What causes pain behind the eye? Discover the 7 potential reasons, from eye strain to migraines, sinus infections, and more. Get concise answers to your questions.

Unraveling the Mystery of Pain Behind the Eye

Pain behind the eye can be a perplexing and debilitating experience, with a wide range of potential causes. From eyestrain to migraines, sinus infections to life-threatening conditions, understanding the underlying reasons for this discomfort is crucial for seeking the appropriate treatment. In this comprehensive guide, we’ll delve into the seven most common causes of pain behind the eye, providing you with the knowledge to better manage your symptoms and take proactive steps towards relief.

Eyestrain: The Digital Age’s Toll on Our Vision

In today’s technology-driven world, prolonged exposure to digital screens can take a significant toll on our eyes, leading to a condition known as eyestrain. When we stare at a screen for extended periods, we tend to blink less, causing our eyes to become dry and fatigued. This can result in a dull, aching pain behind the eye, as well as other symptoms like blurred vision, sensitivity to light, and headaches. To combat eyestrain, it’s important to follow the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds. Additionally, using artificial tears and taking regular breaks from digital devices can help alleviate the strain on your eyes.

Migraines: The Brain’s Painful Companion

Migraines are a common neurological condition that can often manifest as a throbbing, intense pain behind the eye. These headaches are associated with a variety of other symptoms, including visual disturbances like flashes of light or zigzag lines, nausea, and sensitivity to sound and light. Migraines are more prevalent in women and tend to run in families. While over-the-counter medications like aspirin and ibuprofen can provide relief, people with severe or frequent migraines may require prescription medications that target the underlying chemical changes in the brain. Identifying and avoiding potential triggers, such as certain foods, hormonal imbalances, and stress, can also be an effective way to manage migraines.

Sinus Infections: When the Nose Affects the Eyes

Sinus infections, or sinusitis, can also cause pain behind the eye. This is often due to the proximity of the sinuses to the eye socket and the shared nerve pathways between these two areas. Symptoms of a sinus infection may include thick, discolored nasal discharge, headaches, facial pain, a feeling of pressure, and an impaired sense of smell. In some cases, doctors may need to use a CT scan to differentiate between a sinus infection and a migraine as the underlying cause of the pain. Antibiotics are often prescribed to treat bacterial sinus infections, while viral infections may resolve on their own with supportive care.

Cavernous Sinus Thrombosis: A Rare but Serious Condition

Cavernous sinus thrombosis is a rare and potentially life-threatening condition that occurs when a blood clot develops in the cavernous sinus, a vein located between the bottom of the brain and the back of the eye sockets. This condition is often caused by a bacterial infection, such as sinusitis, dental infections, or other ear, nose, and throat infections. People with uncontrolled diabetes or undergoing cancer treatment may be at a higher risk of developing cavernous sinus thrombosis. Symptoms can include a severe, sudden headache, pain or swelling around the eyes, and vision changes. Prompt medical attention is crucial for the successful treatment of this condition.

Glaucoma: When Intraocular Pressure Causes Pain

Glaucoma is a group of eye conditions characterized by increased intraocular pressure, which can lead to damage to the optic nerve and, in some cases, pain behind the eye. This condition is often associated with other symptoms, such as blurred vision, halos around lights, and eye redness. While glaucoma is a serious condition, it can be managed through a combination of medications, laser treatments, and surgery, depending on the severity of the case. Early detection and treatment are crucial to prevent vision loss and control the pain associated with this condition.

Giant Cell Arteritis: An Inflammatory Condition Affecting the Eyes

Giant cell arteritis, also known as temporal arteritis, is an inflammatory condition that can cause pain behind the eye. This condition primarily affects the arteries in the head, including those supplying blood to the eyes, and can lead to vision loss if left untreated. Symptoms may include a constant, throbbing pain behind the eye, as well as headaches, scalp tenderness, and jaw pain when chewing. Prompt treatment with high-dose corticosteroids is essential to reduce inflammation and prevent serious complications.

