Causes of Eye Pain and Treatment Options

Lots of different health conditions can cause eye pain. Some of them are serious, like narrow-angle glaucoma and optic neuritis. Others are less so, like conjunctivitis, styes, or dry eyes.

The kind of pain you're feeling (burning, sharp, aching, etc.) and any additional symptoms you have (sensitivity to light, headache, etc.) can help your healthcare provider determine the cause.

Your healthcare provider may prescribe eye drops or self-care treatments. In some situations, you may need to see an eye doctor.

This article examines some common causes of eye pain. It also explains how they're diagnosed and treated.

Causes

Your eye sits in a bony socket called the orbit. The eye contains several complex parts, including:

• The sclera (the white part)
• Iris (the colored part of your eye)
• Pupil (black spot in the middle)
• Cornea (the clear outer layer of the eye)

Any condition that affects these parts can cause pain. Pain can also come from conditions that affect the optic nerve.

Common Causes

Eye pain can be distracting or debilitating. Most of the common causes can be cured or managed well. Below are some of the more common causes.

Stye

A stye, or a hordeolum, is a red, tender bump that looks like a pimple. It sits on or inside the eyelid. Styes often develop when an oil gland on the eyelid is infected.

The main symptoms are:

• Pain that gets worse over a few days
• Tearing
• Eyelid swelling

Corneal Abrasion

A corneal abrasion is a scratch on the surface of the cornea. Corneal abrasions may occur on their own or as a part of a larger injury or trauma. A torn contact lens could scratch your cornea. So could getting something (a foreign body) in your eye.

The eye pain from a corneal abrasion can be severe. You might not be able to read, drive, go to work, or even sleep. Besides pain, people often experience light sensitivity.

Dry Eye Syndrome

Sometimes, your eye might not make enough tears. It's also possible for your tears to evaporate more quickly than normal.

When the surface of the eye dries out, your eyes can get irritated. You might feel a gritty, burning, or sharp sensation. In addition to discomfort, you may notice red eyes and light sensitivity.

Conjunctivitis (Pink Eye)

Conjunctivitis is inflammation of the conjunctiva. That's a thin membrane that lines the outside of your eyeball and the inside of your eyelid. Allergies and infections are the most common culprits.

Conjunctivitis causes burning pain or soreness in the eye.

Symptoms can vary, depending on the cause:

• When it's is caused by a virus or an allergy, there's often a watery fluid discharge.
• If there's a sticky, pus-filled discharge, the problem is probably caused by bacteria.
• Allergic conjunctivitis causes itchy eyes and puffy eyelids.

Blepharitis

Blepharitis is inflammation of the eyelash follicles. It's usually caused by too much bacteria at the base of the eyelashes.

Common symptoms include:

• Swollen, itchy, and irritated eyelids
• Problems with your eyelashes
• Light sensitivity
• Dandruff-like flakes on the eyelids or eyelashes
• A feeling that there's something in your eye

Symptoms tend to be worse when you first wake up in the morning.

Tear Duct Infection

Dacryocystitis is an infection in the tear drainage system. It often occurs when bacteria clog up the tear duct. The infection causes pain, redness, and inflammation near the inner corner of the eye.

Extra tears, pus, or other types of discharge might drain from your eye. In more severe cases, you might also have a fever.

Sinus Headache

A sinus headache comes from inflammation or infection in one or more of your sinuses. Sinuses are cavities behind your nose, between your eyes, and beneath your cheekbones and lower forehead.

If you have a sinus infection, you might also notice:

• Pain or pressure behind the eyeballs
• Nasal discharge
• Ear pain
• Tooth pain

Less Common Causes

Some of the less common causes of eye pain are serious and require urgent or emergency care.

Acute Angle-Closure Glaucoma

Most cases of glaucoma don't cause symptoms. However, with acute angle-closure glaucoma, the iris suddenly blocks the area where the cornea and iris meet. That means fluid can't drain out of the eyeball. If the drainage angle is blocked, pressure builds up rapidly within the eye. It causes sudden, intense eye pain and swelling.

Other symptoms include eye redness, blurred vision, and seeing halos and rainbows around lights. Acute angle-closure glaucoma is a medical emergency that can cause vision loss. To save your vision, it's vital that you get treatment right away.

Keratitis

Keratitis is inflammation of the cornea. Keratitis is painful. It can also cause redness and blurry vision.

Bacterial, viral, fungal, or parasitic infections can cause keratitis. The condition can also occur if you scratch your eye or wear contacts for too long.

If you think you may have keratitis, don't wait to get medical care. Untreated keratitis can lead to blindness.

Scleritis

Scleritis is inflammation of the sclera, the white part of your eye. Often, the underlying cause is an autoimmune disease, where the body attacks its own tissues.

The pain of scleritis is severe. It feels as though it's coming from deep inside your eye.

Other symptoms of this condition may include:

• Swelling
• Redness of the sclera
• Blurry vision
• Partial or complete loss of vision
• Tearing
• Extreme sensitivity to light

Hyphema

A hyphema is when blood collects between the cornea and the iris at the front of the eye. The blood covers all or part of the iris and pupil. It can also cause blurry vision and light sensitivity.

A hyphema is not the same as a subconjunctival hemorrhage (a broken blood vessel). With a broken blood vessel, blood appears in the white of the eye but is not painful.

Optic Neuritis

Optic neuritis is swelling of the optic nerve. That's the nerve that sends messages from the eye to the brain. Although optic neuritis can occur from several causes, it is most commonly linked to multiple sclerosis.

Symptoms include:

• Pain when you move your eyes
• Blurry vision
• Loss of color vision (dyschromatopsia)
• Blind spot (scotoma)

Pain occurs with eye movement because the optic nerve is like a cable that connects the eye to the brain. As the eye moves back and forth, the inflamed nerve does, too.

Anterior Uveitis

Anterior uveitis is an inflammation of the fluid-filled space at the front of the eye, which can come from an infection, autoimmune disease, or eye injury.

The symptoms are:

• Aching eye pain
• Intense light sensitivity
• Blurry vision

Orbital Cellulitis

Orbital cellulitis is a serious infection of the muscles and fat that surround the eye.

This condition can cause the following symptoms:

• Pain when you move your eye
• Eyelid swelling
• Eyelid drooping
• Fever

Orbital cellulitis is more common in children. It often develops from a bacterial sinus infection.

It's vital to get prompt medical attention for these symptoms. Left untreated, it can lead to vision loss. The infection can also spread to the brain.

Cluster Headache

A cluster headache is a rare, extremely painful headache disorder more common in men.

The condition causes:

• Sharp, burning, or piercing pain near or above one eye or temple
• Redness or tearing of the eye

Treatments can include oxygen supplementation and prescription medications.

When to See a Healthcare Provider

Eye pain has many causes—some are simple, but it can be a sign of a serious problem. It's important to see your healthcare provider if your eye pain continues for more than a couple of hours.

Diagnosis

To evaluate your eye pain, your healthcare provider will examine your eye and talk with you about your medical history. You might also need imaging and blood tests.

Medical History

A medical history is the first step in finding the cause of your eye pain.

Be prepared to answer the following:

• Has your vision changed?
• Have you had any trauma to your eye?
• Are you having other symptoms like a headache, light sensitivity, fever, or discharge from your nose or eyes?
• Do you wear contact lenses? Describe your wearing schedule, overnight wear habits, and hygiene regimen.
• Do you feel like there is an object in your eye?
• Do you have any other health conditions?

Eye Exam

Your healthcare provider will examine your eye. You may need one or more tests, depending on your medical history and preliminary eye exam.

Some examples of eye tests include:

• Visual acuity test, which checks your distance and up-close vision
• Fluorescein staining, which uses dye to detect corneal abrasions
• Tonometry eye pressure test, which checks for glaucoma
• Retinal exam for uveitis and optic neuritis
• Slit lamp exam for uveitis and scleritis

Imaging

Imaging tests might be needed. For example, a computed tomography (CT) scan can show orbital cellulitis. Magnetic resonance imaging (MRI) can detect optic neuritis.

Certain imaging tests can be used to test for other health conditions, such as anterior uveitis or scleritis.

Blood Tests

You may need blood cultures and a complete blood count (CBC) to help diagnose orbital cellulitis.

Blood tests are usually not needed to diagnose the cause of eye pain unless your doctor thinks you may have a widespread illness.

Treatment

Treatment depends on the cause of your eye pain. In some cases, it can be relieved in a short office visit with your primary care physician or healthcare provider. In other cases, you may need to see an ophthalmologist.

Self-Care Strategies

Sometimes you can’t get to the healthcare provider’s office right away. You can try the following self-care strategies to reduce pain until your appointment. Your healthcare provider may also recommend these treatments after your diagnosis.

For a Stye

Apply a warm, wet compress to the eye for 10 minutes, three to four times a day. The compress may coax the stye into draining on its own. Do not squeeze or pop the stye because that can spread the infection or seriously damage your eye.

For Dry Eyes

Try these strategies:

• Run a humidifier in your bedroom or home office.
• Minimize exposure to air conditioning or heating.
• Wear glasses with shields on the sides if you're going to be in windy or dry places.

For a Foreign Body

You will need to be seen within a few hours. In the meantime, try wearing an eye patch until you see your healthcare provider. By keeping yourself from blinking, you may be able to prevent more scratches. Do not cover your eye for more than a few hours, though, as bacteria can flourish in closed environments.

For Viral or Allergic Conjunctivitis

Place a cool, wet compress on your eye to ease the discomfort.

For Blepharitis

Focus on eyelid hygiene to manage flares and symptoms. To keep eyelids clean and loosen crusts, gently press a clean, warm compress over your eyes for 10 minutes, two to four times a day.

Medications

Your healthcare provider may prescribe medication to treat your eye problem.

Non-steroidal anti-inflammatory (NSAID) eye drops can soothe eye pain. These drops are usually not prescribed for long periods because they can cause cornea problems.

Allergy eye drops, either over-the-counter or prescription, can relieve the redness, itchiness, and puffiness of allergic conjunctivitis.

Artificial tears are used to soothe dry eyes. You can find them in liquid, gel, or ointment formulas. When mildly "chilled" or placed in the refrigerator for an hour, they can be extra-soothing.

Topical cyclosporine or lifitegrast are prescription medications used for treating severely dry eyes.

Antibiotic eye drops are often prescribed for treating bacterial conjunctivitis and bacterial keratitis. They are sometimes prescribed for blepharitis as well.

Glaucoma eye drops lower the pressure in your eye. For acute angle-closure glaucoma, eye drops along with an oral or intravenous (IV) medication called acetazolamide will reduce the pressure immediately.

Oral antibiotics treat a few different eye pain diagnoses, such as:

• A stye that does not resolve on its own or becomes infected
• A bacterial sinus infection
• Blepharitis that does not improve with eyedrops or ointments

Intravenous antibiotics, given through your vein, are used to treat orbital cellulitis.

Steroid eye drops (or pills) are used to treat anterior uveitis.

High-dose corticosteroids, given as a pill or a shot, treat optic neuritis.

Surgery

Surgery is not the usual treatment for conditions that cause eye pain, but it is sometimes necessary. Examples of procedures used to treat eye pain include drainage of fluid from the eye, corneal transplant, or opening the tear duct pathway.

Prevention

Eye pain can't always be prevented. But there are some preventative actions you can take, especially if you are at risk of developing certain conditions.

Here are some strategies you can use to prevent eye pain:

• To prevent styes and conjunctivitis, wash your hands often, especially before using eye makeup or putting in contact lenses. Take off your eye makeup every night using a clean cloth. Never share eye drops with anyone or touch the tip of a dropper to your eye—this can spread bacteria.
• To prevent corneal abrasions, wear protective eyewear if you are doing anything that risks eye injury (e.g., cutting wood or metal). Clean your contact lenses well and do not use them for longer than advised.

Summary

Eye pain can be caused. by injury, infection, or another health condition. Dryness or styes may not need immediate medical care. But if you're also experiencing pressure, swelling, drainage, fever, or vision problems, talk to a healthcare provider sooner rather than later. Some eye conditions can cause permanent blindness if they're left untreated.

Eye pain can often be resolved with warm, wet compresses or over-the-counter eye drops for allergies or pain relief. In some cases, prescription eye drops, corticosteroids, or antibiotics might be needed. And you may need surgery for the treatment of certain conditions.

When it comes to your eyes, protection is important. Wear protective eye gear and keep everything that comes near your eyes clean and clear of bacteria.

A Word From Verywell

Seek a healthcare provider's advice if you have eye pain (even if it's after hours or on the weekend). Your condition could be potentially harmful to your vision and may require immediate treatment.