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What is Pain in My Eyes? How to Diagnose

Almost everybody will experience some form of eye pain at some point in their life. In most cases, it simply heals on its own. However, eye pain can be an indication of a more serious issue as well. This is why it is very important to always seek medical advice if you experience it.

Common Causes of Eye Pain

Usually, eye pain happens when the eye or any of the structure around the eye has a problem. The parts that can be affected include:

  • The cornea, which is the front of the eye’s clear window that helps the eye to focus on incoming light
  • The sclera, which is the white part of the eye
  • The conjunctiva, which is a very thin film that covers the sclera and protects the inner parts of the eyelid
  • The iris, which is your eye’s colored part, the middle of which is the pupil
  • The extraocular muscles, which help your eye to rotate
  • The nerves, which are responsible for carrying the messages the eye receives from the brain
  • The eyelids, which cover the eye below and above. The eyelids protect all other elements of the eye and also spread moisture, in the form of tears.

Symptoms Often Experienced Together with Eye Pain

Most people who have eye pain will also experience other symptoms. It is important to pay attention to these, as they can be indicative of the root issue. Common symptoms include:

  • Discharge, which can be yellow and thick or clear
  • Decreased vision
  • Headaches
  • Feeling like there is a foreign body, like a grain of sand, is lodged in the eye
  • Tearing
  • Red eyes
  • Waking up with crusty eyelids

There are numerous things that can cause eye pain. Let’s review some of the most common ones.

Blepharitis

This is an infection or inflammation of the eyelid itself. Pain and irritation are symptomatic of this.

Conjunctivitis

Many people refer to this as ‘pink eye’, due to the pink appearance of the sclera. Infections (bacterial or viral) and allergies usually cause this. When the blood vessels that are found inside the conjunctiva are inflamed, the sclera starts to appear red. Most people also experience discharge from the eye and itchiness.

Corneal Abrasion

This essentially means that your cornea has been scratched. This is often a very painful condition. It is very easy to damage the cornea simply by touching it, but also from tennis balls, tree branches and more. It is vital to have this condition checked out by a medical professional who can prescribe antibiotic and numbing drops. Luckily, the condition can improve with proper care.

Keratitis

This is an infection of the cornea. It is most often caused by a viral or bacterial infection, usually in people who leave their contact lenses in overnight. Others experience it because they do not properly clean and disinfect their contact lenses. Medical care and changing contact lenses usually solves the problem.

A Foreign Body

Anything can get stuck in the eye – plant debris, dirt, contact lens pieces. In most cases, this only causes a minor irritation. Your eye will produce more tears to wash it out, and you can give your eye a helping hand through an eye bath. However, if the foreign body isn’t removed, it can cause an abrasion.

Glaucoma

Usually, people with glaucoma do not experience any kind of early symptoms. The exception is acute angle-closure glaucoma. This means that the inside of the eye experiences a sudden rise in pressure. When this happens, most people experience severe eye pain, headaches, and vomiting and nausea. Additionally, their vision usually gets worse. This is an emergency situation and immediate treatment must be received, as it can lead to blindness.

Uveitis or Iritis

This is caused by a type of inflammation on the inside of your eye. A number of things can cause this, including autoimmune conditions, infections or trauma. Most people experience red eyes and pain, and it is also common for vision to get worse.

Optic Neuritis

This is an inflammation of the optical nerve, which travels from the eyeballs back to the brain. It is often caused by autoimmune conditions like multiple sclerosis, although an infection can also lie at the heart of it. Most people experience pain, full loss of vision and extreme discomfort if they move their eyes from side to side.

Sinusitis

A lot of people are surprised to hear something as common as sinusitis can affect the eye. This is because the eyes are connected to the sinus cavities (this is why you can taste eye drops, and why your tears actually drain out your nose). Hence, if there is an infection in the sinus, the eyes are affected too, usually because of pressure.

Hordeolum

A hordeolum is known as a sty, which is a painful inflammation or infection that usually appears on the outside of the eyelid. Some people experience it on the inside of the eyelid, which is even more uncomfortable. A sty is usually a pus-filled pocket that appears when the follicles of the eyelashes are inflamed, or the oil glands are infected. The condition is painful but usually clears up on its own.

Dry Eye

Dry eye is a condition that often starts to become painful over time. It is a chronic condition and many people find that each flare-up is slightly worse than the previous one. As it is a very common condition, there is a range of treatment options available over the counter. The pain experienced is generally an irritation across the entire surface of the eye.

