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Eye Pain: What Are the Causes and How to Treat Eye Pain

An illustration of two eyes. The outlines are light blue. The irises are medium blue with dark blue pupils. Three yellow lightning bolts emanate from the top of each eye.
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Written by Jack Wilkinson, MD.
Fellow, Cornell/Columbia New York Presbyterian Child Psychiatry Program
Last updated November 27, 2024

Eye pain quiz

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The eye can be affected by painful problems like irritation, injury or infection. Figure out the cause of your right & left eye pain symptoms and relief options.

Symptoms of eye pain

Perhaps you've been staring at the computer screen for hours or you forgot about your contact lenses for a bit too long, and now your eyes don't feel quite right. Vision is precious and eye pain symptoms can be cause for alarm. Eyes are sensitive and there are many causes for eye discomfort, ranging from run-of-the-mill irritation to more serious underlying medical conditions. One such serious condition is optic neuritis, which can lead to eye pain and visual disturbances.

Common characteristics of eye pain

Eye pain can likely be described by the following.

  • Dull, sharp, scratchy, or throbbing
  • Location: It can affect the surface of the eyeball or be felt in deeper structures.
  • Onset: Sometimes there is a provoking factor like injury, though in other cases the pain comes on more gradually and the original cause is not as clear.

Common accompanying symptoms of eye pain

If you have eye pain, it's likely to experience the following as well.

Causes of eye pain

The eye consists of several parts, each of which can be affected by painful problems such as irritation, injury, infection, or keratitis.

Eye anatomy

It is helpful to know the parts of the eye where the most common problems occur:

  • Cornea: This is a thin and very sensitive protective layer that covers the central part of the eyeball including the pupil and iris — the colored area of the eye. Corneal abrasions, or wounds to the cornea, can also cause significant eye pain.
  • Conjunctiva: This protective layer lines the white part of the eyeball (called the sclera) as well as the inner surface of the eyelids.

While irritation to the surface of the eye is most common, eye pain symptoms may also be the result of deeper problems like increased pressure on the eyeball, migraines, or certain nerve issues.

Surface eye pain problems

Pain felt on the surface of the eye may be related to the following.

  • Allergies: Common allergies like hay fever will lead to itchy and scratchy eyes that may also become very red.
  • Dry eye: The eye depends on natural lubricating tears to stay healthy, and without them, it is vulnerable to irritation and injury. Some people simply do not produce enough tears, while certain activities like staring at a computer screen can also lead to dryness.
  • Abrasion: A scratch on the cornea from contact lenses or injury is known to be extremely painful.
  • Infection: Viruses and bacteria can invade the surface of the eye, especially the conjunctiva, and cause pain, redness, and swelling.
  • Foreign body: Anything from an eyelash to a piece of glass can lead to painful eye injuries.
  • Chemical burn: Common household items like cleaning fluid can be dangerous to the eye.
  • Contact lenses: Contacts can be harmful if not removed and cleaned regularly.

Other eye pain problems

Other causes of eye pain may be related to the following.

  • Eyestrain: Struggling to see without correctly prescribed glasses or contacts can be uncomfortable, especially for prolonged periods or in dim light.
  • Increased pressure: Abnormally high pressure behind the eye in conditions like glaucoma can be painful if not properly managed.
  • Headaches and migraines: Pain from these conditions can center around or stem from behind the eye.
  • Nerve pain: The nerve connecting the eye to the brain can become inflamed in certain conditions like multiple sclerosis or optic neuritis.
  • Swelling: Some medications may cause dangerous and uncomfortable swelling around the eyes called angioedema.

This list does not constitute medical advice and may not accurately represent what you have.

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Vernal conjunctivitis

Vernal conjunctivitis is long-term (chronic) swelling (inflammation) of the outer lining of the eyes due to an allergic reaction. Vernal conjunctivitis often occurs in people with a strong family history of allergies, such as allergic rhinitis, asthma, and eczema.

You should visit your primary care physician, where he/she will look at your eyes to inspect for the telltale signs of vernal conjunctivitis. Typical treatments are anti-histamine eye drops, which can be found over-the-counter.

