Pain under the eye with each blink can be an uncomfortable sensation. This discomfort, localized to the bone below the eye, often raises questions about its cause. While many cases are benign and resolve on their own, understanding the potential reasons can help determine when professional evaluation is needed.
Understanding the Causes of Pain
Pain in the bone under the eye during blinking can stem from various sources. A frequent cause is dry eye syndrome, where insufficient or poor-quality tears lead to friction. With each blink, the eyelid drags across a dry ocular surface, creating irritation perceived as pain in the surrounding bony structure.
Inflammation of the eyelid margins, known as blepharitis, is another common culprit, where oil glands near the eyelashes become clogged or infected. This condition can cause redness, itching, and a gritty sensation, and the swelling and irritation can extend to the adjacent bone, making blinking painful. Similarly, a stye, an acute infection of an oil gland in the eyelid, or a chalazion, a non-infectious blocked gland, can create localized tenderness and swelling that radiates pain to the bone under the eye during eye movement.
Beyond the eyelids themselves, issues within the eye can also contribute to this specific pain. Conjunctivitis, an inflammation of the clear membrane covering the white part of the eye and the inside of the eyelids, can cause generalized eye discomfort, including a feeling of pressure or pain that seems to originate from the orbital bone when blinking. Even prolonged eye strain from activities like reading or computer use can lead to muscle fatigue around the eye, manifesting as a dull ache perceived in the bony area.
Sinus-related problems frequently cause pain in the facial bones, including those around the eyes. Sinusitis, an inflammation of the sinus cavities, particularly the maxillary sinuses located under the eyes or the ethmoid sinuses between the eyes, can exert pressure on the surrounding structures. This pressure often intensifies with head movements or blinking, leading to a sensation of pain in the bone beneath the eye. Allergic reactions that cause significant swelling around the eyes can also mimic this pain, as fluid retention and inflammation put pressure on the orbital region.
Infections or inflammation of deeper tissues can also be a source of discomfort. Dacryocystitis, an infection of the tear sac located near the inner corner of the eye, can cause swelling and tenderness that radiates along the orbital bone, making blinking uncomfortable. More seriously, orbital cellulitis, a bacterial infection of the tissues surrounding the eye, presents with severe pain, swelling, and often vision changes, and the pain is distinctly felt in the bony orbit with eye movement.
Trauma, even minor impacts to the area, can bruise the periosteum, the membrane covering the bone, leading to localized pain that is exacerbated by blinking. This can include a direct bump or even repetitive rubbing of the eye. Less commonly, referred pain from dental issues, such as an infection in an upper tooth, can manifest as pain around the eye area, including the bone, due to shared nerve pathways.
When to Seek Medical Attention
While many instances of pain under the eye when blinking are mild and temporary, certain symptoms warrant prompt medical evaluation. If the pain is severe, rapidly worsening, or accompanied by vision changes like blurriness, double vision, or loss of sight, seek immediate attention. A fever alongside eye pain suggests a potential infection requiring urgent treatment.
Significant swelling, redness, or warmth around the eye, especially if it spreads or is accompanied by pus-like discharge, indicates a serious underlying condition. Other concerning signs that should prompt a visit to a healthcare professional include:
- Difficulty moving the eye
- A bulging eye
- Light sensitivity
- Any recent injury to the eye or surrounding area, if pain persists or intensifies
- Pain accompanied by a severe headache, facial numbness, or weakness
Managing Discomfort and Seeking Treatment
Initial steps to manage discomfort in the bone under the eye can involve simple self-care measures, particularly if the pain is mild and without alarming symptoms. Applying a warm compress to the affected area for 10-15 minutes several times a day can help soothe inflammation and promote drainage from blocked glands. Resting the eyes and avoiding prolonged screen time can also alleviate strain that may contribute to the discomfort. Over-the-counter pain relievers, such as ibuprofen or acetaminophen, may help reduce pain and inflammation temporarily.
The definitive treatment for pain under the eye when blinking depends entirely on an accurate diagnosis by a healthcare professional. If dry eyes are the cause, artificial tears or prescription eye drops that promote tear production may be recommended to lubricate the eye surface. Bacterial infections like conjunctivitis or orbital cellulitis require antibiotic eye drops or oral antibiotics to eliminate the pathogen.
For conditions like blepharitis or styes, a doctor might advise specific eyelid hygiene routines, including warm compresses and gentle eyelid scrubs, and sometimes prescribe antibiotic ointments. Allergic reactions causing eye and facial swelling are often managed with antihistamines, either oral or in eye drop form, to reduce the inflammatory response. Sinusitis may be treated with decongestants, nasal corticosteroids, or, in bacterial cases, antibiotics to clear the infection and reduce pressure. A professional diagnosis ensures that the underlying cause is addressed appropriately, leading to effective and lasting relief.