Eye Pain: Causes and When to Worry

Types of eye pain and what they suggest

Where and how it hurts is the best clue.

For deeper pain behind the eye and the conditions that cause it, see pain in the eye: deep and behind-the-eye causes.

Common causes of eye pain

Dry eye

Not enough tears, or poor-quality tears, leave the surface dry. Eyes feel gritty, burning or tired, are often worse with screens, wind, air conditioning and toward evening, and may water as a reflex. See dry eye.

Conjunctivitis

Inflammation of the clear membrane covering the white of the eye. Expect redness, a gritty feeling and discharge: watery in viral, thick and sticky in bacterial, and itchy with allergic conjunctivitis. Vision stays normal and pain is mild. See conjunctivitis.

Foreign body and corneal abrasion

A speck of dust, an eyelash or a contact lens edge can scratch the cornea. A corneal abrasion causes sharp pain, watering, light sensitivity and a feeling that something is still there. Small abrasions usually heal within 24 to 72 hours.

Stye and chalazion

A stye is a painful, red bump at the edge of the eyelid from an infected gland or lash follicle. A chalazion is a firmer, usually painless lump further from the edge.

Blepharitis

Inflamed eyelid margins cause burning, itching, crusty lashes and gritty eyes, often in the morning.

Eye strain

Long periods of screen use, reading or driving can cause aching, tired eyes, headache and blurred vision that improves with rest.

Serious causes of eye pain

• Acute angle-closure glaucoma: the fluid drainage angle in the eye suddenly blocks, and pressure rises fast. It causes severe pain, a red eye, blurred vision, halos around lights, headache and vomiting. It can cause permanent vision loss within hours and needs emergency treatment. Most glaucoma, by contrast, is painless.
• Keratitis and corneal ulcer: infection of the cornea, most often in contact lens wearers, causing pain, redness, light sensitivity and blurred vision.
• Uveitis: inflammation inside the eye, with a deep ache, redness around the colored part of the eye, light sensitivity and blurred vision.
• Scleritis: severe, boring pain that may wake you at night, often linked to autoimmune diseases.
• Optic neuritis: inflammation of the optic nerve, with pain on moving the eye and dimmed vision.
• Orbital cellulitis: infection of the tissues around the eye, with swelling, fever and painful eye movements.
• Shingles affecting the eye.
• Chemical injury and penetrating injury.

How doctors find the cause

A clinician will ask how the pain started, whether you wear contact lenses, about injuries, chemicals and grinding or hammering, and whether vision has changed. They will:

• Check your vision on a letter chart
• Examine the eye with a slit lamp, a microscope with a bright light
• Use fluorescein dye, which glows green under blue light and shows scratches, ulcers and herpes lesions
• Flip the upper eyelid to look for trapped particles
• Measure eye pressure to check for glaucoma
• Dilate the pupils to examine the back of the eye if needed

Treatment and home care for eye pain

What you can do at home for mild eye pain

• Rinse the eye with clean water or sterile saline to wash out dust or an eyelash.
• Do not rub your eye.
• Lubricating eye drops (artificial tears) for dry, gritty eyes. Preservative-free drops are best if you use them more than 4 times a day.
• Warm compresses for 10 minutes, 2 to 4 times a day, for styes, chalazion and blepharitis.
• Cool compresses for itchy allergic eyes.
• Take screen breaks with the 20-20-20 rule: every 20 minutes, look at something 20 feet (6 meters) away for 20 seconds.
• Remove contact lenses until the eye is completely comfortable, and see a clinician if pain persists.
• Pain relief: acetaminophen (paracetamol) or ibuprofen at the label dose.

Do not use leftover prescription drops, especially steroid drops, without advice. Steroids can make some eye infections much worse. Avoid "redness relief" drops for long-term use.

Medical treatments

• Antibiotic drops or ointment for bacterial infections and corneal abrasions
• Antiviral treatment for herpes or shingles
• Steroid and pupil-dilating drops for uveitis, prescribed by an eye doctor
• Emergency pressure-lowering drops, medicines and laser treatment for acute glaucoma
• Removal of a foreign body under a microscope

Frequently asked questions

When should I worry about eye pain?

Get urgent care for eye pain with reduced vision, severe pain, strong light sensitivity, halos around lights, nausea or vomiting, after an injury or chemical splash, or in a contact lens wearer. Mild grittiness or tired eyes with normal vision usually improve with rest and lubricating drops.

Why does my eye hurt when I blink?

Pain on blinking usually means something is irritating the surface: a scratch on the cornea, a particle trapped under the eyelid, a stye, dry eye or conjunctivitis. Rinse the eye with clean water. If it still feels like something is there, or pain persists beyond a day, see a clinician.

What does sharp pain in one eye mean?

Sharp pain in one eye is often caused by a foreign body, a corneal scratch or a stye. If it comes with redness, light sensitivity and blurred vision, it may be keratitis or uveitis, which need prompt eye care. Brief stabbing pains lasting seconds are sometimes harmless "ice-pick" headaches.

Can dry eyes cause eye pain?

Yes. Dry eye commonly causes burning, grittiness, aching and a feeling that something is in the eye, often worse with screens and toward the end of the day. Lubricating drops, regular screen breaks, a humidifier and treating eyelid inflammation usually help.

Is eye pain a sign of glaucoma?

Usually not. The common type of glaucoma is painless and develops slowly. Acute angle-closure glaucoma is the exception: it causes sudden severe eye pain, redness, blurred vision, halos, headache and vomiting. This is an emergency that needs treatment within hours.