Headache Behind Eyes
Identifying the Cause and Getting Treatment
Medically reviewed by Smita Patel, DO
Headaches behind the eyes can cause sharp, stabbing, or dull pain. You may feel pain behind one or both eyes, in the temples, eyebrows, or other parts of your face. Sinus or tension headaches or primary headache disorders can cause these headaches. Various factors, such as eye strain, stress, and certain foods, can trigger headaches behind the eyes.
This article discusses what headaches behind the eyes feel like, the types of headaches that cause this issue, and what you can do to find relief.
Illustration by Mira Norian for Verywell Health
Describing Headache Pain Behind Eyes
Headache pain behind the eyes can take different forms depending on the type of headache. Symptom onset, duration, and location can affect how your pain feels.
Sensations
There is considerable variability in what people mean when they say they feel a headache behind their eyes. Common manifestations include:
Pain pushing out: The pain can feel like it’s pushing out from inside your head or originating in the back of one or both eyes.
Sinus pain: It may feel like pain and pressure coming from the sinuses (hollow spaces in the skull, including behind the eyes, the forehead, the bones in the nose, and the cheeks), a common symptom of sinusitis (sinus infection).
Throbbing pain: With some headaches, eye pain is sharp, pulsing, or burning.
Dull pain: Some headaches cause more sustained pain that's often felt as dull pain or pressure in the face or eye.
Light sensitivity: You may also feel light sensitivity—pain and discomfort in the eye when exposed to light—a feature of several headache types.
Symptom Onset
How quickly symptoms set in also depends on the headache type. Migraine and cluster headaches cause prodromes—changes in mood or behavior for one to two days before the headache and other symptoms. These may also cause aura—changes in vision, hallucinations, muscle weakness, speech difficulties, and nausea—for 30 minutes to several hours before onset.
With cluster headaches, pain comes on suddenly and is intense, with the symptoms lasting 15 minutes to one hour. Migraine, tension, and other types of headaches have a more gradual onset and can last for several hours to days.
Other Facial Pain Locations
Headaches behind the eyes can also spread to or affect other parts of the face. Tension headaches can cause pain to spread across the temples, scalp, or jaw. Cluster headaches, which cause pain inside or around one eye, can cause pressure and pain in the face to spread to the neck.
What Type of Headache Is an Eye Headache?
Headaches behind the eyes belong to two categories, as follows:
Primary headaches occur when symptoms arise independently of an external cause. They include tension headaches, migraines, and cluster headaches.
Secondary headaches are caused by illness, a health condition, or other distinct causes.
For example, sinus pressure, eye strain, dehydration, medication use or withdrawal, and infection or inflammation can lead to secondary headaches.
Causes and Risks Factors of Eye Headaches
Headaches occur when headache triggers stimulate the trigeminal nerves on either side of your temples. These paired nerves receive sensory information from the scalp, blood vessels inside and outside the skull, the tissue surrounding the brain (meninges), and the face, ears, eyes, neck, jaw, and throat. The trigeminal nerves respond to headache triggers and send this information to the brain, resulting in pain.
This stimulation can be caused by a range of conditions, including symptoms of diseases, health conditions, and certain features of headache disorders.
Tension Headache
Nearly 80% of the population experiences tension headaches at some point. Tension headaches cause dull, two-sided, mild to moderate pressure or pain behind the eye due to muscle tension in the shoulders, jaw, neck, or scalp. Postural problems and mental health conditions, like anxiety and depression, may also contribute to tension headaches.
Eye Strain
Eye strain occurs when your eyes get tired from overuse. It can lead to difficulties focusing, achy eye muscles, teary or heavy eyes, and pain or pressure in the eye. Eye strain is caused by excessive screen use, reading small print, exposure to bright light, or sitting too close to a screen.
Migraine
Migraines cause recurring, often severe, attacks of severe, sharp headaches, often on one side of the head. They can last anywhere from four hours to several days. Migraines can cause nausea and other symptoms. They frequently affect vision, sometimes causing temporary blindness to visual distortions. The exact cause of migraines is unknown.
Headache Triggers
Headache triggers vary from person to person and include:
Alcohol, often red wine
Bright or flashing lights
Certain foods, such as cured meats, dark chocolate, caffeine
Certain odors, smoke, or fumes
Changes in weather
Cold, flu, or sinus infection
Dehydration
Emotional distress, stress
Excessive physical exercise or exertion
Insufficient or too much sleep
Loud noises
Menstruation, menopause, or hormonal shifts
Overexertion, physical strain
Physical tension
Skipping meals
Teeth grinding or clenching (bruxism)
Cluster Headache
Cluster headaches cause recurring attacks of sharp, stabbing pain in or around one eye. They can last up to several hours but typically peak within 10 minutes. A swollen, red nose and teary eyes are additional symptoms of cluster headache episodes. Cluster headaches occur multiple times a day during specific periods of the year.
Sleep Apnea and Headaches Behind the Eyes
Obstructive sleep apnea (OSA) causes sleep interruption due to difficulties breathing at night. It can cause snoring, poor sleep, periods of choking at night, and other symptoms. OSA can also trigger headaches in the morning, which can affect the eyes. Researchers found that 29% of those with OSA reported morning headaches.
Sinusitis and Infections
Sinus infections (infections to the passages behind the nose, below the eyes, and above the mouth) are another common cause of eye headaches. Allergies, viruses, bacteria, and fungal infections can cause the tissues lining these passages to become inflamed.