Dental Problems: When Jaw Issues Affect the Eyes

Surprisingly, dental problems can also be a source of pain behind the eye. This is due to the close proximity of the jaw to the eye socket, as well as the shared nerve pathways between these two regions. Conditions like temporomandibular joint (TMJ) disorder, in which the jaw joint becomes inflamed or damaged, can radiate pain to the area behind the eye. Seeking treatment from a dentist or oral surgeon may be necessary to address the underlying dental issue and alleviate the associated eye pain.

Seeking Medical Attention: When to Act

If you are experiencing persistent or severe pain behind the eye, it is crucial to consult a medical professional. While some causes, like eyestrain or migraines, may be manageable with self-care and over-the-counter remedies, others, such as cavernous sinus thrombosis or glaucoma, require prompt medical intervention to prevent serious complications. By working closely with your healthcare provider, you can identify the underlying cause of your eye pain and develop an effective treatment plan to restore your comfort and visual well-being.

7 causes of pain behind the eye

Pain behind the eye can result from eyestrain, migraine, dental problems, glaucoma, giant cell arteritis, and other causes. Treatment will depend on the cause, but applying cool or warm compresses may help.

Pain behind the eye is a nonspecific symptom as it can be associated with many different health conditions.

Common types of pain behind the eye vary from dull aches to sharp and intense pains. Some people experience a sharp pain behind while others have a deeper pain inside the head. Symptoms can also include tearing, sensitivity to light, redness, vision changes, or pain during eye movement.

This article examines the possible causes of pain behind the eye, treatments, alternative therapies, and when to consult a doctor if the pain persists.

Reviewing the possible causes for pain behind the eye may provide people with a better sense of the signs of discomfort and when to seek medical help.

There are as many as 300 types of headaches, including those that may cause pain behind the eye. The specific causes are known for only about 10% of headaches. Where a person feels pain does not necessarily correspond to what is causing it.

Many different health issues can cause pain behind the eye, including the following:

Straining the eyes can leave them feeling dry, tired, and blurry.

Research has shown that if a person stares at something for an extended time, they tend to blink less, so eyes become less moist. People should keep screens at a comfortable distance and take breaks from digital devices to reduce eyestrain.

The following may put people at risk of eyestrain:

• spending long hours staring at a screen
• being exposed to glare
• straining eyes in poor lighting
• driving long distances
• struggling to get by without glasses or an updated prescription when needed
• other underlying vision problems

Treatment

Giving the eyes a chance to rest and recover can do a lot to relieve pain behind the eye due to eye strain. People can use the 20-20-20 rule, which involves looking away to a distance of at least 20 feet for 20 seconds every 20 minutes.

People may also try over-the-counter (OTC) artificial tears to help relieve dry, tired eyes.

Migraine is a common condition related to the brain that can often cause headaches along with extreme pain behind the eye. Migraine affects roughly 2 in 10 people, occurs in females more than males, and tends to run families.

Other symptoms

Migraine symptoms may also include visual disturbances, such as:

• shimmering lights
• zig-zag lines
• flashes of light

These disturbances may occur on only one side of the head and worsen with movement, exposure to sound, light, or strong smells.

Migraine headaches may also cause people to feel nauseated or experience vomiting.

Treatment

Doctors may recommend nonprescription medications, such as aspirin and ibuprofen.

However, people with migraine often need prescription medications. These medications balance the chemical changes leading to a migraine and include:

• Imitrex
• Amerge
• Zomig

If migraine attacks are severe or happen frequently, a doctor may recommend taking daily medication like beta-blockers.

The best remedy to prevent migraine is to avoid triggers where possible. Common triggers include:

• certain foods, like aged cheeses and red wine
• food additives and artificial sweeteners
• hormonal imbalances, for example, during pregnancy or menstruation
• emotional stress or anxiety
• environmental factors, including smells, temperatures, sounds, or lights
• irregular sleep patterns
• poor posture
• dehydration
• certain medications, including sleeping pills or hormonal treatments

Doctors often misdiagnose sinus infection as migraine due to the overlap in symptoms and triggers such as weather changes. A person must consult a medical professional to determine the cause of any headache.

Other symptoms

Thick, discolored nasal discharge is a common symptom of a viral or bacterial infection in the sinuses.

