Eye Pain

Eye pain can range from a mild, dull ache to sharp, stabbing sensations that significantly impact daily life. The pain may occur on the eye surface (ocular pain) or deeper within the eye (orbital pain). While some causes are minor and resolve quickly, others represent serious conditions that can threaten vision if not treated promptly. The eye's complex structure and vital function make proper evaluation of eye pain essential. Understanding the type, location, and associated symptoms helps distinguish between conditions requiring emergency care and those that can be managed routinely.

🚨 SEEK IMMEDIATE EMERGENCY CARE If You Have:

Sudden severe eye pain with vision loss, eye pain with nausea/vomiting (possible acute glaucoma), trauma with vision changes or visible eye damage, chemical in eye, severe pain with red eye and halos around lights, or sudden vision loss with or without pain. These are eye emergencies that can result in permanent vision loss without immediate treatment.

Medical Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Always consult with a qualified healthcare provider for diagnosis and treatment of any medical condition.

Types of Eye Pain

Surface Pain (Ocular)

  • Characteristics:
    • Sharp, scratching sensation
    • Burning or stinging
    • Foreign body sensation
    • Worse with blinking
    • Light sensitivity
  • Common causes:
    • Corneal abrasions
    • Dry eyes
    • Conjunctivitis
    • Foreign bodies

Deep Pain (Orbital)

  • Characteristics:
    • Dull, aching pain
    • Behind or around eye
    • May worsen with eye movement
    • Pressure sensation
    • Throbbing quality
  • Common causes:
    • Glaucoma
    • Optic neuritis
    • Sinusitis
    • Migraine

Common Causes

Eye Emergencies

  • Acute angle-closure glaucoma:
    • MEDICAL EMERGENCY
    • Severe eye pain
    • Blurred vision
    • Halos around lights
    • Red eye
    • Nausea and vomiting
    • Rock-hard eye
  • Corneal ulcer:
    • Severe pain
    • White spot on cornea
    • Discharge
    • Vision loss risk
    • Contact lens wearers at risk
  • Endophthalmitis:
    • Infection inside eye
    • Severe pain
    • Vision loss
    • After surgery or trauma
    • Emergency treatment needed
  • Chemical burns:
    • Immediate severe pain
    • Alkaline worse than acid
    • Requires immediate irrigation
    • Can cause blindness

Surface Conditions

  • Corneal abrasion:
    • Scratch on eye surface
    • Sharp pain
    • Tearing
    • Foreign body sensation
    • Light sensitivity
    • Usually heals quickly
  • Dry eye syndrome:
    • Burning, stinging
    • Gritty feeling
    • Paradoxical tearing
    • Worse in wind/AC
    • Computer use trigger
    • Common with age
  • Conjunctivitis (Pink eye):
    • Red, irritated eye
    • Discharge
    • Crusting of lids
    • Viral, bacterial, allergic
    • Highly contagious types
  • Blepharitis:
    • Eyelid inflammation
    • Burning, itching
    • Crusty eyelids
    • Chronic condition
    • Associated with rosacea

Internal Eye Conditions

  • Uveitis:
    • Inflammation inside eye
    • Deep, aching pain
    • Light sensitivity
    • Blurred vision
    • Floaters
    • Can be autoimmune
  • Optic neuritis:
    • Optic nerve inflammation
    • Pain with eye movement
    • Vision loss
    • Color vision affected
    • Associated with MS
  • Iritis:
    • Iris inflammation
    • Severe eye pain
    • Small pupil
    • Light sensitivity
    • Blurred vision

Pressure-Related

  • Primary open-angle glaucoma:
    • Usually painless
    • Gradual vision loss
    • Peripheral vision first
    • "Silent thief of sight"
  • Ocular hypertension:
    • High eye pressure
    • Usually no symptoms
    • Risk factor for glaucoma
  • Low eye pressure:
    • After surgery
    • Dull ache
    • Vision changes

Referred Pain

  • Sinusitis:
    • Pressure around eyes
    • Worse bending forward
    • Nasal congestion
    • May affect vision
  • Migraine:
    • Throbbing eye pain
    • Visual aura
    • Light sensitivity
    • Nausea
  • Cluster headache:
    • Severe pain behind eye
    • Tearing
    • Nasal congestion
    • Occurs in clusters
  • Temporal arteritis:
    • Jaw pain when chewing
    • Temporal headache
    • Vision loss risk
    • Age >50

Other Causes

  • Eye strain: Computer use, reading
  • Contact lens problems: Overwear, infection
  • Foreign body: Debris in eye
  • Stye/chalazion: Eyelid bumps
  • Shingles: If affects eye area
  • Eye injury: Trauma, surgery
  • Orbital cellulitis: Infection around eye

Associated Symptoms

Vision Changes

  • Blurred vision
  • Double vision
  • Vision loss (partial or complete)
  • Halos around lights
  • Flashing lights
  • Floaters or spots
  • Tunnel vision
  • Color vision changes

Eye Appearance

  • Redness
  • Swelling
  • Discharge or tearing
  • Pupil size changes
  • Drooping eyelid
  • Bulging eye
  • Yellow discoloration

Other Symptoms

  • Headache
  • Nausea and vomiting
  • Light sensitivity
  • Facial pain
  • Fever
  • Jaw pain
  • Nasal congestion

Diagnosis and Evaluation

Eye Examination

  • Visual acuity: Vision testing
  • Slit lamp exam: Detailed eye structures
  • Tonometry: Eye pressure measurement
  • Ophthalmoscopy: Back of eye exam
  • Visual field test: Peripheral vision
  • Pupil reactions: Light response

Diagnostic Tests

  • Fluorescein staining: Corneal defects
  • Gonioscopy: Drainage angle exam
  • OCT scan: Retinal imaging
  • Ultrasound: Internal structures
  • CT/MRI: Orbital problems
  • Blood tests: Systemic causes

Treatment Options

Emergency Treatments

  • Acute glaucoma:
    • IV medications to lower pressure
    • Eye drops
    • Laser iridotomy
    • Surgery if needed
  • Chemical exposure:
    • Immediate irrigation
    • Continue 15-30 minutes
    • pH testing
    • Emergency room

Medical Treatments

  • Eye drops:
    • Antibiotics
    • Steroids
    • Artificial tears
    • Pressure-lowering
    • Dilating drops
  • Oral medications:
    • Antibiotics
    • Antivirals
    • Pain relievers
    • Steroids

Home Care

  • Warm compresses
  • Cold compresses for swelling
  • Rest eyes
  • Avoid rubbing
  • Remove contacts
  • Protect from light
  • Clean eyelids gently

Prevention

  • Wear protective eyewear
  • Proper contact lens hygiene
  • Regular eye exams
  • UV protection (sunglasses)
  • Take screen breaks (20-20-20 rule)
  • Good lighting for tasks
  • Manage chronic conditions
  • Avoid eye rubbing
  • Stay hydrated
  • Proper workplace ergonomics

When to Seek Medical Care

Call 911 or Go to ER

  • Sudden severe pain with vision loss
  • Eye pain with nausea/vomiting
  • Chemical in eye
  • Penetrating eye injury
  • Severe pain after eye surgery
  • Bulging eye with pain
  • Loss of vision in any form

See Eye Doctor Urgently

  • Moderate to severe eye pain
  • Eye pain with discharge
  • Light sensitivity with pain
  • Foreign body sensation
  • Pain after contact lens wear
  • Eye pain with headache

Schedule Appointment

  • Mild persistent eye pain
  • Recurring eye discomfort
  • Eye strain symptoms
  • Dry eye symptoms
  • Regular eye exams due