Eye Pain: What Are the Causes?

Eye pain can be a very irritating condition to have, as it can greatly affect an individual's day-to-day normal activities. Eye pain or irritation can be of various types. It can be felt as a sharp, shooting, burning, dull, gritty, stabbing sensation or a feeling of a foreign body in the eye, aching, pressure like sensation, throbbing type of pain etc. Whatever the nature of eye pain or irritation, it makes the patients feel very uncomfortable and it needs to be looked into immediately. In some cases, eye pain can be confused with other symptoms like headache, sinus pain, toothache or a migraine.Eye Pain

Eye pain can occur in any part of the eye, such as it can occur on the surface of the eye or deep, inside the eye from its inner structures. Eye pain occurring on the surface of the eye is usually felt as itching, burning or shooting pain. It is mostly due to presence of a foreign object in the eye or an eye infection or basically anything which can cause irritation or inflammation of the eye membrane. On the other hand, eye pain originating from deep within the eye is usually felt as throbbing or aching type of pain. This may be due to a serious medical condition.

If the eye pain is very acute or intense and is accompanied by any amount of vision loss, it is an indication of a serious medical condition and requires attention urgently.

Classification and Types of Eye Pain

The type of eye pain depends on the cause, but there are two primary types of pain based on its location.

  1. Ocular Eye Pain: This type of eye pain occurs on the external side of the eye, like pain on the surface of the eye and the surrounding structures of the eye such as the inner eye lids. It usually consists of burning, irritation, shooting pain, and can be accompanied by itching.
  2. Orbital Pain: This type of pain feels as though it is coming from deep inside the eye or from behind the eye. It is located in the internal portion of the eye and is felt as a throbbing or a dull ache.

Where Does It Hurt?

Sometimes discomfort or pain results from a problem in your eye or the parts around it, such as:

Blepharitis: An inflammation or infection of the eyelid
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.
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.

Causes and Risk Factors of Eye Pain

  • Allergies
  • Blepharitis
  • Blocked tear duct
  • Sty
  • Chalazion
  • Cluster headacheProblem due to contact lens
  • Abrasion of the cornea
  • Corneal ulcerations
  • Dryness of the eyes
  • Ectropion
  • Entropion Foreign object in the eye
  • Glaucoma
  • Inflammation of the sclera (scleritis)
  • Injury/trauma
  • Iritis (inflammation of the colored part of the eye)
  • Optic neuritis
  • Conjunctivitis (Pink eye)
  • Sinusitis
  • Migraines
  • Blocked oil gland
  • Uveitis
  • Chemical /flash burns.

Sign and Symptoms of Eye Pain

  • Symptoms of eye pain depend of the cause of eye pain. Eye pain is often accompanied by other symptoms such as:
  • Pain in or around the eye area.
  • Partial or complete loss of vision.
  • Extreme light sensitivity.
  • Double vision.
  • Halos which are colored circles or halos around lights.
  • Floaters such as spots, strings, or shadows before the eyes.
  • Restriction in normal eye movement.
  • Pain upon movement of the eye.
  • Feelings of flashes of light.
  • Intense headache with eye pain.
  • Redness of the conjunctiva.
  • Redness that is flaring out and surrounding the iris.
  • Irregular pupil shape.
  • Protrusion or bulging of the eye.
  • Swelling or redness of the surrounding eye structures such as eyelids.
  • Blood or pus in the front of the eye.
  • Eye discharge.
  • Excessive tearing in the eye.
  • Crusting of the eyes or sticking of eyelids together (especially upon awakening).
  • A scratch to the cornea or eyeball.

When is eye pain an emergency?

If you begin experiencing vision loss in addition to eye pain, this may be a sign of an emergency situation. Other symptoms that need immediate medical attention include:

  • severe eye pain
  • eye pain caused by trauma or exposure to a chemical or light
  • abdominal pain and vomiting that accompanies eye pain
  • pain so severe it’s impossible to touch the eye
  • sudden and dramatic vision changes

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.

Sources:

Eye Pain: What Are the Causes? by Whitney Seltman, OD on August 26, 2020

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At Golden Eye Optometry, we view good vision care as front line protection at every age. A routine eye exam can detect more than poor vision. It can shed early light on glaucoma, macular degeneration, cataracts and diabetes.

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