Sinus headaches cause a feeling of tightness and pressure that affects the eye, face, or teeth, with additional symptoms including runny nose, cough, loss of smell, fatigue, and fever.
Additionally, headaches may be a feature of the common cold, influenza (the flu), or other infections. Furthermore, brain infections or those of the meninges (the tissue surrounding the brain) are rare but cause headaches behind the eyes.
Hormonal Shifts
Shifts in estrogen levels (the female sex hormone) can cause headaches and trigger migraine attacks, which can lead to eye pain. Headache is a common feature of premenstrual syndrome (PMS), along with mood swings, uterine cramps, irritability, anxiety, insomnia, and food cravings, among other symptoms.
Medication Overuse Headache
Taking too many pain-relieving medications can worsen headaches. Prescription opioid medications such as Oxycontin (oxycodone), Vicodin (hydrocodone), or morphine can trigger primary headaches and migraines, resulting in a medication overuse headache.
Eye Conditions
Specific eye conditions can cause headaches and other symptoms. Glaucoma is an eye condition that commonly causes headaches. It is a progressive disease affecting the optic nerve behind the eye. Glaucoma causes intense eye pain and a gradual loss of peripheral (side) vision. If left untreated, it can cause blindness.
Risk Factors
Certain health factors can put you at greater risk of developing a headache behind your eyes, such as:
Alcohol use or smoking
Anxiety disorder, depression
Dry eye disease (chronically dry eyes, a risk factor for migraine)
Excess weight, obesity
Family history of headaches or headache disorders
Having a sleep disorder, such as insomnia or narcolepsy
Working with screens (for eyestrain)
People assigned female at birth are more prone to migraine and tension headaches, while those assigned male at birth are more likely to develop cluster headaches.
How to Relieve Eye Pain From Headache
Headache eye pain relief is individual and can take some trial and error. Common strategies for finding relief include:
Breathing exercises, meditation, or other relaxation techniques
Drinking water
Going to a quiet, dark place to lie down and take a nap
Placing an ice pack or cool towel over your temple and eyes
Taking over-the-counter (OTC) pain medications, such as Motrin or Advil (ibuprofen)
Treatments Based on Eye Headache Cause
The treatment for headache behind the eye depends on the underlying cause. Often, home remedies are sufficient, but for chronic or recurring eye headaches, options range from medications to medical procedures.
Trigger Tracking
An important step in managing tension, migraine, and cluster headaches involves tracking your triggers. Log your symptoms, medications, and dietary and sleep habits. Once you identify the foods, drinks, behaviors, and other triggers, you can work to avoid them whenever possible, preventing attacks.
Medications
If nonprescription medications or other methods don't yield results for migraine, cluster, or tension headaches, healthcare providers can prescribe several classes of drugs to treat your symptoms, such as:
Calcium-channel blockers: Medications typically prescribed to treat high blood pressure work by stabilizing blood vessel walls and regulating blood flow to the brain.
Triptans: These medications increase serotonin and decrease the brain's pain threshold.
Anticonvulsants: These medications work similarly to triptans by increasing neurotransmitters and decreasing the body's pain response.
Beta-blockers: Medications typically used to treat high blood pressure offer headache relief.
Certain antidepressants: Some antidepressants affect certain neurotransmitters, such as serotonin, providing migraine relief.
Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a talk therapy that focuses on changing your thinking and behaviors regarding pain. During CBT, you work with a therapist to identify and challenge negative thoughts about your condition. Your therapist will also support you in making lifestyle changes to help prevent attacks.
Nerve Stimulation
In severe, complex migraine and cluster headache cases, healthcare providers consider electrical stimulation, which involves using a device applied to the skin to direct electricity to nerves involved with pain perception. This approach is meant to scramble pain signaling.
There are several options for electrical stimulation, including the following:
Vagus nerve stimulation (VNS)
Trigeminal nerve stimulation (TNS)
Occipital nerve stimulation (ONS)
Biofeedback
Biofeedback involves wearing devices that measure biological signs of muscle tension. With this information, healthcare providers can help you learn to identify when stress and tension may set off migraines or tension headaches and work to treat or prevent them.
When to See a Healthcare Provider
Since headaches can severely affect your quality of life and signal more severe conditions, it’s essential to know when you need help. Call a healthcare provider if you experience the following:
Headaches accompanied by fever, stiff neck, vomiting, or nausea
Headaches interfering with your daily life
Headaches that worsen over 24 hours
History of cancer or immune system disorders, including human immunodeficiency virus (HIV)
More severe headaches than any others you’ve had before
New headache problems (if you are over 50)
Pain while chewing, unexplained weight loss, or vision problems alongside headaches
Severe headaches in one eye, causing redness
Slurred speech, difficulty with coordination and movement, confusion, or vision changes
Symptoms following a head injury
When Headache Is a Medical Emergency
If your headache symptoms set on very quickly in an explosive, violent manner, it may be due to a ruptured blood vessel. Call 911; this is a medical emergency.
Summary
Several conditions can cause headaches behind the eyes. The pain can be sharp or dull and localize in one or both eyes depending on the type of headache. Headaches behind the eyes can result from infections or other diseases, come after head trauma, or arise from primary headache disorders like migraine or cluster headache, among other conditions.
Treatments for headaches behind the eyes include home remedies, working to identify and avoid headache triggers, medications, and medical procedures. It's critical to seek care for headaches since they can significantly impact your quality of life and signal a more severe condition.
Read the original article on Verywell Health.
