Eye Pain: Why Do My Eyes Hurt?

What Are the Possible Causes of Eye Pain?

Causes Related to the Eye

Corneal Conditions

Keratitis

Keratitis is an inflammation of the cornea caused by various factors:

• Infections: Bacteria, viruses, or fungi can infect the cornea and trigger inflammation.

• Corneal Injuries: Scratches or trauma to the cornea can lead to pain and increased sensitivity to light.

• Contact Lens Misuse: Improper use or cleaning of contact lenses can increase the risk of corneal inflammation.

Corneal Ulcers

Ulcers on the cornea are extremely painful and result from infections or injuries. Infections may be caused by bacteria or the herpes simplex virus.

Refractive Errors

If you suffer from a refractive error that is either uncorrected or inadequately corrected, your eyes can become quickly strained, which may cause pain. The most common types of refractive errors that can lead to eye pain include:

• Short-Sightedness (Myopia): Distant objects appear blurry.

• Long-Sightedness (Hyperopia): Focusing on nearby objects can cause strain and discomfort.

• Astigmatism: This condition leads to distorted or blurry vision and can result in eye discomfort.

Glaucoma

Glaucoma is a condition in which elevated intraocular pressure damages the optic nerve, leading to irreversible vision loss. In some cases, glaucoma can cause acute episodes of severe pain accompanied by nausea and vomiting.

High Tension in the Eye Muscles

Extended periods of intense close-up work, such as reading for hours or staring at screens, can overstrain the eye muscles. This can result in a pressing or burning sensation in the eyes.

Eye Muscle Inflammation

Inflammation of the eye muscles, known as ocular myositis, can have various causes, including autoimmune diseases. This condition leads to pain during eye movements, swelling, and sometimes double vision (diplopia).

Causes in the Eye Socket and Surrounding Areas

Sinusitis

Sinusitis, or inflammation of the sinuses, can put pressure on the eyes, causing dull pain and a sensation of pressure around the eyes.

Migraines

Migraine attacks can cause severe, throbbing pain around the temples and eyes. A specific type of migraine, known as "ocular migraine" or "migraine with aura," may also involve visual disturbances like flickering lights, flashes, or blurred vision.

Foreign Bodies in the Eye

The presence of dust, sand, or other foreign objects in the eye can cause irritation and pain. In some cases, this may also lead to corneal injuries.

Infections

Infections in the eye socket or surrounding areas, caused by bacteria or viruses, can result in pain, redness, and swelling. Conjunctivitis (pink eye) is a common example.

What Symptoms Can Accompany Eye Pain?

Eye pain can be accompanied by a range of additional symptoms. Here are some common symptoms associated with eye pain:

• Redness of the Eyes: Eye redness, often referred to as "bloodshot eyes," is a frequent symptom of eye pain. It indicates increased blood flow to the eyes.

• Feeling of Pressure: A sensation of pressure in or around the eyes often occurs alongside eye pain. This symptom may be caused by increased intraocular pressure, sinusitis, or migraines.

• Foreign Body Sensation: Feeling as though there is something in your eye is a common symptom associated with eye pain. Even a loose eyelash resting on the surface of the eye can cause this sensation.

• Light Sensitivity: Sensitivity to light, also known as photophobia, is a common symptom of eye problems. It may be linked to eye inflammation, migraines, or other conditions.

• Watery Eyes: Excessive tearing, medically known as epiphora, can occur when the eyes are irritated or inflamed. This is often the body’s way of protecting the eyes by keeping them moist or washing away a foreign object.

• Blurred Vision: Eye pain can sometimes lead to temporary blurred vision.

• Headaches: Eye pain may occasionally be accompanied by headaches, particularly if caused by migraines or excessive strain on the eye muscles.

• Swelling: Swelling around the eyes can occur due to inflammation, infections, or allergic reactions.

What Can I Do Myself to Relieve Eye Pain?

If you’re experiencing eye pain, there are some steps you can take to alleviate the discomfort. Here are a few helpful tips:

Home Remedies

• Rinse Your Eyes: Gently rinse your eyes with lukewarm water to remove any irritants or foreign particles.

• Moisturise Your Eyes: Use artificial tears or eye drops to hydrate and soothe dry eyes.

• Compresses: Apply warm or cold compresses to your closed eyelids to reduce pain and swelling. Use a warm compress for tension and a cold compress for inflammation.

Sufficient Rest and Sleep

• Sleep: Ensure you get enough quality sleep, as fatigue and lack of rest can worsen eye pain.

• Breaks During Screen Time: Take regular breaks, especially when working at a screen for extended periods. Blink frequently and focus on distant objects to relax your eye muscles.

• Dark Room: Rest in a dark room if you’re experiencing light sensitivity or migraines to help soothe your eyes.

Hygiene and Precautions

• Contact Lenses: If you wear contact lenses, make sure to care for and clean them properly to avoid infections or irritation.

• Eye Protection: Wear protective glasses in windy or dusty environments to prevent foreign objects from entering your eyes.

• Make-up Removal: Thoroughly remove your make-up, especially mascara, to prevent blocked tear ducts and related discomfort.