Other symptoms may include:

• headaches
• facial pain
• a feeling of pressure
• an impaired sense of smell
• fever

Treatment

Doctors may prescribe antibiotics to treat this type of infection if it is bacterial.

In some cases, doctors will use a CT scan to determine whether sinus disease or migraine is causing the pain.

This rare condition occurs when a potentially life threatening or a septic blood clot develops in the cavernous sinus. The cavernous sinus is a vein running between the bottom of the brain to the back of the eye sockets. A bacterial infection often causes this condition.

Septic cavernous sinus thrombosis can occur due to the following conditions:

• sinusitis
• dental infections
• pharyngitis
• tonsillitis
• other ear, nose, or throat infections

People with uncontrolled diabetes or receiving treatment for cancer may be at risk of developing cavernous sinus thrombosis.

Other symptoms

Symptoms may include:

• a severe, sudden headache
• pain or swelling around the eyes
• vision changes
• high fever

Treatment

Doctors tend to treat this condition with antibiotics and antimicrobial therapies, typically for 3–4 weeks. They should monitor patients’ conditions closely even after the discontinuation of antibiotics.

Other experts recommend anticoagulants to thin blood and therefore prevent further blood clots. Doctors typically prescribe these for several weeks to several months.

Doctors consider this type of treatment effective in slowing down the progression of blood cots and reducing the mortality rate. However, there is also some controversy surrounding anticoagulants as they can result in hemorrhage or bleeding.

Another option that doctors often prescribe is corticosteroids, as there is a potential benefit of reducing inflammation. Doctors do not recommend surgical interventions for the cavernous sinuses themselves.

In cases where the blood clot is septic and potentially fatal, a person may require hospitalization, often in an intensive care unit.

Three nerve branches run through the jaw and eye areas, meaning that issues with the jaw could potentially lead to pain behind and around the eye.

Dental and bite problems that can cause pain behind the eye include tooth infections and temporomandibular (TMJ) disorder, which is dysfunction in the jaw joint.

Other symptoms

If TMJ causes orbital eye pain, people may also experience:

• eye strain
• watery eyes
• sensitivity to light

Treatment

If doctors have ruled out other medical conditions causing pain behind the eye, they may recommend consulting an orthodontist to check jaw joints and bite.

Realigning the bite with custom-made aligners for the teeth, through orthodontic treatment, can reduce the stress put on the muscles and joints in the head and neck. This treatment may alleviate nerve pain and pain behind the eye.

The two types of glaucoma are primary open-angle and angle-closure.

Risk factors include a family history of the condition and other eye-related injuries or surgeries.

Primary open-angle glaucoma is where eye fluid does not drain correctly, causing damage to the optic nerve. However, this type of glaucoma is painless.

Angle-closure glaucoma occurs when a person’s iris blocks the drainage angle where eye fluid leaves the eye. When this is blocked, pressure builds up quickly, and immediate medical attention is needed to protect the vision.

Other symptoms

Symptoms include:

• sudden, severe eye pain
• headache
• blurry vision
• nausea
• vomiting
• seeing halos around lights

Treatment

Medical treatment for angle-closure glaucoma may include eye drops or laser surgery.

A person must use daily eye drops to reduce eye pressure. While this treatment will help maintain the vision, there will be several side effects associated with this medication, including:

• a stinging sensation
• red eyes or inflamed skin around the eyes
• blurred vision
• eyelash growth
• breathing changes
• changes in energy levels
• changes in pulse and heartbeat

The type of surgery used for angle-closure glaucoma is an iridotomy. An ophthalmologist will create a hole in the iris using a laser to help eye fluid flow through the drainage angle.

This condition is a type of vasculitis, a group of rare diseases causing inflammation of the blood vessels. Giant cell arteritis (GCA), which is also referred to temporal arteritis, may cause the arteries in the scalp, head, and temples to swell.

GCA can also occur alongside joint pain disorder known as polymyalgia rheumatica. This condition is a cause of widespread aches and stiffness in people over 50.

Other symptoms

Symptoms of GCA include:

• a new, persisting headache
• fever
• fatigue
• loss of appetite
• temporary loss of vision

Permanent loss of vision can occur in some cases, but appropriate treatment can prevent this.

