Aching Eyes: Why Your Eyes Hurt and What Helps

What aching eyes feel like

People describe aching eyes as tired, heavy, sore, strained, or a pressure behind the eyes. The type of ache gives clues:

Common causes of aching eyes

Digital eye strain

Looking at a screen reduces how often you blink by up to half and keeps the focusing muscles working at one distance for hours. The result is eye strain: tired, aching eyes, blurred vision, dryness and headaches. Glare, small text, poor lighting and a screen too close or too high make it worse.

Dry eye

Dry eye happens when the tears do not keep the eye surface moist, either because too few tears are made or they evaporate too quickly. Eyes feel gritty, burning and achy, sometimes paradoxically watery. It is common with age, menopause, contact lenses, air conditioning, screen use and some medicines.

Uncorrected vision

Needing glasses or an updated prescription forces the eyes to work harder. After about age 40, presbyopia makes close work tiring, often causing aching eyes when reading.

Sinusitis

Inflamed sinuses sit right next to the eye sockets. Sinusitis causes a dull ache behind and around the eyes with a blocked nose, thick discharge and pain that worsens when bending forward.

Headaches

Tension headaches cause a tight ache around the eyes and forehead. A migraine often causes throbbing pain behind one eye. Cluster headaches cause severe, stabbing pain around one eye with a watery eye and runny nostril on the same side.

Allergies and conjunctivitis

Allergic and infectious conjunctivitis cause itchy, red, sore eyes with discharge. Usually more itchy or gritty than painful.

Serious causes

• Acute angle-closure glaucoma: fluid pressure in the eye rises suddenly. Severe pain, a red eye, blurred vision, halos around lights, headache and vomiting. It can cause permanent vision loss within hours. See glaucoma.
• Uveitis (iritis): inflammation inside the eye causing a deep ache, redness around the colored part of the eye, and strong light sensitivity.
• Scleritis: severe, boring pain that may wake you at night, with a deep red or purplish eye. Often linked to rheumatoid arthritis or other autoimmune disease.
• Optic neuritis: inflammation of the optic nerve. Pain on moving the eye and dim or washed-out vision in one eye, sometimes the first sign of multiple sclerosis.
• Corneal ulcer or abrasion: sharp pain, watering and light sensitivity, more likely with contact lenses.

How doctors find the cause

An eye doctor (optometrist or ophthalmologist) will ask about screen use, glasses, contact lenses, headaches and other symptoms, then check:

• vision and your glasses prescription
• the front of the eye with a slit lamp, using dye to look for dryness or scratches
• eye pressure
• pupil reactions and the back of the eye

Relief for aching eyes

• Follow the 20-20-20 rule: every 20 minutes, look at something 20 feet (6 m) away for 20 seconds.
• Blink fully and often during screen use.
• Set up your screen: an arm's length away, the top at or slightly below eye level, brightness matched to the room, and text large enough to read comfortably.
• Use lubricating eye drops (artificial tears). Preservative-free drops are best if you use them more than 4 times a day.
• Warm compresses for 5 to 10 minutes help dry eye and blocked eyelid glands.
• Get your eyes tested and wear the right glasses. Ask about glasses for computer distance if you are over 40.
• Humidify dry indoor air and point fans and car vents away from your face.
• Treat the cause: decongestants or saline rinses for sinus congestion (decongestants are not suitable with high blood pressure), allergy drops for itchy eyes.
• Rest your eyes and sleep enough.

Avoid redness-relieving drops for daily use, as rebound redness is common.

Frequently asked questions

Why do my eyes ache?

The most common reasons are eye strain from screens or reading, dry eye, needing new glasses, sinus congestion and tension headaches. These cause a dull, tired ache that improves with rest. Severe pain, redness, light sensitivity or blurred vision suggest a more serious eye problem.

Why do my eyes ache behind them?

An ache behind the eyes is usually from eye strain, sinusitis, a tension headache or a migraine. Pain behind one eye that worsens when moving the eye, with dimmed vision, can be optic neuritis and should be checked promptly.

Can aching eyes cause headaches?

Yes. Eye strain and uncorrected vision make the focusing and facial muscles work harder, causing headaches around the forehead and temples. The reverse is also true: tension headaches and migraines often cause eye pain.

When should I worry about aching eyes?

Seek urgent care for sudden severe eye pain, especially with a red eye, blurred vision, halos, nausea or vomiting, or after an injury or chemical splash. See a doctor soon for a painful red eye with light sensitivity, or pain on eye movement with vision changes.