Eye pain
Ophthalmalgia; Pain - eye
Pain in the eye may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also feel like you have a foreign object in your eye.
This article discusses eye pain that is not caused by injury or surgery.
The eye is the organ of sight, a nearly spherical hollow globe filled with fluids (humors). The outer layer (sclera, or white of the eye, and cornea) is fibrous and protective. The middle layer (choroid, ciliary body and the iris) is vascular. The innermost layer (retina) is sensory nerve tissue that is light sensitive. The fluids in the eye are divided by the lens into the vitreous humor (behind the lens) and the aqueous humor (in front of the lens). The lens itself is flexible and suspended by ligaments which allow it to change shape to focus light on the retina, which is composed of sensory neurons.
A slit-lamp, which is a specialized magnifying microscope, is used to examine the structures of the eye (including the cornea, iris, vitreous, and retina). The slit-lamp is used to examine, treat (with a laser), and photograph (with a camera) the eye.
Considerations
Pain in the eye can be an important symptom of a health problem. Make sure you tell your health care provider if you have eye pain that does not go away.
Tired eyes or some eye discomfort (eyestrain) is most often a minor problem and it will often go away with rest. These problems may be caused by the wrong eyeglass or contact lens prescription. Sometimes they are due to a problem with the eye muscles.
Causes
Many things can cause pain in or around the eye. If the pain is severe, does not go away, or causes vision loss, seek medical attention immediately.
Some things that can cause eye pain are:
- Infections
- Inflammation
- Contact lens problems
- Dry eye
- Acute glaucoma
- Sinus problems
- Neuropathy
- Eyestrain
- Headache
- Flu
Home Care
Resting your eyes should relieve discomfort due to eye strain.
If you wear contacts, try using glasses for a few days to see if the pain goes away.
When to Contact a Medical Professional
Contact your provider if:
- The pain is severe (call immediately), or it continues for more than 2 days
- You have decreased vision along with the eye pain
- You have chronic conditions like arthritis or autoimmune problems
- You have pain along with redness, swelling, discharge, or pressure in the eyes
What to Expect at Your Office Visit
Your provider will check your vision, eye movements, and the back of your eye. If there is a major concern, you should see an ophthalmologist. This is a doctor who specializes in eye problems.
To help find the source of the problem, your provider may ask:
- Do you have pain in both eyes?
- Is the pain in the eye or around the eye?
- Does it feel like something is in your eye now?
- Does your eye burn or throb?
- Did the pain begin suddenly?
- Is the pain worse when you move your eyes?
- Are you light sensitive?
- What other symptoms do you have?
The following eye tests may be done:
- Slit-lamp examination
- Fluorescein examination
- Eye pressure check if glaucoma is suspected
- Pupillary response to light
If the pain seems to come from the surface of the eye, such as with a foreign body, the provider may put anesthetic drops in your eyes. If the pain goes away, that will often confirm the surface as the source of the pain.
References
Cioffi GA, Liebmann JM. Diseases of the visual system. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 391.
Demirayak B, Yilmaz Tugan B, Toprak M, Çinik R. Digital eye strain and its associated factors in children during the COVID-19 pandemic. Indian J Ophthalmol. 2022;70(3):988-992. PMID: 35225557
Dupre AA, Vojta LR. Red and painful eye. In: Walls RM, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 18.
Pane A, Miller NR, Burdon M. Unexplained eye pain, orbital pain or headache. In: Pane A, Miller NR, Burdon M, eds. The Neuro-ophthalmology Survival Guide. 2nd ed. Philadelphia, PA: Elsevier; 2018:chap 12.
Rusciano D, Bagnoli P, Gallar J, Galor A. Eye pain: editorial etiology and therapeutic approaches. Front Pharmacol. 2022;13:914809. PMID: 35571104
Swartz MH, Hirshaut V. The eye. In: Swartz MH, ed. Textbook of Physical Diagnosis: History and Examination. 8th ed. Philadelphia, PA: Elsevier; 2021:chap 10.
Version Info
Last reviewed on: 11/8/2023
Reviewed by: Franklin W. Lusby, MD, Ophthalmologist, Lusby Vision Institute, La Jolla, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