Treatment

GCA requires immediate medical treatment to reduce the risk of loss of vision. The treatment usually involves high doses of corticosteroids, typically 40–60 milligrams (mg) per day of prednisone for a month.

In most cases, doctors reduce the dose to about 5–10 mg per day for a few months or up to a year. GCA rarely returns after treatment.

In 2017, doctors approved tocilizumab (Actemra) as an effective treatment for GCA as more people are in remission. Medical professionals can administer this drug intravenously on a monthly basis, or patients can self-administer an injection every 1–2 weeks.

The following complementary practices may help people find relief for headaches, which could include pain behind the eye:

• acupuncture
• massaging pressure points
• biofeedback therapy
• relaxation therapy

Home remedies

There are also some common home remedies to prevent or help relieve pain behind the eye, including:

• applying cold or warm compresses
• staying well-hydrated, such as through drinking herbal teas
• exercising regularly
• getting plenty of rest
• limiting alcohol and caffeine use
• relaxing muscles in a hot bath or shower
• avoiding noisy and bright environments
• reducing screen time
• using OTC pain relievers
• reducing stress where appropriate
• magnesium supplements, particularly in the case of migraine attacks

While some conditions improve with home care and OTC medications, other symptoms require prompt medical attention.

Signs that it is time to see a doctor include pain that:

• is severe
• gets worse with time, coughing, or movement
• is accompanied by fever, numbness, a stiff neck, slurred speech, confusion, or visual disturbances
• develops quickly
• is accompanied by a sore, red eye or sore, tender temples
• develops in people with impaired immune systems or cancers

The outlook for pain behind the eye depends on the cause. Doctors can use several treatments to treat the cause of the pain.

Specific causes of pain behind the eye, such as migraine, may be more likely if people have a family history of the condition. It is important to have frequent check-ups with medical professionals to discuss the risk and the signs to look out for.

Other causes, such as eye strain, may resolve with home remedies, including adequate rest and drinking enough water. Doctors may also recommend nonprescription drugs, such as ibuprofen. Alternative therapies may improve the outlook for certain eye conditions.

Some causes of eye pain could require a course of prescription drugs, including steroids, and in some cases, medical treatment and long-term care.

The location of the eye pain may not be related to the cause. A person should keep track of triggers and other symptoms that accompany the pain. This information will help a doctor make an informed diagnosis and provide suitable recommendations for treatment.

7 Reasons Why There’s Pain Behind Your Eye

At one time or another, each of us has likely experienced some type of eye pain. It can range from dull to intense and can be sometimes be accompanied by fever, tearing, redness, light sensitivity, sinus pressure, double vision, and numbness. Most often, pain behind your eye isn’t a serious condition, but in some instances, it can be. That’s why it’s important to figure out what’s most likely causing your eye pain. Here are some common reasons associated with pain behind your eye.

1. Dry eye. Dry eye syndrome is a relatively common condition in which your eyes are unable to produce adequate tears to moisten the eye. Dry eyes can bring on sensitivity to light and headaches, both of which can be painful and lead to pain behind your eyes.
2. Problems with vision. If you have a tendency to focus or squint to make up for a vision problem like farsightedness, nearsightedness, or astigmatism, you are more prone to develop eye pain. That’s because your brain and eyes are trying to compensate for your compromised vision.
3. Sinus inflammation. Also referred to as sinusitis, sinus inflammation causes pressure and pain behind your eyes and tenderness in the front of your face.
4. Throbbing pain from a migraine headache almost always includes pain behind the eyes.
5. This condition is caused by the buildup of intraocular pressure. And when pressure increases in your eye, it can lead to pain oftentimes coupled with nausea, swollen eyelids, watery eyes, and loss of peripheral vision.
6. When pain is felt specifically behind the left eye, it could possibly indicate a brain aneurysm. This occurs when blood vessels or an artery wall in the brain are weak, resulting in possible hemorrhaging or stroke.
7. Stabbing pain behind the eye could be caused by inflammation from inside the sclera (the outer coating of your eye ball.) This condition is sometimes combined with other symptoms like redness and light sensitivity.

If you’re experiencing moderate to severe eye pain, or to learn more about any of the services we provide, please call North Toronto Eye Specialists today to schedule an appointment with one of our doctors at 416-748-2020.

