Most eye pain is temporary and caused by something manageable, like strain, dryness, or a minor irritant. The right response depends on the type of pain you’re experiencing: a gritty, burning sensation on the surface of the eye calls for different steps than a deep, throbbing ache behind it. Here’s how to figure out what’s going on, ease the discomfort, and recognize when you need professional help.
Identify the Type of Pain
Eye pain generally falls into two categories, and telling them apart helps you decide what to do next.
Surface pain feels like burning, stinging, grittiness, or the sensation that something is stuck in your eye. It’s usually caused by dryness, allergies, a scratched cornea, or an infection like conjunctivitis (pink eye). If there’s stabbing pain with discharge, that points toward an infection. If the discomfort is vague and burning, especially in both eyes, dry eye is the most likely culprit.
Deep or orbital pain feels like aching or pressure behind the eye and often gets worse when you move your eyes. This type of pain can come from inflammation inside the eye, sinus pressure, or elevated eye pressure. Conditions like scleritis (inflammation of the white outer wall of the eye) cause a boring, deep pain that intensifies with eye movement because the muscles that move your eyes attach directly to that outer wall. If deep pain comes with vision changes, redness, or nausea, it needs prompt evaluation.
Try These Steps First
If your pain is mild to moderate and you don’t have any alarming symptoms like vision loss, start with basic relief measures at home.
Rest your eyes from screens. Digital eye strain is one of the most common causes of eye discomfort. Follow the 20-20-20 rule: every 20 minutes, look at something about 20 feet away for at least 20 seconds. This gives the focusing muscles inside your eye a chance to relax. If you’ve been staring at a monitor for hours, even a few minutes with your eyes closed can help.
Use artificial tears. Over-the-counter lubricating drops can relieve burning, dryness, and mild irritation. If you’re using them more than six times a day, switch to preservative-free drops. The preservatives in standard eye drops, particularly one called benzalkonium chloride, can actually damage the surface of the eye with repeated use over weeks and months. Preservative-free formulas come in single-use vials and are also the better choice if you wear contact lenses, since preservatives can cling to soft lenses and cause further irritation.
Apply a warm compress for dry, gritty eyes. Many people with chronic dry eye symptoms have blocked oil glands along the eyelid margins. These glands produce the oily layer that keeps tears from evaporating too fast. A warm, damp cloth held over closed eyelids for about five minutes raises the lid temperature enough to soften and unclog the glands. You can repeat this once or twice a day. A cold compress, on the other hand, is better for puffy, swollen, or allergy-irritated eyes.
Flush out irritants. If something got into your eye, rinse it with clean water or sterile saline. Don’t rub it. Blinking rapidly can help dislodge small particles, or try pulling your upper eyelid down over your lower eyelid to trigger tearing that washes the irritant out.
What to Do if You Scratched Your Eye
A corneal abrasion, or scratch on the clear front surface of your eye, causes sharp pain, watering, redness, and sensitivity to light. It can happen from a fingernail, a piece of dust, or even putting in contact lenses too roughly. Minor scratches heal remarkably fast because the cells on the cornea reproduce quickly. Most people feel significantly better within 24 to 48 hours. Larger scrapes take longer.
If you think you’ve scratched your eye, flush it with clean water, avoid rubbing, and keep the eye closed if that’s more comfortable. Don’t patch it with a bandage, as this can trap bacteria against the wound. If the pain doesn’t improve within a day or you notice worsening redness or discharge, have it checked to rule out infection.
Special Concerns for Contact Lens Wearers
If your eyes hurt and you’re wearing contacts, take them out immediately. Contact lenses can trap bacteria against the cornea and cause a serious infection called keratitis. Warning signs include redness, pain that doesn’t resolve after removing the lenses, excessive tearing or discharge, light sensitivity, blurred vision, and difficulty opening your eyelid because of irritation.
Keratitis can lead to permanent vision damage if left untreated, so don’t brush off persistent pain as “just a dry lens.” Avoid sleeping in lenses not designed for overnight wear, and never rinse or store them in tap water. If symptoms continue after you’ve removed your lenses and rinsed your eyes, see an eye care provider the same day if possible.
When Eye Pain Is an Emergency
Some types of eye pain signal conditions that can cause permanent vision loss within hours. Get emergency care if you experience any of these:
- Sudden vision loss or double vision
- Severe eye pain with nausea or vomiting
- Halos around lights with a hard, red eye
- Flashes of light or a sudden increase in floaters
- Eye pain after a direct injury
- Numbness, weakness, confusion, or trouble speaking alongside eye symptoms
The combination of severe eye pain, nausea, and halos around lights is the classic presentation of an acute glaucoma attack. This happens when fluid drainage inside the eye is suddenly blocked, causing pressure to spike from a normal level of around 15 mmHg to as high as 70 mmHg. That’s nearly five times normal pressure, and it can damage the optic nerve rapidly. This is a true emergency that requires treatment within hours.
Eye pain paired with neurological symptoms like weakness on one side of the body, confusion, or difficulty speaking could indicate a stroke or other brain-related problem rather than an eye condition.
What Happens at an Eye Exam
If your eye pain persists beyond a day or two, an eye care provider can pinpoint the cause using several straightforward tests. A slit-lamp exam uses a bright light and magnification to inspect the surface of your eye, eyelids, and the fluid-filled space behind your cornea. This is the best way to spot scratches, infections, and inflammation. It’s painless and takes just a few minutes.
If glaucoma is a concern, tonometry measures the pressure inside your eye. Normal pressure ranges from 8 to 21 mmHg. For a more detailed look at the drainage angle where fluid exits the eye, your doctor may perform gonioscopy, placing a small lens against the eye after numbing it. An ophthalmoscopy exam shines light through the pupil to check the retina and optic nerve at the back of the eye, which helps detect damage from elevated pressure or inflammation.
These tests together give a comprehensive picture of what’s causing the pain, whether it’s something on the surface, pressure building inside, or inflammation deeper in the eye. Most of the exam is quick and painless, and results are usually available the same visit.