Other (less common) causes of anterior eye pain, or pain “in” the eye, include:
In some cases, such as an eye injury, the cause of the pain is obvious. But often it’s difficult to know why your eye hurts. To complicate matters, the severity of eye pain does not indicate how serious the underlying cause of the discomfort is.
In other words, a relatively minor problem, such as a superficial abrasion of the cornea, can be very painful. But several very serious eye conditions — including cataracts, macular degeneration, the most common type of glaucoma, a detached retina, and diabetic eye disease — cause no eye pain whatsoever.
A painful eye can produce various sensations and accompanying symptoms, which can help your eye doctor determine the cause of your discomfort and prescribe the correct eye pain treatment. These include:
Eye pain also is frequently accompanied by blurred vision, redness (bloodshot eyes) and sensitivity to light.
Often, eye pain that feels like something is in the eye actually is caused by irritation or inflammation of the front surface of the eye, particularly the cornea. Common causes of pain emanating from the front surface of the eye or inside the eye include:
The discomfort from a corneal foreign body can range from mild to severe, and typically it is most bothersome when you’re blinking (since the eyelid often is rubbing across it during blinks). Blurred vision and sensitivity to light also are common.
A corneal foreign body requires urgent attention from an eye doctor, because material embedded in the cornea can quickly cause a serious eye infection. Most corneal foreign bodies can be removed easily in the doctor’s office with the proper tools. Antibacterial eye drops may be prescribed to prevent infection while the cornea heals.
Many superficial corneal scratches heal on their own within 24 hours. But deeper abrasions can lead to a serious eye infection and even a corneal ulcer if left untreated. Because it’s often impossible to tell if eye pain is due to a minor scratch, a deep abrasion or a corneal foreign body, it’s a good idea to see an eye doctor for any sharp discomfort of the eye that does not resolve very quickly, to determine the underlying cause.
If using lubricating eye drops significantly improves comfort, the cause of the pain is probably dry eyes. In most cases, dry eye does not require urgent attention; but your eye doctor can perform tests to determine the severity of the dryness and recommend the most effective treatment.
A very serious cause of pain in the eye is a condition called endophthalmitis (en-dahf-thal-MITE-is), which is inflammation of the interior of the eye that most often is caused by a bacterial infection. It also can occur as a rare complication of cataract surgery.
Endophthalmitis, in addition to causing eye pain, causes redness, swollen eyelids and decreased vision. If you have these symptoms after cataract surgery or other eye surgery, see your eye doctor immediately.
Common causes of pain behind the eyes are migraine headaches and sinus infections.
Though pain behind the eyes from these causes typically is not an emergency, if you have chronic or recurring pain of this type, see your eye doctor or general physician for treatment and to see what can be done to prevent future episodes.
Probably the most common pain around the eyes is inflammation within the eyelid, which is the common stye (also called a hordeolum). The primary symptom of a stye is a localized, very tender area on one eyelid.
Another common cause of pain around the eyes and eye muscle pain is overuse of the eyes when working at the computer. This is not an urgent problem, and there are simple steps you can take to relieve computer eye strain.
A much less common and much more serious cause of pain around the eyes is a condition called optic neuropathy, which can cause permanent vision loss. Accompanying symptoms are usually decreased visual acuity and reduced color vision, and the pain typically is worse with eye movements.
Eye pain that may be caused by optic neuropathy requires immediate attention by an ophthalmologist and a neurologist. Among people under 40, multiple sclerosis and other neurological conditions are the most common causes of optic neuritis.