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Eye pains and headaches

Are eye pains always associated with eye disease?

No, other conditions can cause pain in or around the eyes.

In what cases can the causes of eye pain be hidden in other areas of the body?

The eye is a richly nerved organ, whose sensitivity is provided by the trigeminal nerve, which provides sensation in the scalp, upper eyelid, lacrimal gland, cornea and mucous membrane of the eye, in the root of the nose, frontal sinuses, and also in part of the shell brain – in its outer layer and in the blood vessels. One of the manifestations of the disease of this nerve may also be pain in the eyes, although the eye, as an organ, is healthy.

Trigeminal (V) nerve and its branches

One of the nuclei of the trigeminal nerve is located in the cervical region, where its sensory fibers interact with the cerebral XI or accessory nerve, as well as with nerve pathways in the upper part of the neck, thus bringing the pain that appeared in the neck to the head, including the eyes.

Trigeminal V nucleus in the cervical region

Pain in the eyes can also be caused by optic neuritis, as well as occipital neuralgia or nerve disease that has arisen in the region of the first and second cervical vertebrae.

Anatomy of the optic nerve

What diseases cause eye pain and headache?

Migraine or a disease characterized by severe headache. Symptoms of the disease may also include hypersensitivity to light and sound, nausea and vomiting, dizziness, pain in or behind the eyes, blurred vision, changes in the field of vision (floating blurry dots, flashes of light), etc.

Migraine is divided into two types – migraine with or without aura. In the case of migraine with aura, before a migraine attack, symptoms are felt that indicate the approach of an attack. A migraine attack can last from several hours to several days and usually occurs in stages. Despite this, each patient has an attack individually.

There is also ocular migraine, when in the event of an attack the main complaints are related to changes in vision, blurring.

Migraine and cluster headaches

Cluster (bundle) headache is one of the most severe headaches. It usually starts suddenly, without any warning symptoms, and continues as episodic pains that recur periodically. Attacks usually last 6 to 12 weeks and may be seasonal. During an attack, pain usually occurs daily, and sometimes several times a day. The duration of one attack of pain can last from 15 to 180 minutes, moreover, the pain occurs every time at the same time of day, most often at night, 2-3 hours after falling asleep. The pain is usually excruciating, in most cases localized around the eyes, but can also radiate to the face, head, and even to the neck and shoulders. The pain is one-sided, it can also be accompanied by redness of the eye, tearing, swelling, and sometimes even drooping of the upper eyelid.

Occipital neuralgia (occipital neuralgia) is a common type of headache. These headaches are caused by damage to the greater or lesser occipital nerves, which originate in the neck, near the second and third occipital vertebrae. Causes of pain can be tumors, trauma, infections, hemorrhages, or systemic diseases such as osteoarthritis, degenerative changes in the cervical spine, diabetes, and gout. Occipital neuralgia can also be triggered by a long stay in a position with the head tilted down. As a rule, the pain begins in the neck, then spreads upward and is reflected in the region of the eye orbits, the back of the head, forehead and temples. The pain is sharp, pulsating, similar to an electric shock.

Trochleitis – inflammation of the oblique muscle of the eye, which causes pain above the eyeball or in the inner corner. Trochleitis can be caused by autoimmune inflammatory diseases of the connective tissue such as Behcet’s disease, granulomatosis with polyangiitis, lymphoma, Tolosa-Hunt syndrome, and rheumatic diseases – rheumatoid arthritis, systemic lupus erythematosus or inflammation of the sinuses, tumors. In the case of trochleitis, the pain is prolonged and can range in intensity from dull to severe. Various studies also suggest that trochleitis may exacerbate migraine attacks in patients who already have migraine.

Trochlear nerve anatomy

LASH is a very rare type of headache that presents in two ways. In the first case, the manifestations of the disease are episodic, and they are characterized by short-term and frequent attacks of headache, accompanied by symptoms such as conjunctivitis, lacrimation, drooping of the upper eyelid, nasal discharge. One attack lasts from 2 to 45 minutes. In the second case, LASH manifests itself in the form of a mild to moderate, long-term, one-sided headache, during which migraine-like attacks appear with an even more pronounced pain syndrome. In both cases, the localization of pain can also be behind the eyeball.