Rarity: Ultra rare

Top Symptoms: wateriness in both eyes, eye itch, eye redness, sensitivity to light, feeling of something in the eye

Urgency: Primary care doctor

Orbital cellulitis

Orbital cellulitis is a serious infection of the bony cavity (the orbit) which holds the eyeball. This condition affects the eye, eyelids, eyebrows, and cheeks, and causes the eyeball to have a swollen appearance. It can cause blindness if the infection is not treated.

You should seek immediate medical care at an urgent care clinic or ER. Antibiotics are given immediately to treat the infection, even before results from the laboratory have come back. You may likely be hospitalized as well.

Inflamed eyelid (blepharitis)

Inflamed eyelid, or blepharitis, is a bacterial infection of the skin at the base of the eyelashes.

If the oil glands around the eyelashes become clogged, normal skin bacteria will multiply in the oil and cause infection. The glands can become blocked due to dandruff of the scalp and eyebrows; allergies to eye makeup or contact lens solution; or eyelash mites or lice.

Symptoms include red, swollen, painful eyelids; oily, dandruff-like flakes of skin at the base of the eyelashes; and eyelashes that grow abnormally or fall out.

If the symptoms do not clear with hygiene, see a medical provider. Blepharitis can become chronic and lead to infections of the eyelids and cornea; dry eyes which cannot take contact lenses; and scarring and deformity of the eyelids.

Diagnosis is made through physical examination of the eyelids, under magnification and through skin swab of the eyelashes.

Treatment includes warm compresses and careful washing of the eyelids; antibiotics in pill or cream form; steroid eyedrops; and treatment for any underlying condition such as dandruff or rosacea.

Rarity: Common

Top Symptoms: eye itch, sensitivity to light, eye redness, feeling of something in the eye, dry eyes

Symptoms that never occur with inflamed eyelid (blepharitis): severe eye pain

Urgency: Self-treatment

Foreign body in the eye

Foreign bodies like windblown grit, wood or masonry, or flecks of metal can land in the eye and get stuck there, causing extreme discomfort.

You should go to an urgent care clinic immediately, where drops can be given to relieve the intense pain and a proper eye exam can be done. Referral to an opthalmologist may be needed if a leak is found from your eye.

Rarity: Uncommon

Top Symptoms: feeling of something in the eye

Symptoms that always occur with foreign body in the eye: feeling of something in the eye

Urgency: In-person visit

Corneal abrasion

Corneal abrasion is a wound to the part of the eye known as the cornea. The cornea is the crystal clear (transparent) tissue that covers the front of the eye. It works with the lens of the eye to focus images on the retina.

You should visit the ER if the pain is bad or the injury to the eye is severe. Otherwise, you can use any pain relieving eye drops and your eye should heal in 1-3 days.

Rarity: Common

Top Symptoms: blurry vision, sensitivity to light, constant eye pain, moderate eye pain, pain in one eye

Symptoms that always occur with corneal abrasion: pain in one eye, wateriness in one eye, constant eye pain

Urgency: Phone call or in-person visit

Contact lens-related eye infection

Millions of people wear contact lens daily without issue; however, there is a risk of infection. Often, infection is avoidable by keeping lenses clean.

Staphylococcus or streptococcus bacteria are often involved, and anything that brings bacteria to the eye can cause conjunctivitis. Touching the eyes with unwashed hands; sharing eye makeup, washcloths, or towels; or improperly cleaning contact lenses are common causes. The same bacteria that cause the sexually transmitted diseases chlamydia and gonorrhea can also cause conjunctivitis.

Most susceptible are children, but anyone can be affected.

Symptoms include a gritty, burning feeling in the eye; discharge or tears; swelling; itching; pink discoloration due to dilated blood vessels; and sensitivity to light.

Diagnosis is made through patient history, physical examination, and careful eye examination. Smears may be taken from the eye for testing.

You should visit an urgent care clinic for an eye exam. It is likely antibiotics will be prescribed. Treatment involves a course of antibiotic eyedrops. It is important to use all of the drops as prescribed, even when the infection seems to improve. Warm compresses over the eyes can help ease the discomfort.

