If you experience eye pain, a range of conditions could be at play. The severity and type of pain will usually help a doctor to determine what is going on. It is very important that you seek medical attention whenever you have a problem with your eyes. While it is most likely nothing, there could be something serious going on.
Causes of Eye Discomfort
As previously mentioned, eye discomfort can be caused by a number of conditions. The following symptoms could be indicative of what the actual problem is.
- Sore, dry eyes
If your eyes are dry and sore, and if you experience a gritty feeling, you could have dry eye syndrome (DES). Interestingly, this could also make your eyes water a lot, producing excess tears. These tears are of poor quality, however, which means they don’t actually lubricate your eyes.
- Sore, red, itchy eyes
In this case, it is more likely that you have a bacterial or viral infection, or that you are suffering from an allergy. Most of the time, the soreness comes from excessive, often involuntary rubbing. Conjunctivitis, or pink eye, is the most common type of infection that can lead to sore eyes, although it could also simply be from wearing contact lenses for too long.
- Sharp pain in the eye
This could be caused by a trauma to the eye, or by a migraine. Although rare, a sharp pain in the eye can be indicative of something more serious, including an aneurysm, brain tumor, or acute glaucoma. In these cases, you will usually also experience photophobia (extreme sensitivity to light), see halos around your peripheral vision, and experience vomiting and nausea. You must seek immediate medical attention.
- Dull pain
If your pain is dull and aching, or if it feels as if it is deep in your eyeball, you may simply have used your eyes too much and strained the muscle. Give your eyes some TLC and rest. If it does not subside, you must seek medical attention, as it could be glaucoma.
Causes of Sore Eyes
A number of common and less common causes can be at the heart of your painful eyes. These include:
- Corneal scratches or abrasions
- Foreign objects in the eye
- Tiredness
- Infections
- Allergies
- Medical conditions
Warning Signs
In most cases, pain in the eye or sore eyes is not indicative of any serious problem. If, however, you experience any of the following symptoms as well, you must go to the emergency room straight away:
- Seeing halos
- Nausea or vomiting
- Loss of vision or changes in vision
- Muscle aches, fatigue, chills, or fever
- Proptosis, whereby the eye bulges
- Not being able to properly move the eye in any or all directions
Eye Discomfort Diagnosis
When you consult doctors about your sore eyes, they will first ask about the symptoms you are experiencing and they will review your medical history. Next, they will perform a physical examination. If they cannot determine the cause of the pain there and then, further tests will be done.
During your visit, you will need to explain:
- How the pain feels
- When the pain started
- How severe the pain is
- Whether there is pain when you move your eyes or when you blink
They will also look at how well you can see, whether there is any swelling or redness in the eyes, and how your pupils respond to light.
In most cases, all these tests are done not so much to diagnose a condition, but to rule out serious issues. By the power of deduction, it will be determined whether you are experiencing an emergency or not. Some of the things they will try to rule out include:
- Whether you have a disorder of your cornea. You will usually have pain, tearing, and redness of the eye.
- Whether you have a foreign object in the eye. Generally, you will actually feel this being present.
- Whether there is a scratch or ulcer on your eye, which is particularly common if you wear contacts.
- Whether you are suffering from glaucoma, which causes pressure in your eye.
The table below highlights some of the possible causes of eye pain, their common features, and how they are diagnosed.
| Cause | Features | Test |
| Contact lens keratitis, which is an inflammation of the cornea caused by excessive use of contact lenses | · Usually affects both eyes
· Eye hurts and feels gritty · Eye is red and teary · Light sensitivity may be present |
Physician examination |
| Corneal abrasion or foreign body in the eye | · Symptoms start after acute injury to the eye
· Injury may not have been noticed if the patient is young · Pain when blinking · You may feel as if the object is still there · Redness and tearing · Light sensitivity |
Physician examination |
| Corneal Ulcer | · Gray patch on the cornea, or open sore
· Ache · Feeling like there is something in the eye · Redness and tearing · Light sensitivity · Possible injury to the eye · Can happen if people sleep with contacts |
Physician examination as well as ulcer culture taken by an ophthalmologist |
| Epidemic keratoconjunctivities, which is an inflammation of the conjunctiva | · Usually affects both eyes
· Ache and gritty feeling · Redness, tearing, light sensitivity · Swelling of the eyelid · Possible vision blurring |
Physician examination |
| Herpes simplex keratitis | · Usually only in one eye
· Follows conjunctivitis · Blisters and crusting · Redness, watering, pain, light sensitivity, impaired vision |
Physician examination |
| Herpes zoster ophthalmicus | · Usually only in one eye
· Rash, blisters, crustiness on the face · Redness, tearing, light sensitivity, swelling |
Physician examination |
| Welder’s keratitis | · Usually in both eyes
· Happens after significant UV light exposure |
Physician examination |
| Closed angle glaucoma | · Severe pain and redness
· Photophobia · Vomiting, nausea, headache |
Specialist examination required, including tonometry and gonioscopy by an ophthalmologist |
| Anterior uveitis | · Light sensitivity
· Aches · Redness · Loss of vision or blurring · Common in people who have experienced an eye injury and also suffer from an autoimmune disorder |
Physician examination |
| Endophthalmitis | · Usually only affects one eye
· Ache, redness, light sensitivity · Decreased vision · Common in people with serious eye injuries or eye surgery |
Physician examination, as well as a fluids culture by an ophthalmologist |
| Optic neuritis | · Mild pain
· Pain when moving the eye · Complete or partial vision loss · No visible signs on cornea or eyelids |
MRI with radiopaque dye |
| Orbital cellulitis | · Usually only in one eye
· Eye bulges · Redness, deep pain, aches · Swollen, red eyelids · Loss of movement in the eye · Impaired or lost vision · Fever · Can start with sinusitis |
CT or MRI |
| Orbital pseudotumor, which is a benign inflammation | · Aches, sometimes severe
· Bulging · Difficulty moving the eye · Swelling |
CT or MRI, biopsy |
| Scleritis | · Extreme pain
· Light sensitivity · Watering · Violet or red patches on the white of the eye · Common in people with autoimmune disorders |
Physician examination |
| Migraine | · Pain behind the eye
· Light sensitivity · Halos in peripheral vision |
Physician examination |
| Sinusitis | · Some swelling
· Nasal discharge that is green or yellow in color · Possible blood in mucus · Headaches · Facial pain · Fever |
CT |
Sore Eyes Treatment
Treatment of sore eyes depends on the cause. Most of the time, simple painkillers are enough, although opioid drugs may be required. Generally speaking, over the counter remedies and eye drops are sufficient. In the vast majority of cases, something quite simple is actually going on. This includes such things as dry eye syndrome or simple allergies and hay fever. However, because your eyes are so sensitive, it is very important to never simply assume that it is a simple condition and will go away on its own. Unfortunately, if something is actually wrong, there is a chance of permanent loss of vision occurring. Hence, it is always better to be safe than sorry.
Resources and References:
Eye Discomfort and Redness – Symptoms of eye discomfort and redness. (Mayo Clinic)
Pain in Eye – Conditions associated with pain in the eye. (American Academy of Ophthalmology)
