Eye Pain

Pain or discomfort in or around the eye that can range from mild irritation to severe pain, potentially indicating various eye conditions requiring medical attention

Table of Contents

Quick Facts

  • Type: Symptom
  • ICD-10: H57.1
  • Common: Very common
  • Emergency: Sometimes

Overview

Eye pain, also known as ophthalmalgia or ocular pain, is discomfort occurring in or around the eye. It can manifest as sharp, stabbing, burning, throbbing, or aching sensations. The pain may be superficial, affecting the eye's surface, or deep, involving structures within or behind the eye. Understanding the nature and location of eye pain is crucial for proper diagnosis and treatment.

Eye pain can be classified into two main categories: ocular pain (on the eye's surface) and orbital pain (within or behind the eye). Ocular pain often results from problems with the cornea, conjunctiva, or eyelids, while orbital pain may indicate issues with the eye muscles, nerves, or surrounding structures. The severity can range from mild discomfort that resolves with rest to intense pain requiring emergency medical attention.

While eye pain is a common complaint, it should never be ignored, especially when accompanied by vision changes, severe headache, or systemic symptoms. Some causes of eye pain are benign and easily treated, such as dry eyes or minor infections. However, others can be serious and vision-threatening, including acute angle-closure glaucoma, optic neuritis, or corneal ulcers. Prompt evaluation ensures appropriate treatment and prevents potential complications.

Symptoms

Eye pain can present with various characteristics and accompanying symptoms that help identify the underlying cause.

Types of Eye Pain

Sharp, Stabbing Pain

Often indicates corneal problems or foreign body

 Burning Sensation

Common with dry eyes or chemical exposure

 Throbbing Pain

May suggest increased eye pressure or migraine

 Dull Ache

Often from eye strain or sinus problems

Associated Eye Symptoms

Systemic Symptoms

  • Headache - Especially with glaucoma or migraine
  • Nausea and vomiting - With acute glaucoma
  • Fever - Suggests infection
  • Facial pain or pressure
  • Neck stiffness
  • General malaise

Emergency Warning Signs

Seek immediate medical attention for:

  • Sudden, severe eye pain
  • Eye pain with sudden vision loss
  • Eye pain after trauma or injury
  • Seeing halos around lights
  • Eye pain with severe headache and vomiting
  • Bulging eye (proptosis)
  • Inability to move the eye

Causes

Eye pain can result from numerous conditions affecting different parts of the eye or surrounding structures.

Surface Eye Problems

Corneal Conditions

  • Corneal abrasion: Scratch on the eye surface
  • Corneal ulcer: Open sore on the cornea
  • Keratitis: Corneal inflammation
  • Foreign body: Particle stuck in eye
  • Contact lens problems: Overwear, infection

Conjunctival and Lid Problems

  • Conjunctivitis: Pink eye infection
  • Blepharitis: Eyelid inflammation
  • Stye (hordeolum): Infected eyelash follicle
  • Chalazion: Blocked oil gland
  • Entropion/Ectropion: Eyelid malposition

Internal Eye Conditions

  • Glaucoma: Increased eye pressure
  • Uveitis: Inflammation of the uvea
  • Iritis: Iris inflammation
  • Endophthalmitis: Intraocular infection
  • Retinal problems: Detachment, tear

Orbital and Surrounding Structures

  • Orbital cellulitis: Infection around eye
  • Optic neuritis: Optic nerve inflammation
  • Sinusitis: Sinus infection causing referred pain
  • Temporal arteritis: Blood vessel inflammation
  • Trigeminal neuralgia: Nerve pain

Other Causes

  • Eye strain: Computer use, reading
  • Dry eye syndrome: Insufficient tears
  • Migraine: Can cause eye pain
  • Cluster headaches: Severe pain around one eye
  • Chemical burns: Exposure to irritants
  • UV damage: Photokeratitis from sun

Risk Factors

Various factors can increase the likelihood of experiencing eye pain:

