It is a common and often startling sensation when your eyes hurt while coughing. This experience is usually benign, though it can be unsettling. Several factors contribute to this discomfort, ranging from temporary pressure changes within the body to underlying conditions that increase eye sensitivity. Understanding these causes can help alleviate concern and provide clarity on when medical attention might be beneficial.
Understanding Pressure Changes
Coughing is a forceful action causing significant pressure changes in the body. When you cough, muscles in your abdomen and chest contract, causing a sudden increase in intra-abdominal and intrathoracic pressure. This pressure surge can be substantial, sometimes exceeding 300 mmHg.
This temporary pressure can transmit to the head and eye area, affecting the delicate structures around the eyes. The Valsalva maneuver, a related action, also temporarily increases intraocular pressure (IOP), the fluid pressure inside the eye. While the change in IOP can be small, individual responses vary, with some experiencing significant increases. This brief pressure elevation can lead to a transient ache or sharp pain, which resolves quickly once the cough subsides.
The Sinus Connection
The sinuses, air-filled cavities located near the eyes, play a role in eye pain during coughing. These include sinuses located below, between, behind, and above the eyes. Conditions such as sinusitis, an inflammation or infection of the sinuses, can cause congestion and pressure in these areas. Allergies and the common cold also lead to sinus inflammation.
When coughing, the increased pressure within the head can further press on these already inflamed or congested sinus cavities. This can result in referred pain felt in or around the eyes, even though the discomfort originates from the irritated sinus structures. Symptoms of sinusitis include facial pain or pressure around the eyes, cheeks, and forehead, which can worsen when bending over or moving the head.
Existing Eye Conditions and Sensitivity
Pre-existing eye conditions or general eye sensitivity can make a person more prone to experiencing pain during a cough. Conditions such as dry eyes, an imbalance in tear production or tear film drying, can cause irritation and make eyes more sensitive. Eye strain, often from prolonged visual tasks, can also lead to discomfort, including headaches and sensitivity.
Conjunctivitis, or pink eye, involves inflammation of the conjunctiva, the membrane covering the white part of the eye and inner eyelids. This inflammation can make the eyes feel gritty, itchy, or painful, and can be viral, bacterial, or allergic. If the eyes are already irritated or inflamed from these conditions, slight pressure changes or muscle contractions during a cough can intensify discomfort. Allergies, including hay fever, can also increase eye sensitivity, causing symptoms like itchy, watery, and red eyes, which may ache more readily with coughing.
When to Consult a Doctor
While eye pain when coughing is often temporary and harmless, certain signs warrant medical evaluation. You should seek medical attention if the pain is persistent or worsens over time. Any vision changes, such as blurriness, double vision, or sudden loss of vision, are significant “red flag” symptoms.
Additional concerning symptoms include severe headaches, eye redness accompanied by pain, eye discharge, or increased sensitivity to light. A fever with eye pain, or pain without coughing, also indicates a need for medical assessment. These symptoms could point to more serious underlying conditions, such as glaucoma, orbital cellulitis, or retinal detachment, which require prompt diagnosis and treatment.