What To Know and Do About Eye Pain

Eye pain is common for many people. It's not always a sign of a serious condition and usually resolves within a few days or weeks with minimal treatment. Corneal abrasion (when scratches form on the part of your eye that covers the iris and pupil) and infections like conjunctivitis (pink eye) or sinusitis (inflamed sinuses) are common causes of eye pain.

Ocular migraines, cluster headaches, and optic neuritis are all signs of potentially more serious eye health issues. It's important to monitor your symptoms closely and communicate with your healthcare provider so you can receive any necessary treatment for the underlying cause.

How Eye Pain Presents

How you experience eye pain depends on the part of your eye that’s affected. Some pain may feel like more of a stinging sensation, while other sources of pain may cause burning or itching. The pain can be chronic (long-lasting) or go through periods of flare-ups (short bouts of pain) and remission (when symptoms go away on their own).

You may experience the following symptoms:

• Stinging in both eyes
• Pain when moving the eye
• Photophobia (sensitivity to light)
• Burning, red eyes
• Swollen, itchy eyelids
• Discomfort between the eyes or behind them
• Partial or complete loss of vision

Potential Causes of Eye Pain

Several temporary issues can lead to eye pain. Various chronic conditions can affect the outside and inside of your eyes, as well as the tissues surrounding them. knowing the cause behind your eye pain—whether from an acute or chronic condition—can help you understand what to expect and how to best manage the pain.

If your pain does not come from a chronic condition, you can manage most common causes of eye pain with home treatments. If you don't notice your eye pain getting better, speak with your healthcare provider about options for treatment.

Corneal Abrasion

Corneal abrasion is acute pain caused by a scratch on the eye's cornea, the domed front portion that helps your eyes focus on what is in your line of vision. The scratch can appear if you get injured, put in contact lenses incorrectly, or get something stuck in your eye. Corneal abrasion pain can be severe and cause sensitivity to light (photophobia) and eye redness. 

Stye

Also known as a hordeolum, a stye is a painful, red bump that forms on or inside the upper or lower eyelid. You may experience burning or swelling with a stye for a short period of time. Styes occur when glands within the eyelid become infected by Staphylococcus aureus bacteria.

Dry Eyes

You can develop dry eyes when your eyes aren’t making enough tears to keep them properly lubricated or your tears are evaporating too quickly.

Dry eyes can cause the following symptoms:

• Scratchiness (feeling like there's something in your eye)
• Stinging
• Burning
• Sensitivity to light
• Blurriness
• Redness

As you get older, your risk of dry eyes increases. People assigned female at birth are also more likely to experience dry eyes. Health conditions like Sjögren syndrome, lupus, or other autoimmune conditions can also increase your risk of dry eyes.

Consider consuming more omega-3s and sources of vitamin A to prevent dry eyes.

Pink Eye

Medically known as conjunctivitis, pink eye is an infection of the clear outside membrane (conjunctiva) of your eye that causes burning and irritation. Viruses, allergens, or exposure to pollutants and smoke can cause conjunctivitis.

Typical signs of conjunctivitis include:

• Pink or red color in the whites of your eyes
• Swelling in the conjunctiva or eyelid
• Excess tear production
• Itching
• Mucus or pus discharges from the eye
• Crust on the eyelids or lashes, especially when waking up
• Pain when wearing contact lenses

Blepharitis

Blepharitis is inflammation and irritation at the base, or follicle, of the eyelash, typically brought on by bacterial infection. You may feel a burning or stinging pain if you have blepharitis.

This causes a range of symptoms, including:

• Developing red or swollen eyes or eyelids
• Feeling like something is in your eye
• Having watery or itchy eyes
• Developing light sensitivity
• Seeing foamy tears, tiny bubbles in your eyes
• Experiencing dry eye
• Crusting on the eyelids or lashes upon waking up

You may be more prone to harmful bacteria that cause blepharitis if you have oily skin, rosacea (a skin condition that causes red patches or bumps), or certain allergies. Dandruff on your face or scalp can also cause inflammation.

Sinusitis

Sinusitis is inflammation in the sinuses, which are passages behind your face. This type of inflammation is typically a sign of allergies that many people experience seasonally. Sinusitis can cause mild pain or pressure behind your eyes. You may also experience headaches, nasal discharge, and tooth and ear pain.

Less Common Causes

A range of other conditions can cause acute (short-term) and chronic eye pain. Less common causes include:

