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.

Optometrist vs Ophthalmologist vs Optician

Written by WebMD Editorial Contributors

• Ophthalmologist: Medical and Surgical Eye Care
• Optometrist (OD): Vision Care and Eye Care Services
• Optician: Eyeglasses and Contact Lenses
• How to Choose an Eye Doctor

There are two main types of eye doctors: ophthalmologists and optometrists. Confused about which is which and who does what? Here’s a look at how they’re different. Keep in mind that these professionals can work together and that a team approach can be the best option for eye care.  

They went to medical school. After that, they had a 1-year internship and a residency of 3 years. That’s sometimes followed by a 1 to 2 years fellowship. 

They offer complete eye care services:

• Vision services, including eye exams
• Medical eye care — for conditions like glaucoma, iritis, and chemical burns
• Surgical eye care — for trauma, crossed eyes, cataracts, glaucoma, and other problems
• Diagnosis and treatment of eye conditions related to other diseases, like diabetes or arthritis
• Plastic surgery — to raise droopy eyelids or smooth out wrinkles

Optometrists take care of primary health care for the eye. After college, they spent 4 years in a professional program and got a doctor of optometry degree. Some optometrists get additional clinical training or complete a specialty fellowship after optometry school. They focus on regular vision care and they:

• Perform eye exams and vision tests.
• Prescribe and fit eyeglasses and contact lenses
• Monitor medically related eye conditions related to diseases like diabetes 
• Manage and treat conditions like Dry Eye and glaucoma
• Provide low-vision aids and vision therapy

Optometrists and ophthalmologists often work together to take care of you.

Opticians aren’t eye doctors and can’t give eye exams. They get a 1- or 2-year degree, certificate, or diploma. They fill the prescription your eye doctor gives you. They also:

• Check lens prescriptions
• Provide, adjust, and repair glasses, frames, and contact lenses
• Take facial measurements
• Help decide which type of lenses and frames will work best
• Order and check products, including contacts and eyeglass lenses

One type isn’t automatically better than the other. The right choice depends on your needs. The best eye doctor for you should be:

• Recommended by your doctor, friends, or family
• Someone you like and trust

A good rule of thumb would be:

• For primary eye care, you may wish to start with an Optometrist. From there, they may refer you to an Ophthalmologist if needed
• If you think you need eye surgery for cataracts, glaucoma or another eye disease, an ophthalmologist with the appropriate specialty would be a good place to start

© 2022 WebMD, LLC. All rights reserved. View privacy policy and trust info

how it manifests, causes, symptoms and prevention

Primary glaucoma is a progressive disease of both eyes, characterized by increased intraocular pressure (IOP) and the development of glaucomatous optic nerve atrophy, eventually leading to irreversible blindness. Glaucoma is the leading cause of blindness and low vision among other eye diseases worldwide. The danger of the problem lies in the absence of vivid symptoms, glaucoma is often called the “silent killer” of the optic nerve, even if good vision remains, a person may have the penultimate stage of glaucoma development. The figure shows how the peripheral field of view changes:

Normal field of view

Narrowed field of vision, corresponds to stage II glaucoma

Narrow field of view, corresponds to stage III glaucoma, >70% of the nerve fibers of the optic nerve died We conduct a comprehensive diagnostic examination, which includes 12 diagnostic tests and takes about 1. 5 hours. The value of such a detailed examination lies in determining the type and stage of glaucoma, the degree of intraocular pressure compensation, and determining the “target pressure”. Target pressure is a level of intraocular pressure at which further death of the nerve fibers of the optic nerve is suspended; this is the pressure to which it is necessary to strive for the treatment of a patient with glaucoma. It is also possible to conduct an examination – electrotonography, with which it is possible to determine the ratio of inflow and outflow of intraocular fluid. Electrotonography parameters influence the choice of further treatment. Hypotensive eye drops, laser or surgical treatment is prescribed for each patient individually.

Glaucoma can be either open-angle or closed-angle.

Open-angle glaucoma “does not hurt” and the patient will come to the doctor only when vision is reduced. In this case, the treatment may no longer be effective.

Angle-closure glaucoma is accompanied by periodic pain in the eye, in the corresponding half of the head, manifested by an acute pain attack, in which intraocular pressure will be significantly increased, and visual acuity will be noticeably reduced. If such an attack is not removed in time, the eye will go blind.

The goal of glaucoma treatment is to reduce intraocular pressure to a safe level for each individual patient, to prevent the development of optic nerve atrophy.

Optical tomograph Cyrrus HD OCT

An indisputable advantage of the complex diagnosis of glaucoma in our Clinic is the study of the condition of the optic nerve using the method of optical coherence tomography of the eye, which allows to determine the size, area, depth of glaucomatous changes in the optic nerve, the thickness of the nerve fibers, which is very valuable information for early detection of glaucoma. This is a highly informative intravital layered diagnosis of the optic nerve.