Rarity: Rare

Top Symptoms: eye redness, wateriness in both eyes, sensitivity to light, constant eye redness, eye redness

Symptoms that always occur with contact lens-related eye infection: eye redness, constant eye redness

Urgency: In-person visit

Chronically dry eyes

Dry eye syndrome (medically known as keratoconjunctivitis sicca), occurs when there is a problem with the thin film of tears that keeps the eye moist and lubriated. This is a condition that can affect people of all ages, but becomes more common as one gets older. The causes include aging, some medications, increased evaporation of tears (due to low humidity in the air, low blink frequency, wearing contact lenses, or windy conditions), and underlying illness in rare cases.

You can safely treat this condition on your own with artificial tears, which come as eye drops and gels, and are usually great at relieving symptoms. You can purchase these at a pharmacy. You might want to consider consulting your primary care physician (PCP) if over-the-counter remedies don't help.

Bacterial conjunctivitis

Bacterial conjunctivitis, or pinkeye, is an inflammation of the clear membranes covering the eye. It causes redness, pain, and irritation of one or both eyes.

Staphylococcus or streptococcus bacteria are often involved, and anything that brings bacteria to the eye can cause conjunctivitis. Touching the eyes with unwashed hands; sharing eye makeup, washcloths, or towels; or improperly cleaning contact lenses are common causes. The same bacteria that cause the sexually transmitted diseases chlamydia and gonorrhea can also cause conjunctivitis.

Most susceptible are children, but anyone can be affected.

Symptoms include a gritty, burning feeling in the eye; discharge or tears; swelling; itching; pink discoloration due to dilated blood vessels; and sensitivity to light.

Diagnosis is made through patient history, physical examination, and careful eye examination. Smears may be taken from the eye for testing.

Treatment involves a course of antibiotic eyedrops. It is important to use all of the drops as prescribed, even when the infection seems to improve. Warm compresses over the eyes can help ease the discomfort.

Rarity: Common

Top Symptoms: sore throat, eye redness, eye itch, watery eye discharge, eye redness

Symptoms that always occur with bacterial conjunctivitis: eye redness

Urgency: Primary care doctor

Anterior uveitis

Uveitis is the inflammation of of the blood vessels between the back and the front of the eye. Anterior uveitis is inflammation of the front of the eye: the iris (the round hole that light goes through) and the ciliary body (the muscles and connective tissue behind the eye's surface). Uveitis can affect adults and children, and there's typically no cause that can be identified.

You should go to the ER or walk-in ophthalmology clinic immediately. You cannot shrug off this "pink eye" because there's a possibility of vision loss without treatment. You must see an ophthalmologist within 24 hours for follow-up after your initial treatment.

Acute close-angle glaucoma

Acute closed-angle glaucoma is also called angle-closure glaucoma or narrow-angle glaucoma. "Acute" means it begins suddenly and without warning.

"Glaucoma" means the fluid pressure inside one or both eyes is too high. "Closed-angle" means that the iris – the circular band of color in the eye – does not dilate open properly and blocks the natural drainage mechanism within the eye. The fluid builds up and causes the pressure to increase.

The exact cause of any glaucoma is not known. It may be an inherited trait.

Acute closed-angle glaucoma can be triggered by an extreme dilation of the eyes, as when walking from bright light into total darkness.

Symptoms include sudden eye pain, headache, nausea, blurred vision, and seeing a rainbow-like aura around lights. This is a medical emergency. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through patient history and thorough eye examination.

Treatment involves surgery to correct the dilation and drainage mechanisms of the eyes, as well as prescription eyedrops and oral medications.

Rarity: Rare

Top Symptoms: headache, nausea or vomiting, vision changes, being severely ill, eye pain

Urgency: Hospital emergency room

Eye pain treatments and relief

Though the eyes are vulnerable to injury, it only takes a few simple steps to keep problems at bay. If a problem does arise, you probably already have several remedies available in your medicine cabinet at home. If your eye pain worsens or persists, however, you should consult your physician.

At-home treatment

Treatments for eye pain that you can try at home include the following.

