Eye Pain:
What Are the Causes?
Nearly everyone has had sore eyes at some point. Sometimes they get better on their own, but they can also be a sign of something more serious.
Your eye doctor can figure out what's going on and find the right treatment for you.
Where Does It Hurt?
Sometimes discomfort or pain results from a problem in your eye or the parts around it, such as:
- Cornea: The clear window in the front of your eye that focuses light
- Sclera: The whites of your eyes
- Conjunctiva: The ultra-thin covering of your sclera and the inside of your eyelid
- Iris: The colored part of your eye, with the pupil in the middle
- Orbit: A bony cave (eye socket) in your skull where the eye and its muscles are located.
- Extraocular muscles: They rotate your eye.
- Nerves: They carry visual information from your eyes to your brain.
- Eyelids: Outside coverings that protect and spread moisture over your eyes.
Common Eye Problems
Blepharitis: An inflammation or infection of the eyelid which typically is not painful
Conjunctivitis (pinkeye): This is inflammation of the conjunctiva. It can be from allergies or infections (viral or bacterial). Blood vessels in the conjunctiva swell. This makes the part of your eye that’s usually white look red. Your eye could also get itchy and gunky. This condition is typically not painful.
Corneal abrasions: That’s the official name for a scratch on this part of your eye. It sounds minor, but it can hurt. It’s easy to do, too. You can scratch your eye while rubbing it. Your doctor will give you antibiotic drops. It should get better in a couple of days without further problems.
Corneal infections (keratitis): An inflamed or infected cornea is sometimes caused by a bacterial or viral infection. You may be more likely to get it if you leave your contacts in overnight or wear dirty lenses.
Foreign bodies: Something in your eye, like a bit of dirt, can irritate it. Try to rinse it out with artificial tears or water. If you don’t get it out, it can scratch your eye.
Glaucoma: This family of conditions causes fluid to build up in your eye. That puts pressure on your optic nerve. If you don’t treat it, you could lose your sight. Most of the time there are no early symptoms. But a type called acute angle-closure glaucoma causes pressure inside your eye to rise suddenly. Symptoms include severe eye pain, nausea and vomiting, headache, and worsening vision. This is an emergency. You need treatment ASAP to prevent blindness.
Iritis or uveitis: An inflammation inside your eye from trauma, infections, or problems with your immune system. Symptoms include pain, red eye, and, often, worse vision.
Optic neuritis: An inflammation of the nerve that travels from the back of the eyeball into your brain. Multiple sclerosis and other conditions or infections are often to blame. Symptoms include loss of vision and sometimes deep discomfort when you look from side to side.
Sinusitis: An infection in one of your sinuses. When pressure builds up behind your eyes, it can cause pain on one or both sides.
Stye: This is a tender bump on the edge of your eyelid. It happens when an oil gland, eyelash, or hair follicle gets infected or inflamed. You may hear your doctor call it a chalazion or hordeolum.
Other Symptoms
Eye pain can happen on its own or with other symptoms, like:
- Less vision
- Discharge: It can be clear or thick and colored
- Foreign body sensation -- the feeling that something is in the eye, whether real or imagined
- Headache
- Light sensitivity
- Nausea or vomiting
- Red eye or pinkeye
- Tearing
- Your eye is crusted shut with discharge when you wake up.
Other symptoms along with sore eyes can be a clue to what is causing the pain.
Tests to Diagnose Eye Pain
See your eye doctor if you have eye pain, especially if you have less vision, headache, or nausea and vomiting.
Eye doctors use a variety of tools to diagnose eye pain:
- A slit-lamp exam uses bright light to look at all the structures of your eye.
- Dilating drops expand your pupil to let the doctor see deep into your eye.
- A tonometer is a tool that measures eye pressure. The doctor uses it to diagnose glaucoma.
Treatments
Just as causes can vary, so do treatments. They target the specific cause of eye pain.
Conjunctivitis: Antibacterial eyedrops can cure bacterial conjunctivitis. Antihistamines in the form of eyedrops, a pill, or a syrup can improve conjunctivitis from allergies.
Corneal abrasions: These heal on their own with time. Your doctor might prescribe an antibiotic ointment or drops.
Glaucoma: You’ll get eyedrops and maybe pills to reduce pressure. If they don't work, you may need surgery.
Infected cornea: You may need antiviral or antibacterial eyedrops.
Iritis: The doctor will treat this with steroid, antibiotic, or antiviral eyedrops.
Optic neuritis: It's treated with corticosteroids.
Styes: Use warm compresses at home for a few days.
The only way to sort out the causes of eye pain and to get the right treatment is to see a doctor. Your vision is precious. Protect it by taking eye pain seriously.
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