessarily accompanied by other eye symptoms:

• itching of the eyelid skin
• redness of the eyelid skin in the corner of the eyes
• redness of the eyes
• discharge from the eyes
• lacrimation

Causes of pain in the corner of the eye

Canaliculitis .
Inflammation of the tear ducts causes pain in the inner corners of the eyes. Inflammation of the tear duct develops with infectious problems both in the eye itself and in the nasal cavity. Together with pain in the corner of the eye, swelling and redness of the lower or upper eyelid, lacrimation and purulent discharge from the eyes appear. For treatment, antibacterial and anti-inflammatory drops are used.

2. Partial or complete obstruction of the lacrimal passages .
Causes active lacrimation and discomfort in the inner corner of the eyes. The cause may be trauma or swelling of the tear ducts. Often, for this reason, surgical treatment is necessary to restore the patency of the tear ducts.

3.Dacryocystitis .
Inflammation of the lacrimal sac will also cause localized pain in the inner corner of the eye. The inner corner of the eye swells, profuse purulent discharge appears. In most cases, it goes away as a result of conservative treatment.Sometimes surgical treatment is required

4. Blepharitis.

Inflammation of the skin of the eyelids in the initial stages causes unpleasant sensations and itching in the corners of the eyes, both in the outer and in the inner.

5. Angular conjunctivitis .
Infectious inflammation of the mucous membrane caused by the bacterium Morax-Axenfeld affects the skin of the eyelids in the corner of the eyes. In this case, a characteristic clinical picture develops: the corners of the eyes hurt, turn red, and small cracks appear.Pain in the corners of the eyes increases with blinking.

6.Ocular herpes .
Herpetic eye infection may begin with discomfort in the outer corner of the eye. With an increase in symptoms, swelling of the eyelid appears, pain in the eyes, redness and photophobia.

7. Ingrown hair (eyelashes)
Ingrown hair in the inner corner of the eye can cause discomfort and redness in the inner corner of the eye. At the same time, it is impossible to see the problem with the naked eye.

8.Allergic conjunctivitis.
If, along with discomfort in the corners of the eyes, you experience nasal congestion and watery eyes, the cause may be an allergy. Treatment is carried out with antihistamines.

9. Incorrectly fitted glasses .
In some cases, incorrect adjustment of the nasal pads in the frame of glasses causes pain or discomfort in the corners of the eyes.

10.Computer visual syndrome.
Many people experience gas discomfort and discomfort in the corners of the eyes when viewing the screens of computers, tablets and phones. The severity of symptoms directly depends on the amount of time spent behind the screen. They pass on their own after rest or sleep.

Treatment of pain in the corners of the eyes

It is possible to eliminate the symptom of pain in the corners of the eyes only after identifying the cause of the disease. Be sure to see your doctor for a correct diagnosis.You can apply cold compresses to your eyes and moisturizing drops on your own.
Remember that eye pain that is combined with symptoms such as:

• decreased vision
• redness of the eyes
• become sensitive to light

require urgent medical attention .

Scientists warned about the vitality of coronavirus in the eyes

Coronavirus survives on the mucous membrane of the eyes for at least a week after it ceases to be detected on the nasal mucosa, Italian scientists have found.They warn that the eyes of coronavirus patients are a source of infection, and urge doctors, especially ophthalmologists, to observe the necessary safety measures.

RNA of the SARS-COV-2 coronavirus persists on the mucous membrane of the eye for a long time after the test for it becomes negative, Italian scientists from the National Institute of Infectious Diseases Lazzaro Spallanzani found out. The work was published in the journal Annals of Internal Medicine .

Transmission of the virus from person to person is possible not only through sneezing and coughing, but also through other biological fluids, the doctors explain.For example, during the SARS epidemic, eye contact with patients increased the risk of infection among healthcare workers.

At the same time, there have already been reports of conjunctivitis with COVID-19.

Although not the most common symptom, it is generally typical of coronaviruses.

The first confirmed coronavirus patient in Italy was a 55-year-old woman from Wuhan who flew to Italy on January 23. Five days later, she was hospitalized with complaints of dry cough, sore throat, and inflammation of the mucous membranes of the nose and eyes.The test for SARS-COV-2 turned out to be positive, and after a few days the patient’s temperature increased, nausea and vomiting began.

On the third day of the woman’s stay in the hospital, health workers took a swab from her eyes and found viral RNA there.

Doctors took a swab daily. Although on the 20th day of treatment, the inflammation had already passed, traces of the virus still continued to be determined. At the same time, the nasal mucosa was clean.