• Tear duct infection: Also known as dacryocystitis, tear duct infection arises from a buildup of bacteria, causing pain, inflammation, and redness in the corner of the eye. Pus or excess tears are additional signs. Severe cases of tear duct infection may cause fever.
• Acute angle-closure glaucoma: This medical emergency blocks fluid from leaving your iris (tissue at the front of the eye) and cornea. Pressure builds, leading to sudden and intense pain, swelling, and visual distortions.
• Keratitis: This inflammation of the cornea causes sharp pain, blurriness, and redness in the whites of the eyes. It can result from an infection or wearing contact lenses for too long. If left untreated, it can cause blindness.  
• Scleritis: This is severe inflammation of the sclera (the outside layer of the eye) caused by infection, cancer, autoimmune diseases, or medication or surgery side effects. Symptoms include mild-to-moderate pain that can get worse at night, swelling, redness, blurry vision, and light sensitivity.
• Hyphema: With this condition, blood collects in the anterior chamber of the eye (the front part between the cornea and iris) and causes pain, light sensitivity, and blurriness. Hyphema is typically caused by trauma to your eye.
• Optic neuritis: This inflammation of the optic nerve at the back of the eye is most often linked to multiple sclerosis. You may feel pain with eye movement and also experience blind spots and loss of color perception.
• Anterior uveitis: Injuries, infections, or autoimmune diseases can cause anterior uveitis, an inflammation of the uvea (fluid-filled chamber in the front of your eye). Symptoms include aching pain, light sensitivity, and blurry vision.
• Orbital cellulitis: This is a severe infection of the tissues and muscles surrounding your eye. Symptoms include pain with eye movement, swelling or drooping eyelids, and fever. The condition can lead to vision loss if untreated.
• Ocular migraine: Besides severe eye and headache pain, this type of recurrent headache can cause temporary partial or total loss of vision and visual disturbances.
• Cluster headache: Besides sudden and intense stabbing pain in or around one eye, cluster headaches can cause drooping eyelids, tears, and eye redness.

When To See a Healthcare Provider

Since eye pain can be common, it’s important to know when your symptoms require emergency treatment. In general, you should call your healthcare provider if you have intense pain or discomfort that lasts longer than a few hours.

The following symptoms may also be a sign of severe damage:

• Injury or exposure to harsh chemicals
• Excessive light sensitivity
• Very severe, persistent eye pain
• Abrupt changes in vision, including distortions or loss of vision
• Fever
• Severe headache
• Nausea
• Vomiting
• Leaking blood, fluid, or pus from your eyes
• Seeing auras or halos when you look at lights

How Is Eye Pain Diagnosed?

An optometrist (a doctor who manages eye health) or ophthalmologist (a doctor who treats and can perform surgeries for eye conditions) can find the source of your eye pain using several tests. First, your eye doctor will likely ask about your medical history and the symptoms you are experiencing.

They then might perform some diagnostic tests, including:

• Visual acuity test: The provider uses visual tasks to test your ability to see near or far and track eye movements.
• Fluorescein eye stain: This test involves applying a special dye to the eye and using a blue light to detect scratches or damage to the cornea.
• Tonometry: A device that puffs air into the eye to measure your eye's internal pressure and tests for glaucoma.
• Retinal exam: After dilating your pupils with drops, eye doctors use instruments to evaluate the retina for signs of optic neuritis or anterior uveitis.
• Slit lamp exam: In this alternate way of diagnosing optic neuritis or anterior uveitis, the provider uses a specialized microscope and examines your retina after dilating your pupils.
• Imaging: Magnetic resonance imaging (MRI), computerized tomography (CT) scan, or other imaging tests check for optic neuritis, anterior uveitis, and other eye conditions.
• Blood tests: Your provider may send a blood sample to a lab for testing to check for eye conditions.

How Is Eye Pain Treated?

How your healthcare provider chooses to treat your eye pain depends on the underlying cause. Treatment can include at-home treatment for mild pain or medications and surgeries for more severe cases.

At-Home Care

In many cases, at-home treatment is sufficient for eye pain. Strategies that may help include:

• Using over-the-counter (OTC) artificial tear solutions or eye drops
• Applying cool, wet compresses on affected eyes for 10 minutes at a time multiple times a day
• Taking OTC pain relievers, such as Tylenol (acetaminophen) and Motrin (ibuprofen)
• Reducing your use of contact lenses

Prescription Medications

Your healthcare provider may prescribe you medication to relieve symptoms if needed.

Options for medication vary but may include:

• Oral antihistamines, such as Zyrtec (cetirizine) and Claritin (loratadine)  
• Nasal antihistamines, such as Astepro (azelastine) and Patanase (olopatadine)
• Eye drops such as Restasis (cyclosporine) and Xiidra (lifitegrast) to treat dry eyes
• Prescription-strength artificial tear solutions
• Steroid nasal sprays like Flonase (fluticasone) and Beconase (beclomethasone)
• Oral antibiotics
• Intravenous antibiotics for orbital cellulitis
• Corticosteroid pills or injections
• Triptans (medications used to treat migraines), such as Zembrace Symtouch (sumatriptan) and Zomig (zolmitriptan)

Surgery

Depending on the underlying cause, your pain could benefit from surgery. In rare cases, healthcare providers may suggest surgery to fix damage to your cornea caused by trauma, burn, or chemical exposure to your eye. In some cases, laser treatments can drain excess fluid from the eye to treat acute angle-closure glaucoma.

Lifestyle Changes

Changes to your lifestyle and hygiene practices help prevent and treat eye pain. Steps you can take include the following:

• Reduce how often you wear contact lenses
• Clean and disposing of contact lenses properly
• Wash your hands before touching your eyes
• Dim computer and device screens and keeping them an arm’s length from your face
• Take regular breaks from screens (every 20 minutes, look at something 20 feet away for at least 20 seconds).
• Wear protective eyewear when using chemicals, playing sports, or other potentially hazardous tasks

A Quick Review

Eye pain is not uncommon and can usually resolve on its own. Common causes include styes, pink eye, or sinusitis.

If you experience intense eye pain that won't go away, consider seeing an ophthalmologist or optometrist to find out what may be causing your pain or discomfort.

See a healthcare provider immediately if you notice your vision changing drastically, you have been exposed to harmful chemicals, or have a fever and eye pain.