Nutrition and Hydration

• Healthy Diet: Follow a balanced diet rich in omega-3 fatty acids and vitamins essential for eye health.

• Water Intake: Stay well-hydrated by drinking enough water to ensure your eyes remain adequately moisturised.

When Should I See a Doctor About Eye Pain?

It’s important to take eye pain seriously and consult a doctor promptly in certain situations. Eye pain can indicate a variety of health issues, some of which may be serious. If you’re unsure or experiencing severe symptoms, seeking professional medical advice immediately is crucial for an accurate diagnosis and appropriate treatment.

Here are some signs and circumstances that mean you should see a doctor without delay:

Sudden and Sharp Pain

If your eye pain comes on suddenly and intensely, particularly if accompanied by headaches, nausea, or vomiting, this could indicate acute glaucoma or a migraine. These conditions require urgent medical attention.

Changes in Vision

If you notice sudden changes in your vision, such as blurred vision, double vision, flashes of light, or a “curtain” across your field of view, this is a serious warning sign. It could point to a retinal detachment, vascular blockages, or other significant eye problems.

Eye Injuries

If you’ve suffered an injury and foreign objects have entered the eye, seek medical help immediately to prevent further damage or infections. Avoid trying to remove the object yourself.

Persistent Pain and Discomfort

If your eye pain persists for an extended period or occurs repeatedly, it’s essential to see an eye doctor to determine the cause. This is particularly important if the pain is accompanied by redness, swelling, or discharge.

Eye Infections

Symptoms like intense itching, discharge, pus formation, or visible signs of an eye infection require a doctor’s evaluation to ensure the appropriate treatment.

Pre-existing Eye Conditions

If you have an existing eye condition, such as glaucoma or diabetic retinopathy, it’s vital to consult your eye doctor. This ensures that the eye pain isn’t a sign of worsening symptoms or complications.

Eye Pain in Children

If a child complains of eye pain or shows signs of eye problems, they should be examined promptly by a paediatrician or an eye doctor. Children often find it difficult to express their discomfort clearly.

How Is Eye Pain Diagnosed?

Diagnosing eye pain requires a thorough examination by an ophthalmologist or an eye specialist. The diagnostic process can vary depending on the specific symptoms and suspected cause but typically involves the following steps:

Medical History (Anamnesis)

The doctor will first take a detailed medical history to gather information about your symptoms, previous conditions, medications, allergies, and any potential eye injuries. This helps narrow down possible causes.

Eye Examination

A comprehensive eye examination will then be carried out, which may include:

• Vision Test: Checking your visual acuity to identify refractive errors like short-sightedness, long-sightedness, or astigmatism.

• Slit-Lamp Examination: Using a specialised microscope (slit lamp) to examine the front and back parts of the eye to detect injuries, inflammation, or infections.

• Intraocular Pressure Measurement: Measuring the pressure inside your eye, which is crucial for ruling out glaucoma.

• Corneal Examination: Assessing the cornea for injuries, ulcers, or inflammation.

• Pupil Reaction Test: Checking how your pupils react to light to identify potential issues within the nervous system.

Additional Tests

Depending on the suspected cause of the eye pain, further specialised tests may be necessary, such as:

• Retinal Examination: This involves using drops to dilate your pupils, allowing for a thorough evaluation of the retina and optic nerve.

• Imaging Tests: If serious conditions like retinal detachment or tumours are suspected, imaging tests such as optical coherence tomography (OCT) or magnetic resonance imaging (MRI) may be recommended.

• Blood Tests: If a systemic condition is suspected, blood tests may be conducted to check for inflammatory markers or diabetes.

How Is Eye Pain Treated?

The treatment for eye pain depends on its underlying cause. Here are some potential treatment methods based on the diagnosis:

Pain Relief

For mild to moderate pain, over-the-counter painkillers such as ibuprofen or paracetamol can help alleviate discomfort. However, keep in mind that these medications only address the symptoms temporarily and do not treat the root cause of the pain.

Eye Drops or Ointments

• Artificial Tears: For dry eyes, artificial tears or lubricating eye drops can provide moisture and reduce discomfort.

• Antibiotic Eye Drops or Ointments: Bacterial infections such as conjunctivitis may require prescription antibiotic eye drops or ointments.

• Antiviral Eye Drops: For viral eye infections, such as herpes simplex keratitis, antiviral eye drops are necessary.

• Anti-Inflammatory Eye Drops: In cases of eye inflammation, including allergic reactions, anti-inflammatory eye drops may be prescribed.

Antiviral Medications

For severe viral infections, your doctor may prescribe oral antiviral medications to prevent the virus from spreading and aid in recovery.

Surgical Intervention

In some cases, such as acute glaucoma attacks or retinal detachment, urgent surgical intervention may be required to address the issue and preserve vision.

Other Treatment Methods

• Physiotherapy for Eye Muscles: For issues like muscle tension or strabismus, physiotherapy can help improve eye muscle function.

• Lifestyle Changes: For chronic issues like dry eyes, lifestyle changes such as reducing screen time and using specialised glasses can support eye health.

• Treatment of Underlying Conditions: If eye pain is caused by an underlying condition such as diabetes or rheumatoid arthritis, addressing the root cause is essential for effective relief.