For several days, smears from the mucous membranes of the eyes were negative, but on day 27 the virus reappeared.

“SARS-CoV-2 RNA was found in eye swabs a few days after it disappeared from nasal swabs,” the authors write. Moreover, laboratory experiments showed that a sample of the virus taken from the patient’s eye replicated and thus could be viable.

“We have found that the eye fluids of patients with COVID-19 can contain the virus and therefore be a potential source of infection,” the researchers write. “These findings highlight the importance of control measures such as avoiding touching your nose, mouth and eyes and washing your hands frequently.”

They also urge ophthalmologists to be more careful during clinical examinations – the eyes can be not only the “gateway” for the coronavirus, but also the source of its spread. Research has shown that eye-related symptoms of infection can appear even in the early stages of the disease. Therefore, measures to prevent transmission of the virus by this route should be taken as early as possible, scientists emphasize.

In the future, it is necessary to find out how infectious the viral particles in the eyes actually are.

It is very easy to bring the virus into the body through the eyes or nose – after all, we touch our faces much more often than we think, is noted by Israeli specialists. They believe it has to do with hand-sniffing: smells for mammals are a way to learn more about themselves and their surroundings. All primates touch the head very often, and humans are no exception.

A person left alone with him spends almost a quarter of his time with a hand in the area of ​​the nose, the researchers say. This is not too different from the results in monkeys – in 20 minutes, gorillas, chimpanzees and orangutans touch their faces about 20, 24 and 12 times, respectively.

Most people report that they regularly sniff themselves, their partners, children, and even strangers. And one study shows that inhalation more than doubles when you bring your hands to your face and touch or near your nose.

“In other words, people sniff their hands,” the scientists conclude. “Somehow we saw it all the time but didn’t notice.”

So far, scientists have only guesses as to why people sniff their hands.Perhaps this is a way to get information about what a person has touched, or to check if it stinks. At a subconscious level, the researchers believe, this allows people to strengthen their sense of their own identity.

90,000 For what reason can the corners of the eyes hurt?

Eye pain in various diseases can manifest itself in different ways. Sometimes the patient complains of pain in the outer or inner corners of the eyelids. What may be the cause of this symptom, we will consider in this article.

Pain in the corners of the eyes: probable causes

If your eyes hurt in the corners, this may indicate the following diseases or conditions.

Overwork.

This is perhaps the most harmless cause that can cause this symptom. In such cases, the pain syndrome usually goes away on its own after a few hours of rest; drug treatment is not required.

Barley.

In case of a disease, the hair follicle of the eyelash or the sebaceous gland located next to it becomes inflamed.Against the background of inflammation, pain occurs in the area of ​​both eyelids, which also affects the corners of the eyes.

Incorrect optics.

Optics with incorrectly selected diopters leads to rapid fatigue of the visual organs, in which pain syndrome occurs. Also, the eyes closer to the bridge of the nose can hurt if a person wears glasses that do not fit him in size. In this case, it is enough to change the frame or adjust the nose pads, taking into account your anatomical features.

Demodecosis.

The symptom can manifest itself in case of skin lesions of the eyelids with a demodex mite. Along with pain, the patient may complain of such manifestations of the disease as severe itching, swelling, redness of the conjunctiva, and loss of eyelashes.

Allergy.

Often the corners of the eyes itch and hurt in allergic conditions. Usually, allergies are accompanied by other symptoms – tearing, eye irritation.

Dacryocystitis and canaliculitis.

Sometimes the cause of pain in the corners of the palpebral fissure can be inflammation localized in the lacrimal ducts.

The outer or inner corner of the eye hurts – is there a difference?

If the pain is localized from the temporal side, its causes may be overwork, foreign object, traumatic injury, dry eye syndrome, some forms of conjunctivitis.
If the corners located closer to the nose hurt, then most often this symptom is of an infectious and inflammatory nature. The inner corners of the eyelids can hurt with herpes, blepharitis, dacryocystitis.

How to treat?

You can get rid of an unpleasant symptom only by correctly determining its cause.This can be done by an ophthalmologist. If the diagnosis shows that the pain syndrome is due to a bacterial infection, eye drops or ointments with the appropriate effect will be prescribed as treatment.
A symptom of an allergic nature is treated with antihistamine drops and tablets. With demodicosis, ointments with a bactericidal effect, antiparasitic drops are prescribed. There is no specific prevention of a symptom, but if you follow certain rules, you can reduce the risk of its occurrence. So, you need to follow the rules of personal hygiene in order to avoid infectious and inflammatory diseases.In particular, you cannot use someone else’s cosmetics, towels, bed linen, contact lenses. It is also necessary to strengthen the immune system in order to prevent the activation of opportunistic microflora like the demodex mite.

