Eye pain—that stabbing, throbbing, burning, gritty, sharp, aching, “something in my eye” feeling—can be very uncomfortable. Many people seek medical care when they have eye pain, and for good reason. Eye pain can take two forms: ocular pain or orbital pain. The word pain is generally open for interpretation. Some people describe it as in their eyes, around their eyes, behind their eyes, etc. Some people have eye pain with movement, while others experience eye pain when blinking.
Eye Pain Symptoms
Depending on the cause of the eye pain, additional symptoms may include:
- Eye discharge
- Red bloodshot eyes
- Itchy eyes
- Headache or migraine
- Ear ache
- Burning sensation in eye
- Feeling of foreign body in eye
- Vision changes (should be considered a medical emergency)
Eye Pain Causes
As mentioned before, eye pain can be placed into two categories, ocular or orbital. There can be many reasons for eye pain. Most causes should be treated by a primary care doctor or eye care specialist.
Ocular pain comes from the outer structure of the eye and can be caused by any of the following conditions:
- Pink Eye: This is the most common eye problem, and it can be caused by allergies, bacterial or viral infection, or chemical burn. Pain is usually mild.
- Stye or chalazion: Causes eye pain due to irritation. A lump forms within the eyelid and becomes very painful to the touch.
- Blepharitis: Plugged oil glands at the edges of the eyelid become inflamed and cause pain around the eyelids.
- Corneal Abrasions/Ulcers: These two conditions are very common causes of eye pain. Abrasions occur when the cornea is scratched, and ulcers occur from infections of those abrasions. Often this will cause a constant feeling that something is in the eye, which can be as annoying as it is painful.
- Chemical Burn: This can be extremely painful, and is caused by flash burns or exposure to chemicals such as acid.
Orbital pain is usually caused by a disease of the eye, and can be described as a deep, dull ache behind or within the eye itself. Some of the diseases that can cause orbital pain are:
- Glaucoma: Glaucoma in general is mostly painless, but if the pressure builds up very quickly, orbital pain occurs and the condition can become an emergency.
- Migraines: A very common form of eye pain that is associated with headaches.
- Optic Neuritis: This painful condition is the inflammation of the optic nerve, which connects to the back of the eye. Viral or bacterial infections can be the cause of this condition.
- Iritis: The iris is the colored part of the eye, and when this becomes inflamed it can cause a deep pain.
- Trauma: Trauma can be caused by a variety of things, ranging from a blow to the eye with an object to scratches to car crashes. These events can cause terrible eye pain.
Diagnosing Eye Pain
If you are unsure what is causing the eye pain, you should seek medical attention from your eye care provider. He or she will ask you about the severity of your pain and when it started, among other questions. You will also be given a thorough eye examination to rule out certain conditions and diseases. If a correct diagnosis cannot be made based on the eye exam, additional tests may be conducted. These tests may include:
- Tonometry: checks intraocular pressure
- Refraction tests: to see whether you have any refractive problems such as astigmatism
- Visual acuity test: measures how well you can see
- Motility: checks eye movements
Once a correct diagnosis is made an appropriate treatment plan can be created.
Treatment for Eye Pain
If you are experiencing eye pain you should consider seeking medical attention. If you think you know what the problem is and do not feel like you need a doctor, you can try different things at home, such as flushing your eyes with lukewarm water or commercial eye solutions. Also, try to avoid touching or rubbing your eyes, as this usually increases irritation. This will only make the situation worse, and could cause further damage. If the pain is mild, you can try taking over-the-counter pain relievers such as ibuprofen. If you can see the debris in your eye, and flushing your eye out with water has not worked, do not attempt to remove the debris. Instead seek medical attention. In fact, the only thing you should do as a “home remedy” is flush your eyes out with water or solution or take a pain reliever. All other treatments should be performed by a doctor, who can determine whether there are other problems, such as an eye disease. Treatments will vary depending on the severity of the eye pain and the cause of the problem.
When to See an Eye Doctor
If you begin experiencing the following symptoms, seek medical attention immediately:
- Eye is too painful to touch
- Pain is severe
- Sudden vision changes
- Abdominal pain or vomiting accompanies eye pain
Likewise, seek medical attention immediately if any of the following events occur:
- Foreign object in eye
- Chemical burn to eye
- Chemicals splash into eye
In most cases, eye pain is temporary and goes away quickly. Often the eyes become tired and painful after a long day at work, or after several hours of reading or staring at the computer. In other cases, the pain is an indicator of an underlying condition such as optic neuritis, or a problem such as an improper prescription for eyeglasses. In any case, eye pain is usually reason for an examination by an eye care professional.
Talking to Your Eye Doctor
If you have eye pain, contact your eye doctor. Use the following questions to help you get started:
- Which diagnostic tests will be used to diagnose my eye pain?
- Which over-the-counter products will reduce my eye pain?
- Based on the cause of my eye pain, what treatment options do I have?
- Which additional symptoms should I watch for?
- How long will it be before I have relief?
- Why do my eyes ache at certain times of the day and not others?
Did you know…In Nepal, herbal doctors advise people with eye problems to stare at the moon.
- R. Abel, Jr. MD “The Eye Care Revolution” (Kensington Books, 2004) xx
- H. Winter, MD, S. Moore, MD, K. Yoder, MD “Complete Guide to Symptoms, Illness & Surgery” (The Berkeley Publishing Group, 2006) 40
- J. Lavine, MD “The Eye Care Sourcebook” (Contemporary Books, 2001) 222