Eye pain has dozens of possible causes, ranging from a long day staring at a screen to a serious condition that needs immediate treatment. The location, type, and timing of the pain are the biggest clues to what’s going on. Surface-level irritation that feels gritty or burning usually points to something different than a deep, throbbing ache behind the eye.
Surface Pain vs. Deep Pain
The first useful distinction is whether the pain feels like it’s on the surface of your eye or deeper inside or behind it. Surface pain typically involves stinging, burning, itching, or the sensation that something is stuck in your eye. Deep or orbital pain feels more like a pressure, throb, or ache that seems to come from behind or within the eyeball itself.
Surface pain is most commonly tied to dryness, allergies, a scratch on the cornea, or contact lens irritation. Deep pain can signal elevated pressure inside the eye, sinus inflammation, a migraine, or in rare cases an infection of the tissues surrounding the eye. Some people experience burning and light sensitivity that looks like dry eye on the surface but is actually caused by sensitized nerves. The American Academy of Ophthalmology notes that when symptoms don’t match what a doctor sees on examination, nerve-related pain is a likely explanation, especially in people who also have migraines, fibromyalgia, or a history of corrective eye surgery.
Dry Eye Disease
Dry eye is by far the most common reason for ongoing eye discomfort. Conservative estimates suggest that 10 to 20 percent of people over 40 experience moderate to severe dry eye symptoms or seek treatment for them. The pain tends to feel like burning, grittiness, or a tired heaviness, and it often gets worse later in the day, in air-conditioned rooms, or during prolonged reading.
Your eyes stay comfortable when a thin layer of tears coats them evenly. When that tear film breaks down, either because you’re not producing enough tears or because the tears evaporate too quickly, exposed nerve endings on the surface of the eye start firing. Wind, dry air, ceiling fans, and staring at screens without blinking all make it worse.
Preservative-free lubricating drops (artificial tears) are the standard first-line treatment. They temporarily restore that protective moisture layer, relieving burning and minor irritation. If you’re reaching for drops more than four times a day, preservative-free versions are better because the preservatives in regular drops can irritate the surface over time. Redness-relief drops are a different product entirely. They contain chemicals that shrink blood vessels to make your eyes look whiter, but they don’t address the underlying dryness and can cause rebound redness when you stop using them.
Digital Eye Strain
If your eyes hurt most after long stretches on a computer, phone, or tablet, screen time is the likely culprit. You blink about 60 percent less often when focused on a screen, which dries out the eye surface faster. The muscles inside your eye that control focus also fatigue after hours of holding the same near-distance position, producing a dull ache or a feeling of strain around the eyes.
The most practical fix is the 20-20-20 rule: every 20 minutes, look at something roughly 20 feet away for at least 20 seconds. This gives both your focusing muscles and your tear film a break. Positioning your screen at arm’s length and slightly below eye level also helps, because looking slightly downward reduces the amount of exposed eye surface and slows tear evaporation.
Scratched Cornea
A corneal abrasion, or scratch on the clear front surface of the eye, causes sharp, sudden pain that’s hard to ignore. It typically happens when something gets in your eye: dust, sand, a fingernail, a makeup brush, even a contact lens edge. The hallmark feeling is that something is stuck in your eye even after the object is gone, along with watery eyes, redness, blurred vision, light sensitivity, and sometimes swelling of the eyelid.
Most minor scratches heal on their own within one to three days as the corneal surface regenerates quickly. An eye doctor can confirm the diagnosis by placing a yellow fluorescein dye in your eye, which fills in any break on the surface and makes it glow under a blue light. Until a scratch heals, avoid rubbing the eye, and don’t wear contact lenses.
Contact Lens Complications
Contact lenses sit directly on the cornea, so problems with them tend to show up fast. Wearing lenses too long, sleeping in them, or not cleaning them properly can lead to bacterial keratitis, an infection of the cornea. Symptoms include eye pain, redness, blurred vision, light sensitivity, excessive tearing, and discharge from the eye.
The CDC recommends removing your lenses immediately if you notice unusual irritation and calling your eye doctor before wearing them again. Keratitis can progress quickly and, if untreated, may cause permanent scarring that affects vision. Even without a full infection, overworn or poorly fitting lenses can create small areas of oxygen deprivation on the cornea that feel painful and gritty.
Acute Glaucoma
Acute angle-closure glaucoma is rare but serious. It happens when the drainage channel inside the eye suddenly closes off, causing fluid to build up and pressure to spike rapidly. The pain is severe, often described as an intense ache in or around the eye accompanied by a bad headache. Nausea or vomiting, blurred vision, seeing halos or colored rings around lights, and eye redness are the other key symptoms.
This is a medical emergency. Without prompt treatment to lower the pressure, the optic nerve can be permanently damaged within hours, leading to vision loss. If you experience sudden severe eye pain with any combination of the symptoms above, you need emergency care, not a wait-and-see approach.
Sinus-Related Eye Pain
Your sinuses sit directly behind and around your eye sockets, so when they’re inflamed or infected, the pressure can radiate into the eyes as a deep, dull ache. This type of pain often gets worse when you bend forward, feels heavier in the morning, and comes with nasal congestion, facial pressure, or a postnasal drip. It responds to treating the sinus problem itself, whether that means decongestants, saline rinses, or antibiotics if there’s a bacterial infection.
When Eye Pain Needs Emergency Attention
Most eye pain is temporary and resolves with rest, lubrication, or removing whatever’s irritating the eye. But certain combinations of symptoms signal something that can threaten your vision or health if left untreated. Seek emergency care if your eye pain is severe or comes with a headache, fever, or increased light sensitivity. The same applies if your vision changes suddenly, you experience nausea or vomiting alongside the pain, you see halos around lights, or you can’t move your eye or keep it open. Blood or pus coming from the eye, swelling in or around the eye, and pain caused by a chemical splash or embedded foreign object all warrant immediate attention as well.
For pain that’s mild but persistent, lasting more than a couple of days without improvement, an eye exam is worth scheduling. Chronic, low-grade eye pain sometimes reflects a treatable condition like dry eye, an outdated glasses prescription, or early nerve sensitization that responds well to targeted therapy once correctly identified.