  • Over-the-counter eye drops: Frequent use of lubricating eye drops can slow many eye problems, especially dry eye.
  • Rest: Take short breaks from demanding tasks — like computer work — every 30 to 60 minutes. Look at something further away or out a window to give some of your eye muscles a break.
  • Cold or warm compresses: Temperature change can be soothing to the eyeball but be sure the compress isn't too hot or cold.
  • Allergy medication: Over-the-counter treatments like Zyrtec or Claritin help with itchiness and redness from allergies.
  • Flush with water: If you suspect there is something in your eye, flush with cool tap water on and off for at least 15 minutes before seeking medical attention.

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When to see a doctor

If other methods are not working and your eye pain persists, the following treatments — with the help of your physician — may be beneficial.

  • Slit-lamp exam: An eye doctor can take a close look at both eyes to determine the underlying cause of eye pain such as injury, foreign body, or infection.
  • Glasses or contact lenses: Correcting vision problems is an important step in addressing eye discomfort.
  • Prescription eye drops: A doctor may prescribe more potent eye drops to treat an infection or lower the pressure behind the eye.
  • Surgery: In rare cases, a procedure in the operating room may be necessary to address your eye problem.

When it is an emergency

It is best to seek care right away if you have the following.

  • Injury to the eye
  • Exposure to a foreign object like glass, metal, or chemicals
  • Sudden-onset, severe pain
  • Sudden worsening of an underlying condition: Like glaucoma
  • Pain with new vision problems
  • A protruding eyeball
  • Blood or pus in the eye

Prevention

The best ways to prevent eye pain include the following.

  • Get regular checkups: Seeing an eye doctor at least once per year can detect problems before they become severe.
  • Wear eye protection: When outside, throw on a pair of shades. Use goggles when handling dangerous chemicals like household cleaners or doing work like sanding or welding.
  • Avoid people with eye infections: People with infections like conjunctivitis are extremely contagious. If you must be around them, wash your hands frequently and do not touch your face.
  • Change and clean contact lenses: It's very important to remove your contact lenses each night and clean them according to manufacturer's instructions or you could risk a serious eye infection.

FAQs about eye pain

Will pink eye cause eye pain?

“Pink eye” is the popular term for an infection of the eye, or “conjunctivitis.” Pink eye may present with redness, itchiness, tearing, or a gritty or foreign-body sensation in one or both eyes. Pain is a less common symptom. Other serious medical conditions can cause eye redness and severe eye pain, for which you should seek prompt evaluation from a medical professional.

Can eye pain be caused by a lack of sleep?

Generally, a lack of sleep may cause your eyes to become irritated and bloodshot. The red appearance is due to the blood vessels within the white part of your eye (the “sclera”) dilating, or from irritation of the sclera due to poor lubrication of the surface of the eye. Keeping your eyes open for a prolonged period of time causes them to dry out and strain. Lack of sleep should not lead to significant eye pain.

Does stress cause eye pain?

Stress does not cause eye pain. However, stress can trigger other conditions which may mimic eye pain, such as headaches. You may also be experiencing irritation of the eyes as a result of your work environment (which can be simultaneously stressful). However, stress itself is not a cause of eye pain.

Why do my eyes hurt when they're closed?

Any of the reasons for which your eyes hurt when they are open can cause pain when they are closed. In most conditions, however, closure of the eyes reduces pain as it reduces exposure to light and keeps the eyes lubricated. Eye pain when your eyes are closed may be caused by dry eyes. However, if you find that you experience severe eye pain only when in dimly lit conditions or keeping your eyes closed, you may have angle-closure glaucoma and should seek medical care immediately.

What does it mean when your eye hurts when you blink?

When you blink, your eyelid moves across the surface of your eye (the cornea). Any condition which irritates the cornea may cause eye pain when you blink. Dry eyes, conjunctivitis, a corneal abrasion, or an infection of the eyelid (a stye) may cause eye pain with blinking. Additionally, the presence of a foreign body or trauma of the eye can lead to such symptoms.

Questions your doctor may ask about eye pain

  • Do your eyelids feel sticky?
  • Have you noticed any vision changes?
  • Do you have dry eyes?
  • Have you ever been diagnosed with a psychiatric issue, such as depression, bipolar, schizophrenia, or anxiety disorder?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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References

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