Pain Behind Eye Causes and Treatment

Pain behind the eyes could have several possible causes, including eye-related causes like dry eye syndrome and problems unrelated to the eyes, like migraines. 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 the 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.

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

Eye-Related Causes of Pain Behind the Eye

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:

• Nearsightedness (blurry distance vision)
• Farsightedness (blurry close-up vision)
• Astigmatism (blurry and distorted vision)
• Presbyopia (blurry close-up vision in people over 40)

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:

• Artificial tears
• Other drops, gels, and ointments
• Prescription medications

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

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.

Non-Eye-Related Causes of Pain Behind the Eye

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)

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

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.