The photograph shows the optic disc of a patient with glaucoma. A deep “pit” is visible – excavation of the optic disc, which occurs as a result of squeezing and death of nerve fibers from too high intraocular pressure

It is important to remember the risk factors for glaucoma:

• age over 40 years;
• the presence of glaucoma in the immediate family;
• high or low blood pressure;
• myopia II-III degree;
• hyperopia;
• long-term use of steroid drugs.

Norm of intraocular pressure (IOP): it is generally accepted to consider the normal level of IOP with contact tonometry from 17 to 24 mmHg. If you take into account risk factors, then each person has his own “safe” IOP rate. With an increase in IOP beyond a safe level in the eye, irreversible changes in the optic nerve fibers occur, which lead to a narrowing of the field of vision, and then to complete blindness.

Glaucoma can be either open-angle or closed-angle. Before understanding how glaucoma develops, it is necessary to understand how fluid circulates inside the eye.

Fluid is produced inside the eyeball by a structure called the ciliary body. Fluid passes through the pupil and leaves the eye through the eye’s drainage system, the trabecular meshwork. In healthy eyes, there is a balance between the fluid that is produced in the eye and the fluid that flows out of the eye. As a result, normal pressure is established inside the eye. This pressure is called intraocular pressure, it is measured by the doctor at the reception.

Open-angle glaucoma is the most common type of glaucoma. It runs latently without any symptoms. Even a significant increase in the level of IOP can go unnoticed by a person, the eye does not hurt, but gradually becomes blind. The reason for the increase in IOP is the clogging of the drainage system of the eye – the trabecular network, through which the outflow of fluid from the eye is carried out. As a result, fluid cannot leave the eye at the same rate as it is produced. There is an accumulation of excess fluid, which leads to an increase in IOP. If not treated, then in the future there is a loss of the peripheral, then the central field of vision, followed by atrophy of the optic nerve and blindness.

The figure shows the optic disc in the normal state (left) and in the developed stage (right). The upper part of the figure shows the changes in the visual fields.

Angle-closure glaucoma is manifested by attacks, during which there is a sharp pain in the eye area, pain in the superciliary region and temple area, accompanied by a sharp decrease in vision, the appearance of “fog”. With such complaints, it is necessary to urgently consult a doctor for medical help. Lack of timely assistance can lead to irreversible blindness! In angle-closure glaucoma, fluid builds up inside the eye because the iris blocks the angle of the anterior chamber of the eye, meaning there is no access to the eye’s natural drainage system. Anything that can dilate the pupil, such as dim light, certain medications, and even eye drops that dilate the pupil before an eye exam, can cause the iris to block the circulation of aqueous humor in some people. When this form of the disease occurs, the eyeball quickly hardens, and the suddenly raised pressure causes pain and blurred vision. It is with this form of the disease that an acute attack is possible – a sharp increase in pressure in the eye. Due to the fact that it is accompanied by nausea and a general deterioration in the condition, it is often confused with other diseases and time is missed. And help in this case should be provided in the next day, otherwise blindness may occur.

Goal of glaucoma treatment:

• Reduction of intraocular pressure to a safe level.
• Preservation of visual functions, stabilization of the glaucoma process.

It must be remembered that the earlier glaucoma is detected, the higher the chance of maintaining good vision! Reducing IOP is achieved in three ways: medication, laser or surgical treatment. All three techniques are carried out in our Clinic by highly qualified specialists using the latest equipment that meets modern standards for the treatment of glaucoma.

It is also important to maintain visual functions when a normal IOP level is reached. To do this, there are courses of anti-dystrophic vascular therapy, which are also carried out in the conditions of our treatment room. Treatment takes an average of 10 days, consists of parabulbar (into the periorbital tissue), intravenous, intramuscular injections, electrical stimulation of the optic nerve.

Pain in the eyes when moving or from bright light: causes and treatment.

Are you ready to test your vision?

From Gary Heiting, OD, and Adam Debrowski

Eye pain is a commonly used term to describe discomfort on the surface, inside, behind and around the eyes.

The pain may be unilateral or bilateral. In other words, you may experience pain in only your right eye, only your left eye, or discomfort in both eyes. There is no evidence that pain in the right eye occurs more often than in the left, and vice versa.

In some cases, for example at eye injury , the cause of the pain is obvious. But it is often difficult to understand why the eye hurts.

To complicate matters, the intensity of the pain does not indicate the severity of the underlying cause of the discomfort. In other words, a relatively minor problem, such as superficial damage to the cornea, can cause unbearable pain.

And some very serious eye diseases – cataracts, macular degeneration, glaucoma, retinal detachment and diabetic retinopathy – are completely painless.

ARE YOU READY FOR AN EYE TEST? Find an optometrist nearby .

Eye pain can be accompanied by a variety of sensations and symptoms that will help the optometrist determine the cause of discomfort and prescribe the correct effective treatment for eye pain. For example:

• Sharp, stabbing sensation

• Burning in the eyes

• Dull aching pain

• Sensation as if something were “in” the eye (foreign body sensation)

Eye pain is often accompanied by blurred vision, redness ( bloodshot eyes ) and sensitivity to light .