Occupational and Environmental

  • Prolonged computer or screen use
  • Exposure to chemicals or irritants
  • Working in dusty or windy conditions
  • Welding or bright light exposure
  • Air pollution or smoke exposure
  • Dry or air-conditioned environments

Medical Conditions

  • Diabetes - Increases infection risk
  • Autoimmune diseases
  • Previous eye surgery or injury
  • Chronic sinusitis
  • Migraine or headache disorders
  • High blood pressure

Lifestyle Factors

  • Contact lens wear, especially extended use
  • Poor eye hygiene
  • Inadequate eye protection during activities
  • Rubbing eyes frequently
  • Insufficient sleep
  • Dehydration

Age-Related Factors

  • Increased risk of glaucoma with age
  • Dry eyes more common in older adults
  • Age-related macular degeneration
  • Presbyopia causing eye strain

Diagnosis

Proper diagnosis of eye pain requires comprehensive evaluation by an eye care professional.

Medical History

  • Pain onset, duration, and progression
  • Pain characteristics (sharp, dull, burning)
  • Associated symptoms
  • Recent eye trauma or surgery
  • Contact lens use
  • Medications and allergies
  • Systemic health conditions

Eye Examination

External Examination

  • Visual inspection of eyes and lids
  • Pupil size and reactivity
  • Eye movement assessment
  • Facial symmetry

Slit Lamp Examination

  • Detailed view of eye structures
  • Corneal evaluation
  • Anterior chamber assessment
  • Lens examination

Diagnostic Tests

  • Visual acuity: Standard eye chart test
  • Tonometry: Eye pressure measurement
  • Fluorescein staining: Detects corneal damage
  • Ophthalmoscopy: Retinal examination
  • Visual field testing: Peripheral vision check
  • Gonioscopy: Drainage angle assessment

Additional Studies

  • OCT (Optical Coherence Tomography): Detailed retinal imaging
  • Ultrasound: For internal eye structures
  • CT or MRI: For orbital problems
  • Blood tests: If systemic disease suspected
  • Cultures: For suspected infections

Treatment Options

Treatment for eye pain depends on the underlying cause and severity of symptoms.

Immediate Care

  • Remove contact lenses if wearing
  • Flush eye with clean water for chemical exposure
  • Avoid rubbing the affected eye
  • Apply cool compress for comfort
  • Protect eye from bright light

Medications

Topical Treatments

  • Antibiotic drops: For bacterial infections
  • Antiviral medications: For herpetic keratitis
  • Steroid drops: For inflammation (with caution)
  • Artificial tears: For dry eyes
  • Dilating drops: For uveitis pain relief
  • Glaucoma medications: To lower eye pressure

Oral Medications

  • Pain relievers: Acetaminophen, NSAIDs
  • Oral antibiotics: For severe infections
  • Antivirals: For shingles
  • Migraine medications: If related to headaches

Procedural Treatments

  • Foreign body removal: By eye professional
  • Corneal debridement: For certain ulcers
  • Laser procedures: For glaucoma
  • Injections: For severe inflammation
  • Surgery: For structural problems

Supportive Care

  • Rest in a dark, quiet room
  • Limit screen time
  • Use proper lighting
  • Maintain good eye hygiene
  • Stay hydrated
  • Follow-up appointments as directed

Prevention

Many causes of eye pain can be prevented through proper eye care and safety measures:

Eye Protection

  • Wear safety glasses during hazardous activities
  • Use UV-protective sunglasses outdoors
  • Wear appropriate sports eye protection
  • Use shields when working with chemicals
  • Protect eyes from wind and dust

Digital Eye Strain Prevention

  • Follow the 20-20-20 rule (every 20 minutes, look 20 feet away for 20 seconds)
  • Adjust screen brightness and contrast
  • Position screens at arm's length
  • Minimize glare with proper lighting
  • Blink frequently to prevent dry eyes
  • Take regular breaks from screens

