Experiencing a deep ache, throbbing, or sharp pain in the eye can be quite alarming. Eye pain is a widespread complaint with a broad spectrum of possible causes. These range from minor irritations to more serious underlying medical conditions. Understanding the nature and location of the pain can provide important clues about its origin.
Surface-Related Eye Discomfort
Eye pain originating from the surface often stems from external factors or issues with the eye’s outer layers, such as the cornea, conjunctiva, or eyelids. Even a small foreign body, like a speck of dust, an eyelash, or grit, can cause significant pain, often described as a feeling of something being “stuck” or scratching the eye. This can also lead to excessive tearing, redness, and light sensitivity.
A corneal abrasion, a scratch on the clear front surface of the eye, commonly results from minor trauma such as a finger poke or contact lens misuse. This injury typically causes sharp, intense pain, tearing, redness, and sensitivity to light. The cornea’s high density of nerve fibers makes even small abrasions very painful.
Severe dry eye syndrome can also cause eye pain, producing a gritty, burning, or aching sensation, especially with prolonged screen use or in dry environments.
Inflammation of the conjunctiva, conjunctivitis or “pink eye,” can cause irritation, redness, and discomfort. While it typically presents as a dull ache, it still contributes to overall eye discomfort. Symptoms like itching, burning, and a gritty feeling are common with conjunctivitis.
Internal Eye Conditions
Pain originating from within the eyeball can feel deep and aching. Uveitis, an inflammation of the uvea, the middle layer of the eye, can cause a deep, aching eye pain, redness, light sensitivity, and blurred vision. This condition can affect one or both eyes and may be associated with systemic medical conditions. Untreated uveitis can lead to serious complications like cataracts and glaucoma.
Acute angle-closure glaucoma involves a sudden increase in pressure inside the eye. This condition often results in severe, throbbing eye pain that may spread to the head, accompanied by nausea, vomiting, blurred vision, and seeing halos around lights. It is an ophthalmological emergency requiring immediate medical attention to prevent permanent vision loss.
Scleritis, an inflammation of the sclera, the white outer layer of the eyeball, causes intense, deep pain that can radiate to the head or face. This pain is often severe enough to interfere with sleep and can worsen with eye movement.
Optic neuritis, inflammation of the optic nerve, can cause pain, especially when moving the eye. This pain often precedes or accompanies vision changes like blurred vision, dimmed vision, or dull colors. It can affect one or both eyes and may be linked to other health conditions such as multiple sclerosis.
Referred Pain and Other Causes
Sometimes, eye pain is felt in the eye area but originates from other parts of the head or body, known as referred pain. Sinusitis, an inflammation or infection in the air-filled cavities around the eyes and nose, can cause pressure and pain behind or above the eyes. This pain often intensifies with head movements.
Migraine and cluster headaches frequently cause severe pain behind or around one eye. Migraines may be accompanied by sensitivity to light, noise, or odors, as well as nausea and vomiting. Cluster headaches can also present with symptoms such as eye redness, tearing, nasal congestion, or swelling around the affected eye.
Dental issues, especially severe toothaches or infections in upper teeth, can sometimes radiate pain to the eye area. This is due to shared nerve pathways, specifically the trigeminal nerve, which supplies sensation to both teeth and the eye region. Nerve pain conditions, such as trigeminal neuralgia, involve irritation of the trigeminal nerve, leading to severe, sharp, shock-like pain in the face, including around the eye. This pain can be triggered by routine activities like touching the face or brushing teeth.
When to Seek Medical Attention
Any severe, sudden, or persistent “punch-like” eye pain warrants professional medical evaluation. Seek immediate care for sudden vision changes, including blurred vision, double vision, or seeing halos around lights. Medical attention should also be sought quickly if eye pain is accompanied by symptoms such as headache, nausea, vomiting, fever, chills, unusual eye discharge, or extreme sensitivity to light.
Physical signs like a red eye that does not improve, bulging of the eye, inability to move the eye, or any visible foreign object embedded in the eye also necessitate urgent evaluation. Following any eye injury, even if it seems minor, prompt evaluation by an ophthalmologist or an emergency room physician is important to prevent potential permanent damage.