Pain Behind the Eyes

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Pain behind the eyes is a common complaint with myriad possible causes. A proper diagnosis isn't always easy.

Your eye doctor or another healthcare provider will need to evaluate your eye health to find the source of pain.

This article explores the symptoms and possible causes of pain behind the eyes plus when you need to call your healthcare provider about it.

Causes of pain behind the eyes
Illustration by JR Bee, Verywell  

Symptoms

Pain behind your eye can feel like a dull ache or a sharp, intense pain. Some people complain of explosive pain. Others say it feels like they're being stabbed with an ice pick. And some describe eye pain as a deep headache.

Pain or headaches behind the eye may come along with other symptoms such as:

  • Red eyes
  • Tearing
  • Light sensitivity
  • Numbness
  • Weakness
  • Double vision
  • Fever
  • Pain with eye movement
  • Sinus pressure

Don't ignore persistent pain behind your eyes. It's usually not serious. But sometimes it signals a serious condition.

Eye-Related Causes

A lot of things can cause pain behind the eyes. Some of them are eye-related or vision-related while others just happen to cause pain there.

Eye-related causes include:

  • Vision problems
  • Dry eye syndrome
  • Scleritis
  • Optic neuritis

Vision Problems

Poor vision is sometimes behind eye pain. It can go along with:

This pain isn't caused by the vision problem itself. It's caused by the eye and brain trying to make up for the vision deficit. Squinting and intense focusing cause pain to build up inside and behind the eye.

New corrective lenses may relieve the pain behind your eyes. You may also be able to make changes to your environment that can help. As your eye doctor for ideas.

Dry Eye Syndrome

Dry eye syndrome is more than just dryness. It can cause a wide range of symptoms, including:

  • Itching, burning, or stinging
  • Red eyes
  • Light sensitivity
  • Blurry vision
  • Feeling like something is in your eye

You have many options for treating dry eye syndrome. They are:

Simple solutions like using a humidifier can also help.

Scleritis

The sclera is the tough outer coating of the eyeball. Scleritis is inflammation that develops inside the sclera.

Scleritis causes pain behind the eye or when the eye moves. You may also notice redness and light sensitivity.

Depending on the cause, scleritis may be treated with:

  • Oral steroids
  • Topical steroids
  • Immunosuppressive drugs

Dry Eyes, Scleritis, and Autoimmunity

Dry eye and sclerosis are common symptoms of several immune-system diseases, especially:

Optic Neuritis

Optic neuritis can cause pain behind the eye or with eye movement. It's an inflammatory condition of the optic nerve, which connects the eyes to the brain.

The optic nerve plugs into the back of your eye. Moving your eyes can tug on it. When the nerve is inflamed, that causes pain.

Optic neuritis may be tied to the development of multiple sclerosis. Treatment generally involves intravenous (IV) steroids followed by oral steroids.

Recap

Pain behind the eyes may be caused by the brain and eyes trying to compensate for poor vision. It can also be due to dry eyes, or inflammation from scleritis or optic neuritis. Additional symptoms and treatments depend on the cause of the pain.

Non-Eye-Related Causes

Other causes of pain behind the eyes include feelings of pressure from other problems, including:

  • Sinusitis
  • Migraines
  • Cluster headaches

Sinusitis

Sinusitis is inflammation of the sinuses. It and sinus infection can cause pain around the eyes.

You have sinus cavities around the bony orbit that houses your eyeball. So sinus pain can develop in and around the eye.

This pressure behind the eye is usually accompanied by other symptoms such as:

  • Facial headaches
  • Fever
  • Cough
  • Congestion
  • Sinus drainage
  • Weakness
  • Fatigue

Treatments depend on suspected causes. They may include:

  • Antibiotics
  • Decongestants
  • Pain relievers
  • Applying heat
  • Saline nasal sprays
  • Vaporizers

Some people only have isolated incidents of sinusitis. For others, it may recur often or become chronic.

Migraines

People with migraines often complain about throbbing pain behind one eye.

Hormones can play a role in migraines. But environmental triggers can cause a migraine to develop. These can include:

  • Stress
  • Certain smells
  • Flashing strobe lights
  • Eating something you're allergic to

Migraine treatment can include:

  • Prescription medications (triptans, steroids, opioids, and more)
  • Injected or infused medications
  • Neuromodulators (devices that stimulate the nervous system with magnets or electrical currents)

Some people with migraines have strange visual auras that restrict their peripheral vision. These generally go away in less than 20 minutes.

Cluster Headaches

Cluster headaches are extremely painful headaches that cause pain behind the eyes. They can come on suddenly and reoccur at regular intervals over a 24-hour period. They may also be tied to seasonal changes.

Scientists believe the hypothalamus in the brain may be involved. The hypothalamus controls the way your nervous system and endocrine (hormonal) system interact.

Your hormones fluctuate in patterns during the day and over the seasons. Cluster headaches tend to follow a similar pattern.

Cluster headaches affect men more often than women. Treatments include:

  • Prescription medications for pain (triptans, local anesthetic, injections)
  • Prescription medications for prevention (steroids, calcium channel blockers)
  • Procedures such as nerve blocks and nerve or brain stimulation

Recap

Inflammation of the sinuses (sinusitis), migraines, and cluster headaches can all cause pain behind the eyes that isn't actually related to the function of the eye. Treating the underlying cause may help alleviate the eye pain.

When to See a Healthcare Provider

Call your healthcare provider or seek emergency medical attention if:

  • Eye pain is severe and/or persistent
  • You also have a headache or fever
  • You have extreme light sensitivity or see halos around light
  • Your vision changes suddenly
  • You have swelling in and around the eyes
  • It's hard to move your eyes or keep them open
  • Blood or pus are coming from your eyes

Summary

Pain behind the eyes can be caused by a variety of conditions. It may be tied to vision problems, dry eyes, or inflammation of the structures of the eye.

It may also be felt behind the eyes while having nothing to do with the eyes themselves. Sinus pressure, migraines, and cluster headaches can all cause pain in that area.

A Word From Verywell

Having pain behind your eyes can be scary. You may fear that there's something wrong with your eyes or your brain.

Most of the time, this pain isn't tied to serious illness. Even so, talk to your healthcare provider about it. Mention any other symptoms that occur with the pain.

Getting a correct diagnosis means you can look for treatments that help alleviate the pain behind your eyes and whatever else comes with it.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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