It's hard to ignore pain the eyes, as they are among the most sensitive of all our organs. Pain in one eye ranges in causes and severity, and has a variety of associated characteristics, such as swelling, fever, blurred vision, and more.
10 most common cause(s)
Symptoms of pain in one eye
The eyes are among the most sensitive and important of all of our organs. If anything begins to go wrong with an eye, you will likely notice right away and become very protective of it.
Pain in only one eye is often a symptom of infection following some sort of trauma. Rubbing the eye when it feels dry or itchy can scratch the cornea, which is the clear tissue covering the surface of the eyeball. This will allow bacteria or other infectious agents to enter. [5,14] Eye infections can start suddenly and worsen quickly, so it is important to get professional care for symptoms of pain in one eye symptoms and not try to treat them yourself. [14]
Characteristics:
- Pain in one eye, which is usually severe and of sudden onset.
- Red, swollen, irritated, watery eyes, with discharge.
- Drooping eyelid.
- Seeing white, yellow, or dark spots in your field of vision.
- Blurred or cloudy vision.
- Photophobia, which means a painful sensitivity to light.
- Swollen eyelids.
- Fever, headache, nausea, and vomiting.
- A lesion on the cornea. This will look like the clear tissue of the cornea has turned cloudy and ulcerated.
- Seeing rainbow-like halos around lights.
- Pain in the eye, the top of the head, and the forehead.
- A line of red, blister-like spots on the face near the eye.
Who is most often affected by pain in one eye?
- Contact lens wearers.
- Those who had chickenpox as a child.
- Those who have had an autoimmune disorder, such as rheumatoid arthritis, ulcerative colitis, or type 1 diabetes.
- Those who have had a metabolic disorder such as type 2 diabetes.
- Those who have a serious systemic illness such as tuberculosis, because the infection can spread throughout the body and reach the eye.
- Anyone with a weakened immune system from chemotherapy, radiation therapy, or AIDS.
Is pain in one eye serious?
- A mild irritation that clears on its own within 24 hours is most likely not serious.
- Localized redness, swelling, and mild pain in one eye is probably not a threat to sight, but should still be treated by a medical provider.
- Sudden, severe pain with blurred vision and blank spots can be very serious and may lead to a loss of sight in one or both eyes.
Causes of pain in one eye
Causes include abnormal conditions involving the cornea, outlined in this section.
These are things that make the cornea susceptible to infectious agents:
- Abnormal blinking, meaning the eyelids do not blink rapidly enough or close fully during blinking.
- The cornea may become dry from lack of tears and normal moisture.
- Degenerative disease of the cornea.
- Use of steroid eyedrops.
- Trauma, which can scratch or otherwise damage the cornea and allow infectious agents to get through it.
- Acute injury.
- Surgery.
An actual infection of the cornea, due to:
- Bacteria.
- Contact lenses.
- Wearing lenses overnight or otherwise too long.
- Improper cleaning and storage of lenses.
- Infection of the eyelids that spreads to the damaged cornea.
- Contact lenses.
- Fungus.
- This is usually from plant material (earth, grass, leaves, etc.) being blown into the eyes.
- May also be due to contaminated contact lenses or solution.
Infection of the middle layer of the eye, which is often seen with:
- Autoimmune disorders.
- A weakened immune system.
- Untreated systemic bacterial or viral infections, since the infectious agents can spread through the bloodstream to the eyes.
A build-up of fluid within the eyeball (glaucoma)
- This can put pressure on the optic nerve and cause pain and blind spots.
A flare-up of the virus that causes chickenpox.
- If this occurs near the eye, it can interfere with vision.
Rare and unusual causes:
- Immunocompromised cases, such that person's immune system has been weakened due to illness or treatments such as:
- Chemotherapy.
- Radiation therapy.
- Acquired immune deficiency syndrome (AIDS) or HIV.
This list does not constitute medical advice and may not accurately represent what you have.
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
Pain in one eye treatments and relief
Seek immediate pain in one eye treatment in the emergency room or call 911 if:
- You have sudden, severe pain in one eye along with impaired vision, especially if there appears to be a spot on the surface of the eye. This is a medical emergency that can lead to permanent vision loss. Be sure to bring any contact lenses and cases with you, since the medical providers may want to culture them to find a possible organism causing the problem.
Schedule an appointment for:
- A sore, reddened, irritated eye with moderate pain and some discharge. Bring any contact lenses and cases with you to the appointment.
Pain in one eye remedies that you can try at home:
- For very mild symptoms you can use over-the-counter eyedrops, but if the symptoms do not clear up quickly you must visit a medical provider.
- Be aware of the limitations of wearing contact lenses and learn the proper way to care for your lenses and cases.
- Frequent and thorough hand washing, as well as touching your eyes as little as possible, will help greatly with avoiding any sort of eye infection.
Here are some over-the-counter (OTC) treatment options that may help alleviate your symptoms:
- Artificial Tears: For dryness-related discomfort, artificial tears can provide relief. They help lubricate the eye, reducing pain and irritation.
- Antihistamine Eye Drops: If allergies are the culprit, these drops can help relieve itching and redness.
- Eyelid Cleansing Wipes: For blepharitis or general eyelid hygiene, these wipes can help remove irritants and reduce inflammation.
Questions your doctor may ask about pain in one eye
- Do you feel like there is something in your eye?
- Have you noticed any vision changes?
- Do your eyelids feel sticky?
- Do you have dry eyes?
Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.
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References
2 https://tuh.templehealth.org/content/corneal_diseases_trauma.htm
4 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711963/
5 https://my.clevelandclinic.org/health/articles/contact-lenses/contact-lens-care
6 https://www.cdc.gov/fungal/diseases/fungal-eye-infections/risk-prevention.html
7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5711963/
8 https://nei.nih.gov/health/uveitis/uveitis
9 https://www.ncbi.nlm.nih.gov/pubmed/15488221
10 https://tuh.templehealth.org/content/glaucoma.htm
11 https://eye.keckmedicine.org/the-facts-infections-eye/
14 https://www.aao.org/eye-health/tips-prevention/first-aid-eye-scratches
15 https://tuh.templehealth.org/content/drooping_eyelid_ptosis.htm
16 https://www.mayoclinic.org/diseases-conditions/eye-floaters/symptoms-causes/syc-20372346
17 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5365040/
18 http://www.glaucoma.org.il/glaucoma/sub-types/types
19 https://www.healthline.com/health/allergies/dizziness
20 https://med.nyu.edu/research/zoster-eye-disease-study/zoster-eye-disease-study
21 https://tuh.templehealth.org/content/diabetic_eye_diseases.htm
22 https://www.nicklauschildrens.org/health-information-library/symptoms/eye-pain
23 https://www.sbcc.edu/healthservices/resources/files/handouts/Conjunctivitis.pdf