What is pain in the eyes?
The cornea is one of the most sensitive tissues of the body, so even a microscopic scratch causes severe pain, lacrimation and spasm of the eyelids. This pain intensifies when blinking and feels like a speck. Deep pain is caused by inflammation of the choroid, sclera, optic nerve and a sharp increase in intraocular pressure: it is pressing, bursting and often radiates to the eyebrow, temple, and teeth. Optic neuritis is characterized by pain when moving the eyes. Pain behind the eye occurs with migraines, cluster headaches and sinusitis.
- Superficial - pain, sand, burning
- Deep - pressing, bursting
- Pain when moving the eyes
- Pain behind the eye
- Acute and chronic
- One- and two-sided
Possible reasons
The most common causes are foreign body, corneal erosion after a scratch, dry eye syndrome, conjunctivitis, stye and blepharitis. Working in front of a screen for long periods of time without breaks causes aching pain and fatigue. Keratitis, especially in those who wear contact lenses, causes severe pain and photophobia. Uveitis manifests as deep pain, redness around the cornea, and clouding. An acute attack of angle-closure glaucoma begins suddenly with severe pain, vomiting and decreased vision. Optic neuritis, scleritis, inflammation of the orbit, herpes zoster and temporal arteritis are less common but are dangerous for vision.
- Foreign body and corneal erosion
- Dry eye syndrome
- Conjunctivitis, stye, blepharitis
- Visual fatigue
- Keratitis and uveitis
- Acute attack of glaucoma
- Optic neuritis
- Migraine, sinusitis, neuralgia
Associated symptoms
The feeling of a speck and watery eyes after wind or working with wood or metal indicate a foreign body. Dryness, burning and pain in the evening are characteristic of dry eyes and fatigue. Pain with photophobia, redness around the cornea and clouding occurs with keratitis and uveitis. Sharp pain with rainbow circles, headache, nausea and a dilated pupil is a sign of an attack of glaucoma. Pain when moving the eyes with darkening and dullness of colors is characteristic of neuritis. Swelling of the eyelids, protrusion of the eye and temperature indicate inflammation of the orbit. A blistering rash on the forehead indicates shingles.
- Mote sensation and watery eyes
- Dryness and burning in the evening
- Photophobia and fog
- Rainbow circles and nausea
- Pain when moving and dull colors
- Swelling of the eyelids and protrusion of the eye
- Blistering rash on forehead
What examinations are needed
The ophthalmologist checks visual acuity and pupillary response, examines the eye at a slit lamp, everts the eyelid to look for a foreign body, and stains the cornea with fluorescein. Be sure to measure intraocular pressure so as not to miss glaucoma, and examine the fundus. If neuritis or glaucoma is suspected, a visual field study and OCT of the optic nerve are performed. Ultrasound of the eye is performed in opaque environments. In case of injury, protrusion of the eye and suspected inflammation of the orbit, a CT scan of the orbits is prescribed; in case of neuritis, an MRI of the brain is prescribed. People over 50 with temple pain have their ESR and C-reactive protein checked.
- Checking visual acuity and pupil reaction
- Biomicroscopy with fluorescein
- Tonometry
- Fundus examination
- Computer perimetry
- Ultrasound of the eye
- CT of the orbits or MRI of the brain
What to do and how to treat it
If chemicals come into contact, immediately rinse your eye with water for 15–20 minutes and seek immediate help. Do not rub your eye or try to remove stuck debris or shavings with sharp objects - this is done by the doctor. Remove your contact lenses. You cannot use painkillers and hormonal drops on your own: the former, if used frequently, destroy the cornea, the latter are dangerous in case of infection. Treatment depends on the cause: removal of the foreign body, moisturizing drops, anti-inflammatory and anti-infective therapy, urgent pressure reduction and laser treatment for glaucoma, treatment of neuritis together with a neurologist.
- Washing with water for a chemical burn
- Do not rub your eyes, remove contact lenses
- Removal of a foreign body by a doctor
- Moisturizing drops for dry eyes
- Anti-inflammatory and anti-infective treatment as prescribed
- