Pain Behind the Eyes

Symptoms, Causes, and When to See a Doctor

Businesswoman with headache
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Many people complain to their eye doctor about "pain behind the eyes." Pain behind the eye can feel somewhat like a deep headache. Pain, headache or achiness that occurs behind the eye is a common complaint and can be concerning. However, a proper diagnosis is not always easy. Your eye doctor will need to evaluate your eye health to determine a possible source of pain.

Symptoms

Pain behind your eye can feel like a dull ache or sharp, intense pain. Some people complain of an explosive pain behind the eye or describe it as feeling like their eye is being stabbed with an ice pick. Some people describe eye pain as a deep headache.

Pain or headaches behind the eye may be accompanied by the following symptoms:

  • Redness
  • Tearing
  • Light sensitivity
  • Numbness
  • Weakness
  • Double vision
  • Fever
  • Pain on eye movement
  • Sinus pressure

If you experience persistent pain behind your eyes, it is best not to ignore it. While it will usually not be serious, it may be a sign of an associated condition which may be far more concerns.

Here are just a few of the possible causes:

Dry Eye Syndrome

 When we think of dry eye syndrome, we imagine symptoms of pain, dryness, and redness affecting the front part of the eye. However, when dry eye persists, light sensitivity, pain, and general headaches can occur.

This pain can cause pressure to build up around and behind the eye. Although there are many different options for treating dry eye syndrome, sometimes all it takes is a good quality artificial tear applied several times daily to resolve the symptoms.

Vision Problems

Although this seems logical, sometimes we do not equate the cause of frank eye pain with vision problems such as nearsightedness, farsightedness, astigmatism, or presbyopia (the over-40 syndrome that causes blurred near vision).

The cause of pain associated with vision problems stems more from our eye and brain trying to compensate for the disorder rather than the deficit itself. Squinting and intense focusing can cause pain to build up inside and behind the eye.

Sinusitis

Sinusitis (inflammation of the sinuses) and sinus infection can cause facial pain around the eyes. Because there are sinus cavities around the bony orbit that houses the eyeball, pain can develop in and around the eye. This pressure behind the eye is usually accompanied by facial headaches as well.

Scleritis

The sclera is the tough outer coating of the eyeball. Scleritis is the inflammation that develops inside the sclera. Scleritis produces pain behind the eye or upon eye movement. There can also be redness and light sensitivity.

While scleritis may have no underlying cause, it often accompanies immune-mediated disorders such as rheumatoid arthritis, lupus, scleroderma, and inflammatory bowel disease.

Depending on the cause, scleritis may be treated with oral and topical steroid medications or immunosuppressive drugs.

Optic Neuritis

Optic neuritis often causes pain behind the eye or pain upon eye movement. Optic neuritis is an inflammatory condition of the optic nerve, the cable that connects the eye to the brain. It inserts into the back of the eye and can be tugged slightly from side to side when the eye moves back and forth. When inflamed, pain occurs behind the eye.

Although not entirely proven, optic neuritis is strongly linked to the development of multiple sclerosis.

Migraines

Migraine sufferers often complain about throbbing pain behind one eye. Hormones can play a role in migraines but certain triggers can cause a migraine to develop. These triggers can be stress, certain smells, flashing strobe lights or even eating something you are allergic to.

Some migraine sufferers will experience strange visual auras that restrict their peripheral vision. These visual obscurations are generally short-lived, lasting for less than 20 minutes.

Cluster Headaches

Cluster headaches are extremely painful headaches that cause pain behind the eyes. Cluster headaches can come on suddenly and reoccur almost on a clockwise basis within a 24-hour period.

Scientists believe that the hypothalamus in the brain may be involved because of the reoccurrence and seasonal patterns of cluster headaches. For reasons unknown, cluster headaches affect men four times more often than women.

When to See a Doctor

  • If the eye pain is severe and/or persistent
  • If the eye pain is accompanied by a headache or fever
  • If you extreme light sensitivity or see halos around light
  • If your vision changes suddenly
  • If you experience swelling in and around the eyes
  • If you have trouble moving the eyes or keeping them open
  • If there is blood or pus coming from your eyes
What Is an Eye Stroke?
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