Causes of eye pain

Below are the most common causes of eye pain, based on the location of discomfort.

Pain on or inside the eye

Often eye pain that feels like something is in the eye is caused by irritation or inflammation of the outside of the eyeball, particularly the cornea.

The main causes of pain coming from the outer or inner part of the eyeball:

Foreign body in the cornea

It is not surprising that in most cases the sensation of a foreign body is caused by the foreign body itself. Metal shavings, inorganic abrasive particles (sand, fine stone chips), sawdust, and other organic materials are examples of the most common foreign bodies that land on and penetrate the corneal surface.

Discomfort from a foreign body in the cornea may be mild or severe. Usually, blinking causes the most unbearable pain (because at this time the eyelid rubs against a foreign body). Blurred vision and sensitivity to light also often accompany eye pain.

A foreign body in the cornea requires immediate referral to an ophthalmologist, as a foreign body that enters the cornea can soon lead to a serious eye infection.

In most cases, the ophthalmologist easily removes the foreign body from the eye using special tools. He also prescribes antibacterial eye drops to prevent infection while the cornea is repaired.

Corneal abrasion

This is a corneal abrasion. Although corneal abrasion is not usually dangerous, it can cause severe discomfort, as well as sensitivity to light and tearing.

Most superficial corneal scratches go away on their own within 24 hours. But deeper scratches, if left untreated, can lead to serious eye infections and even corneal ulcers.

Because it’s often impossible to tell for sure if the pain is caused by a small scratch, deep wound, or foreign body in the cornea, you should see an optometrist to determine the underlying cause of the pain if you experience severe eye discomfort that doesn’t go away quickly.

Dry eyes

Dry eyes are another common cause of discomfort. If we compare the discomfort associated with dry eyes with the pain of a foreign body or a scratch on the cornea, then it develops much more slowly. Sometimes dry eyes can lead to corneal abrasion because there isn’t enough tear fluid on the surface of the eye to moisturize the cornea.

If the use of moisturizing eye drops significantly improves the condition, dry eyes are probably the cause of the pain. In most cases, dry eyes do not require immediate action; but an optometrist can perform some tests to determine the degree of dryness and recommend the most effective treatment.

Other (more rare) causes of pain in the anterior chamber or “inside” the eye:

• Conjunctivitis (“pink eye”)

• Iritis (anterior uveitis), i.e. inflammation of the iris

• Discomfort caused by contact lenses

Endophthalmitis is a disease that causes very severe pain in the eyes. This is an inflammation of the inside of the eyeball caused by a bacterial infection. It also occurs in rare cases as a complication after cataract surgery.

Endophthalmitis causes not only pain in the eyes, but also redness, swelling of the eyelids and blurred vision. If you experience these symptoms after cataract surgery or other eye surgery, contact your optometrist immediately.

Stinging pain in the eyes

The main causes of pain behind the eyeballs are migraine and sinus infection.

In the case of migraine, the pain is almost always felt behind one eye and is often accompanied by pain elsewhere on the same side of the head.

Pain associated with a sinus infection is usually less than migraine pain, and both eyes may be affected.

Although pain behind the eyeballs caused by a migraine or sinus infection is not an emergency, you should see an optometrist or physician if you suffer from chronic or recurring pain of this type and get the necessary treatment that can prevent such attacks in future.

Eye pain

Perhaps the most common pain around the eyes is inflammation of the eyelid, namely stye (or hordeolum). The primary symptom of stye is a very painful lump on one eyelid.

Barley does not require an urgent visit to the ophthalmologist. It is easily treated at home with a warm compress applied to the eyelid several times a day for several days.

OTHER RELATED MATERIALS: 2 easy ways to cure stye

Blepharitis is another common (and usually harmless) condition that causes eyelid swelling and discomfort around the eyes.

Prolonged computer use can also cause pain around the eyes and pain in the eye muscles. This problem does not require urgent action. There are simple steps you can follow to relieve eye strain.

A less common and more serious cause of eye pain is optic neuropathy, which can lead to permanent vision loss. Usually this disease is accompanied by a decrease in visual acuity and deterioration in color perception, as well as increased pain when moving the eyes.

Eye pain caused by optic neuropathy requires immediate referral to an ophthalmologist or neurologist. In people under the age of 40, the main causes of optic neuritis are multiple sclerosis and other neurological diseases.

Treatment of eye pain

Eye pain is an emergency. In almost all cases, choosing the right treatment for eye pain begins with an eye examination by an optometrist nearby. Only an ophthalmologist can determine the exact cause of eye pain and prescribe the correct treatment to prevent damage to the eye and possible permanent loss of vision.

In particular, see an ophthalmologist immediately if your eyes hurt and: goggles or screens).

When it comes to eye pain, don’t push your luck.