Trigeminal neuralgia is a chronic condition that affects the trigeminal nerve, in which case even the slightest facial irritation can cause an onset of acute pain. Pain can be caused by smiling, talking, touching your face, drinking cold or hot drinks, shaving your beard, brushing your teeth, etc. Seizures may initially be short and mild, gradually progressing in both duration and intensity. The pain is cutting in nature and similar to an electrical discharge, the cause of their occurrence is completely unknown.

Optic neuritis is a demyelinating inflammation of the optic nerve in which the optic nerve loses its myelin fiber, resulting in impaired transmission of visual information to and from the brain. This inflammation is characterized by blurred vision and pain that is aggravated by eye movement. Changes in the perception of colors are also usually common. Often pain is the first manifestation of optic neuritis. The causes of this inflammation are often systemic diseases such as multiple sclerosis and neuromyelitis.

Postherpetic neuralgia occurs in 7% of patients with herpes zoster, in whom the course of the disease also affected the eyes. After recovery, the patient may have episodic or even persistent pain for months or even years, including the area around the eyes. The greatest chance of developing postherpetic neuralgia occurs in the elderly, as well as in people whose herpes began with a prodrome – symptoms similar to a cold.

Disease of the paranasal sinuses is an inflammation or swelling of the sinuses that can result from exposure to various viruses, bacteria, fungi, or allergens. Inflammation creates a blockage of these sinuses, which is expressed by characteristic symptoms – discharge from the nose, pain in the facial area, including around the eyes, headache, fever, weakness, pain in the neck and cough.

Sinuses

Reflective pain. Eye pain also occurs with pain in the frontal lobe, reflecting pain from the frontal lobe to the eye, with damage to the back of the brain, and also with cervicalgia or pain in the neck.

The already famous philosopher Socrates, who lived before our era, said: “Just as one cannot start treating the eye without thinking about the head, or treating the head without thinking about the whole organism, so one cannot treat the body without treating the soul …” Although modern medicine is extremely specialized in various medical fields, it is always worth remembering that the human body is a holistic entity that needs to be looked at on a larger scale.

“Pressing pain” inside the eye: possible causes

Pressing pain in the eyes is a complaint that worries some of our patients. Attributing such sensations to general fatigue and overload, many of them do not seek help from an ophthalmologist and do not even realize that eye pain can be the first symptom of the development of a dangerous disease.

Possible causes of pressing pain in the eyes

The cause of pressing pain in the eyes can be not only eye diseases, but also pathologies of other organs and body systems. First of all, these are diseases of the central nervous system, ENT pathologies and others.

Among the most common causes of pressing pain in the eyes are:

Optic neuritis – inflammation of the optic nerve, accompanied by decreased visual acuity, blurred vision, pain in the eyes, headache, changes in color perception, changes in the field of vision.

Glaucoma is an ophthalmic disease usually accompanied by an increase in intraocular pressure. This condition provokes the development of degenerative and atrophic changes in the optic nerve, which progress and lead to a gradual decrease in vision, and sometimes even its complete loss. Some forms of glaucoma can also be accompanied by symptoms such as pressing pain inside the eye, a sharp decrease in visual acuity, fog before the eyes.

Migraine is a neurological disease characterized by recurrent headaches or eye pain lasting from 4 to 72 hours without interruption. The pain is usually throbbing in nature and is accompanied by additional symptoms: nausea, vomiting, increased sensitivity to light and sounds.

Cluster headaches is a bodily condition characterized by multiple and frequent attacks of headache. Such pain occurs abruptly and lasts from 30 minutes to 3 hours. The pain can radiate (give) to various parts of the face, including the eyes. In addition, cluster pain may be accompanied by redness of the eyes, the appearance of lacrimation and swelling around the eyes.

Sinus infections can also cause headaches that radiate to the eye area. Usually the cause of pain is an inflammatory process in the nasal sinus (maxillary, frontal). Treatment is carried out by an otolaryngologist and includes the appointment of drugs to eliminate the cause of inflammation, as well as decongestants.