Eye Pain

Eye Pain: Causes, Symptoms, Diagnosis, and Treatment

Nearly everyone suffers from eye pain or sore eyes at some point in life. Eye pain may be something that resolves on its own. It also can be a sign of something more serious. WebMD helps sort out the different causes of eye pain, their symptoms, and treatments.

What Causes Eye Pain?

A feeling of discomfort or pain in the eye can be caused by a problem in the eye itself. It can also be caused by a problem involving any of the structures around the eye. The pain might stem from problems with any of the following:

• Cornea -- the clear window in the front of the eye that does most of the focusing of incoming light
• Sclera - the white outside wall of the eye
• Conjunctiva -- the ultrathin covering of the sclera and the inside lining of the eyelid
• Iris -- the colored part of the eye, with the pupil in the middle
• Orbit -- the bony cave in which the eye and eye muscles are located
• Muscles of the eye (extraocular muscles) -- which rotate the eye
• Nerves -- which carry visual information from the eyes to the brain
• Eyelids -- which protect and continually spread moisture over the eyes

Problems can include:

• Corneal abrasions. The cornea is the clear disc covering the colored part of the eye, known as the iris. The cornea is vulnerable to injuries from children's flying fingers, errant tree branches, or tennis balls. A scratch on the cornea is called an abrasion. It can be very painful.
• Corneal infections. The cornea can also become inflamed or infected, a condition called keratitis. Herpes zoster, or shingles, which is caused by the same virus that causes chickenpox, can involve the cornea.
• Conjunctivitis is inflammation of the conjunctiva, the ultrathin lining over the front of the eye and on the inner side of the eyelids. Allergies or infections (viral or bacterial) can cause conjunctivitis, commonly called pinkeye. Blood vessels in the conjunctiva become engorged, and the normally white part of the eye looks red. Other symptoms usually include itchiness and discharge.
• Blepharitis occurs when there is inflammation or infection of the eyelid. A sensation of grit in the eyes, and sometimes pain, result.
• A sty or stye -- also known as hordeolum -- is an infection or inflammation of the eyelid margin that can come from the hair follicles of eyelashes or from oil glands. A sty is often painful and most often caused by infection.
• Foreign bodies. Sometimes there really is something in the eye -- a bit of dirt, plant debris, or a fragment of a contact lens. Foreign bodies are usually just irritating, and tears or a water rinse clears them out. If not removed, foreign bodies can cause corneal abrasions.
• Glaucoma is an eye condition that usually has no early symptoms. In some cases of glaucoma, though, pressure inside the eye rise suddenly. The condition is called acute angle closure glaucoma, and the symptoms include severe eye pain, nausea and vomiting, headache, and decreased vision. Acute angle closure glaucoma is an emergency and needs immediate treatment to prevent blindness.
• Iritis or uveitis is inflammation inside the eye. Iritis is uncommon, but can be due to trauma, infections, or autoimmune conditions. Symptoms include pain, red eye, and, often, decreased vision.
• Optic neuritis. The nerve traveling from the back of the eyeball into the brain can become inflamed. Multiple sclerosis or other autoimmune conditions or infections are often to blame. Symptoms include loss of vision and sometimes pain.
• Sinusitis can create pressure behind the eyes, causing eye pain on one or both sides.

What Symtoms Are Associated With Eye Pain?

Eye pain can occur by itself, or there may be various other symptoms present:

• Red eye or pinkeye
• Tearing
• Light sensitivity (photophobia)
• Discharge, which can be clear, or thick and colored (pus)
• The eye being crusted shut after sleep due to discharge
• Foreign body sensation -- the feeling that something is in the eye, whether or not anything actually is
• Nausea or vomiting
• Decreased vision
• Headache

Other symptoms accompanying sore eyes can be a clue to what is causing the eye pain.

How Is Eye Pain Diagnosed?

Severe eye pain needs medical attention, especially if decreased vision, headache, or nausea and vomiting are present.

A primary care doctor can diagnose some common eye conditions, such as conjunctivitis. For any potentially serious cause of sore eyes, your doctor will refer you to an ophthalmologist.

Ophthalmologists use a variety of tools to diagnose eye pain, all generally used in an office setting:

• A slit-lamp exam uses bright light to look into all the structures of the eye.
• Dilating drops expand the pupil to allow the doctor to see deep into the eye.
• A pressure-gauging instrument (tonometer or Tono-Pen) can detect high pressures from glaucoma.

How Is Eye Pain Treated?

The causes of sore eyes vary widely, and so do the treatments for eye pain. Treatments are tailored to the specific cause of eye pain:

• Conjunctivitis. Antibacterial eye drops can cure bacterial conjunctivitis. Antihistamines -- eye drops or in an oral form -- can often improve allergic conjunctivitis.
• Corneal abrasions heal on their own with time and are treated with pain medication and antibiotic ointments.
• Glaucoma severe enough to cause eye pain is treated urgently with eye drops to reduce eye pressure. If these don't work, surgery may be needed.
• Styes are usually cured by applying regular warm compresses at home for a few days.
• Infections of the cornea (keratitis) may require antiviral or antibacterial eye drops.
• Optic neuritis is generally treated with intravenous corticosteroids. Usually, this requires admission to the hospital.
• Iritis may be treated with antibiotic or antiviral eye drops, if an infection is the cause. For autoimmune causes, corticosteroids -- eye drops or in an oral form -- are used.

The only way to sort out the various potential causes of eye pain and to get appropriate treatment is to see a doctor. Your vision is precious -- protect it by taking eye pain seriously.