What Causes Pain Behind the Eye? 10 Causes

Troy Bedinghaus, OD
·7 min read

Medically reviewed by Johnstone M. Kim, MD

Pain behind the eyes could have several possible causes, including eye-related causes like dry eye syndrome and problems unrelated to the eyes, like migraines. The pain can feel like a dull ache, sharp pain, explosive pain, or a deep headache. Eye pain or headaches behind the eye may happen along with other symptoms such as red eyes, tearing, sensitivity to light, and vision changes.

Your eye doctor or another healthcare provider will need to evaluate your eye health to find the source of the pain. A proper diagnosis isn't always easy.

This article explores the symptoms and possible causes of pain behind the eyes plus when you need to call your healthcare provider about it.

Illustration by JR Bee, Verywell  
Illustration by JR Bee, Verywell



Takeaway

Don't ignore persistent pain behind your eyes. It's usually not serious. But sometimes it signals a serious condition.



Related: What Causes a Sharp Pain in the Eye?

What Causes Pain Behind the Eye?

A lot of things can cause pain behind the eyes. Some of them are eye-related or vision-related while others just happen to cause pain there.

Eye Strain

Eye strain is common in people who spend a lot of time looking at screens, such as people who work with computers. You may also experience eye strain after spending time reading, driving long distances, or doing another activity where you are required to look at something for long periods of time. Glare, poor lighting, and underlying vision problems can also contribute.

Eye strain can be prevented by taking frequent breaks and making sure you are seated at a comfortable distance from the thing you are looking at.

Eye strain can be treated with rest and over-the-counter artificial tears.

Vision Problems

Poor vision is sometimes behind eye pain. It can go along with:

This pain isn't caused by the vision problem itself. It's caused by the eye and brain trying to make up for the vision deficit. Squinting and intense focusing cause pain to build up inside and behind the eye.

The type of eye pain may be treated with new corrective lenses. You may also be able to make changes to your environment that can help. Ask your eye doctor for suggestions.

Related: An Overview of Eye Strain (Asthenopia)

Migraine

People with migraines often complain about throbbing pain behind one eye.

Hormones can play a role in migraines. But environmental triggers can cause a migraine to develop. These can include:

  • Stress

  • Certain smells

  • Flashing strobe lights

  • Eating something you're allergic to

Migraine treatment can include:

  • Prescription medications (triptans, steroids, opioids, and more)

  • Injected or infused medications

  • Neuromodulators (devices that stimulate the nervous system with magnets or electrical currents)



Takeaway

Some people with migraines have strange visual auras that restrict their peripheral vision. These generally go away in less than 20 minutes.



Cluster Headaches

Cluster headaches are extremely painful headaches that cause pain behind the eyes. They can come on suddenly and reoccur at regular intervals over a 24-hour period. They may also be tied to seasonal changes.

Scientists believe the hypothalamus in the brain may be involved. The hypothalamus controls the way your nervous system and endocrine (hormonal) system interact.

Your hormones fluctuate in patterns during the day and over the seasons. Cluster headaches tend to follow a similar pattern.

Cluster headaches affect men more often than women. Treatments include:

  • Prescription medications for pain (triptans, local anesthetic, injections)

  • Prescription medications for prevention (steroids, calcium channel blockers)

  • Procedures such as nerve blocks and nerve or brain stimulation

Tension Headaches

Tension headaches are the most common type of headache. Symptoms can include pain behind and around the eyes as well as in your forehead and temples. Neck pain is also common.

This type of headache happens because of overtight muscles in the neck and scalp. You may get a tension headache if you sleep in an uncomfortable position or if you clench your jaw when you're asleep. You can also get a tension headache after you've been doing close work for long periods of time.

Tension headaches are usually treated with over-the-counter pain medications such as Tylenol (acetaminophen), although they will often go away on their own after a few hours. Some people have chronic tension headaches that require evaluation by a healthcare provider.