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It hurts to move your eyes – what is the reason?

Based on the location and nature of the pain in the eyes, the ophthalmologist can often suggest the likely cause of the symptom. What diseases can be indicated by pain syndrome arising from eye movement, we will talk in this article.

A healthy person does not experience pain when he moves his eyeballs – looks up or down, observes moving objects. If your eyes hurt when you move, then there is a problem. It can be severe overwork of the visual organs, ophthalmological or general disease. The doctor will be able to establish the exact cause.

Ophthalmic pathologies, in which it is painful to move the eyes

The cause of painful sensations that occur when the eyeballs move is often directly related to diseases of the visual system.

Usually pain during movement appears in the later stages of inflammation, when the pathological process has spread from the eyelids to the entire eyeball. The patient in this case can hardly move his eyes, which fester and look reddened.

• Neuritis of the oculomotor nerve.

The disease does not occur very often, but one of its characteristic signs is precisely the difficulty in moving the eyeballs and the resulting pain.

• Ocular myositis.

In this disease, the external eye muscles become inflamed, which naturally leads to pain when trying to change the direction of gaze. The inflammatory process in the oculomotor muscles can be caused by infectious and inflammatory diseases, trauma, intoxication and a number of other reasons.

Sometimes a patient who has consulted a doctor with a complaint “it hurts to move his eyes” is diagnosed with glaucoma. In this disease, pain in the eye area can be “given” to the head, accompanied by swelling of the eyelids, vomiting, decreased visual acuity, change in the size of the pupil.If a person has similar symptoms, you can not postpone going to the doctor. Glaucoma is dangerous, first of all, by irreversible loss of vision.

Other causes of the symptom

In addition to ophthalmic diseases, pain during eye movement can also cause general pathologies.

• Respiratory viral infections.

Any ARVI, “cold”, flu contribute to the accumulation of toxins in the body. One of the forms of manifestation of intoxication is pain when rotating the eyeballs.

With sinusitis, the sinuses of the nose are inflamed, which are connected with the common walls of the eye sockets. The inflammatory process, which began in the ENT organs, can lead to squeezing of muscle tissues, which interferes with the free movement of the eyeballs and causes pain.

• Migraine pain.

Migraine headache is often accompanied by painful sensations in the eyeball. Since migraine is characterized by unilateral localization, eye pain is also concentrated on one side.

Treatment methods

It is impossible to cure a symptom without first identifying its cause. Therefore, if it hurts you to move your eyes, go through a comprehensive diagnosis by an ophthalmologist. After the doctor finds the source of pain, he will select the optimal treatment, whether it be antiglaucoma, antiviral, restorative or other therapy.

Eye hurts at night. Eye pain at night reasons what to do

It is imperative to consult a doctor in case.Dull pain in the eye, uveitis, as well as in systemic diseases with eye damage. Photophobia, as well as on palpation of the eyeball in the area of ​​the projection of the ciliary body, ciliary soreness. However, when the first signs of uveitis appear, it is not always possible to establish the cause of the disease. The pain can be worse at night, and poor personal hygiene can also contribute to this condition. Patients complain of redness of the eye, pain in the eye, symptoms of which diseases may be the manifestation of various pains in the eyes.The iris thickens due to vasodilation and inflammatory edema. At the initial stage, it is characterized only by eye pain.

This disease is accompanied by symptoms such as discharge of pus, photophobia in the eye at night, redness of the mucous membrane.

Cut in the eye at night, forum

Glaucoma ranks first among diseases. The type of inflammation is an acute or chronic type of inflammation, granulomatous or nongranulomatous.After the treatment, the thought about the causes of such a problem does not leave anyway. Yarrow, forming a hyphema, a three-leafed watch, it should be remembered that the onset of the disease, acute or gradual involvement in the process of one or both eyes, is important to establish the etiology of uveitis. It is imperative to show the child to the ophthalmologist, redness and swelling of the eyelids, 5 ml is injected under the conjunctiva or parabulbar or collalizin is injected.

Palpation at a point at night hurts the eye of the exit of the upper branch of the trigeminal nerve is sharply painful.After waking up, some people are worried about the discomfort of the eyelids, with which many are struggling to no avail, the morning cramps of the eyes can simply drive you crazy, and then the quite understandable question arises, what to do? If the work is connected with a computer, dry eye syndrome may be added to this, a feeling of dryness and cramps in the eye, accompanied by reddening of the eye; mechanical damage to the cornea when solid particles of dust, branches, burns enter the eye.

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