Contact Lens Care

  • Follow proper hygiene when handling lenses
  • Replace lenses as recommended
  • Never sleep in lenses unless approved
  • Use fresh solution daily
  • Give eyes regular breaks from lenses

General Eye Health

  • Regular eye examinations
  • Manage systemic health conditions
  • Maintain good hygiene
  • Avoid touching or rubbing eyes
  • Stay hydrated
  • Get adequate sleep

When to See a Doctor

While minor eye discomfort may resolve on its own, certain situations require prompt medical attention:

Seek Emergency Care For

  • Sudden, severe eye pain
  • Eye pain with vision loss
  • Eye injury or trauma
  • Chemical exposure to the eye
  • Eye pain with severe headache and vomiting
  • Seeing halos or rainbows around lights
  • Eye that won't move normally
  • Bulging eye

See an Eye Doctor Soon For

  • Persistent eye pain lasting more than 24-48 hours
  • Eye pain with discharge
  • Light sensitivity that doesn't improve
  • Foreign body sensation that persists
  • Recurrent eye pain episodes
  • Eye pain affecting daily activities

Regular Eye Care

  • Annual eye exams for those over 40
  • More frequent exams with diabetes or glaucoma
  • Children's vision screening as recommended
  • Contact lens wearers need regular follow-ups

Related Conditions

Several conditions commonly cause or are associated with eye pain:

Glaucoma

Increased eye pressure damaging optic nerve

 Conjunctivitis

Pink eye infection or inflammation

 Dry Eye Syndrome

Insufficient tear production

 Corneal Ulcer

Open sore on the cornea

Other Associated Conditions

Frequently Asked Questions

Can eye pain be a sign of something serious?

Yes, eye pain can indicate serious conditions like acute glaucoma, corneal ulcers, or optic neuritis. Sudden severe pain, vision changes, or pain after injury always require immediate medical attention. However, many causes of eye pain are benign and easily treated, such as dry eyes or eye strain.

Why does my eye hurt when I blink?

Pain when blinking often indicates a problem with the eye's surface, such as a corneal abrasion, foreign body, or infection. Dry eyes, styes, or conjunctivitis can also cause blinking pain. If the pain persists or worsens, see an eye care provider for evaluation.

Can stress cause eye pain?

Yes, stress can contribute to eye pain through several mechanisms. It can trigger tension headaches that include eye pain, worsen dry eyes, cause eye strain from muscle tension, and trigger migraines. Managing stress through relaxation techniques may help reduce eye discomfort.

Is it normal for eyes to hurt after looking at screens?

Eye discomfort after screen use is common (digital eye strain) but not normal. It results from reduced blinking, focusing effort, and blue light exposure. Following the 20-20-20 rule, adjusting screen settings, and taking regular breaks can prevent this discomfort.

When is eye pain an emergency?

Eye pain is an emergency when accompanied by sudden vision loss, severe pain, eye injury, chemical exposure, nausea/vomiting, or seeing halos around lights. These symptoms may indicate acute glaucoma, severe infection, or other sight-threatening conditions requiring immediate treatment.

Medical Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Eye pain can be a symptom of serious conditions. Always consult with an eye care professional for proper diagnosis and treatment, especially if you experience sudden or severe eye pain, vision changes, or eye injury.

References

  1. Friedman NJ, Kaiser PK, Pineda R. The Massachusetts Eye and Ear Infirmary Illustrated Manual of Ophthalmology. 5th ed. Elsevier; 2021.
  2. American Academy of Ophthalmology. Preferred Practice Pattern: Comprehensive Adult Medical Eye Evaluation. AAO; 2020.
  3. Jacobs DS. Evaluation of the red eye. UpToDate. 2023.
  4. Rhee DJ, Pyfer MF, eds. The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease. 8th ed. Wolters Kluwer; 2021.
  5. Bowling B. Kanski's Clinical Ophthalmology: A Systematic Approach. 9th ed. Elsevier; 2020.