Sinusitis

Sinusitis is inflammation of the sinuses. It and sinus infection can cause pain around the eyes.

You have sinus cavities around the bony orbit that houses your eyeball. So sinus pain can develop in and around the eye.

This pressure behind the eye is usually accompanied by other symptoms such as:

  • Facial headaches

  • Fever

  • Cough

  • Congestion

  • Sinus drainage

  • Weakness

  • Fatigue

Treatments depend on suspected causes. They may include:

  • Antibiotics

  • Decongestants

  • Pain relievers

  • Applying heat

  • Saline nasal sprays

  • Vaporizers

Some people only have isolated incidents of sinusitis. For others, it may recur often or become chronic.

Dry Eyes

Dry eye syndrome is more than just dryness. It can cause a wide range of symptoms, including:

  • Itching, burning, or stinging

  • Red eyes

  • Light sensitivity

  • Blurry vision

  • Feeling like something is in your eye

You have many options for treating dry eye syndrome. They are:

Simple solutions like using a humidifier can also help.

Scleritis

The sclera is the tough outer coating of the eyeball. Scleritis is inflammation that develops inside the sclera.

Scleritis causes pain behind the eye or when the eye moves. You may also notice redness and light sensitivity.

Depending on the cause, scleritis may be treated with:

  • Oral steroids

  • Topical steroids

  • Immunosuppressive drugs



Dry Eyes, Scleritis, and Autoimmunity

Dry eye and sclerosis are common symptoms of several immune-system diseases, especially:



Learn More: 5 Ways Lupus Affects Your Eyes

Optic Neuritis

Optic neuritis can cause pain behind the eye or with eye movement. It's an inflammatory condition of the optic nerve, which connects the eyes to the brain.

The optic nerve plugs into the back of your eye. Moving your eyes can tug on it. When the nerve is inflamed, that causes pain.

Optic neuritis may be tied to the development of multiple sclerosis. Treatment generally involves intravenous (IV) steroids followed by oral steroids.

Dental Issues

Dental problems can cause pain in other parts of the face, including the eyes. This type of pain happens with the nerves that travel to your eyes carry pain from the jaw.

Eye pain caused by dental issues can be treated by correcting the underlying problem. Make sure to see a dentist if you develop a tooth or gum infection or other dental problems.

Home Remedies for Pain Behind the Eye

Some causes of eye pain require a visit to your healthcare provider. For minor issues, however, you can try home remedies to help reduce the pain. Some of these include:

  • Warm or cold compresses

  • Staying hydrated

  • Resting

  • Following the 20-20-20 rule for screen time (20 minutes of screen time, followed by 20 seconds of looking away for at least 20 seconds)

  • Over-the-counter pain medication or antihistamines

When to See a Healthcare Provider

Call your healthcare provider or seek emergency medical attention if:

  • Eye pain is severe and/or persistent

  • You also have a headache or fever

  • You have extreme light sensitivity or see halos around light

  • Your vision changes suddenly

  • You have swelling in and around the eyes

  • It's hard to move your eyes or keep them open

  • Blood or pus are coming from your eyes



Takeaway

Sudden pain behind the left eye could be a sign of a brain aneurysm, which requires emergency medical treatment. Other symptoms that may indicate a brain aneurysm include:

  • Severe headache

  • Nausea and vomiting

  • Vision problems and light sensitivity

  • Drooping eyelid

  • Stiff neck

  • Loss of consciousness



Related: Do You Need a Headache Specialist?

Summary

Pain behind the eyes can be caused by a variety of conditions. It may be tied to vision problems, dry eyes, or inflammation of the structures of the eye.

It may also be felt behind the eyes while having nothing to do with the eyes themselves. Sinus pressure, migraines, and cluster headaches can all cause pain in that area.

Related: Nearsightedness vs. Farsightedness: What Are the Differences?

Read the original article on Verywell Health.