Anxiety

Interestingly, quite a bit of research is now indicating that, sometimes, eye pain is of a psychological nature, or rather that a psychological disorder, namely anxiety, causes disruptions in the body that lead to eye pain. For instance, people who are anxious often:

  • Have dilated pupils, as they are constantly in ‘fight or flight mode’. The body’s natural response to this is to dilate the pupils so that it can see the perceived danger better. However, long dilation will feel painful as it is exposed to too much light, similar to staring directly into the sun.
  • Strain their eyes, as they find it difficult to focus. People who need prescription glasses but don’t wear them also often experience eye pain, as they have to strain in order to see properly. The same happens with people suffering from anxiety, mainly due to pupil dilation.
  • Experience migraines, which can also be experienced behind the eye. They often come with pain and a feeling of being able to see sparkles and stars within your peripheral vision.
  • Tense their muscles, as they are stressed. A number of muscles are connected to the eyes and tensing these will eventually lead to pain.

Tests to Diagnose Eye Pain

If you do experience eye pain, it is very important that you seek medical advice, as it can be indicative of something more serious. This is particularly true if you also suffer from nausea and/or vomiting, headaches and decreased vision. A doctor or ophthalmologist will be able to use a number of different tools in order to diagnose what is going on. These tools include:

  • A tonometer, which is an instrument that gauges pressure. This is vital if glaucoma is suspected.
  • Dilating drops, which will enable the doctor to see what is actually happening inside of the eye.
  • Slit lamp examinations, whereby bright lights are used to see how the eye’s structure is performing.

Treatments for Eye Pain

The table below highlights some of the most common treatments for eye pain. Because there are so many different potential causes for eye pain, there are also many different treatments. This further highlights why it is so important to seek medical advice, as many treatments are available over the counter but won’t actually improve certain conditions.

Condition Treatment
Conjunctivitis ·         Antihistamines, either as drops or in pills, can help if the conjunctivitis is caused by allergies.

·         Antibacterial drops can be prescribed in cases of bacterial conjunctivitis.

Corneal abrasion Antibiotic ointments, which usually also have numbing agents to prevent you from wanting to rub your eyes and to lower the feelings of pain and discomfort.
Corneal infections Prescription antibacterial or antiviral drugs may be required depending on the infection.
·         Glaucoma ·         Eye drops will be prescribed as a matter of urgency.

·         Pills can be prescribed to help lower the pressure behind the eye.

·         Surgery is offered if conventional medication is ineffective.

Iritis Prescription eye drops are usually given for this. Depending on the cause, they can be antiviral, antibiotic or steroid.
Optic neuritis Corticosteroids
Sty Warm compresses to be applied at home
Dry eye ·         Over the counter drops or gels

·         Prescription drops or gels

·         Warm compresses

·         Vitamin supplements

When to See a Doctor

Clearly, from the above, eye pain could be indicative of a medical emergency, so you should always go and see a doctor as soon as possible. If you experience any of the following symptoms as well, you must travel to your nearest eye infirmary or intensive care unit:

  • The pain started straight after or while you were sawing wood, grinding metal, or taking part in any other type of activity that could have led to a sharp object entering your eye. This is even more vital if you were not wearing protective eyewear or glasses.
  • You know that your eye is injured and this is causing the pain.
  • You experience sensitivity to light, your vision is blurred and your pain is severe.
  • You have recently had cataract surgery, a LASIK procedure or any other type of medical procedure to your eyes.
  • You experience redness and significant eye discharge.
  • You know you are at risk of glaucoma and severe pain came on suddenly. This could point to angle-closure glaucoma, which rarely can cause rapid and permanent blindness.
  • Never take any chances when it comes to your eyes. Always see a doctor and have the problem diagnosed and properly treated. In so doing, you also stand the best chance of keeping your vision.

Resources and References:

What Causes Eye Pain? 26 Possible Conditions – Causes of pain in the eyes. (Healthline)

Eye Pain – Information on eye pain. (MedicineNet)

Eye Pain – Information on pain in the eyes. (eMedicineHealth)

Eye Pain – Causes of eye pain. (Mayo Clinic)

Eye Health Guide – Information on eye health. (WebMD)

Eye Pain: Symptoms, Causes and Treatment – Information on eye pain. (Eye Health Web)

Eye Pain – Information on pain in the eyes. (NIH.gov)

Eye Pain Consumer Manual – General information on eye pain. (MSD Manual)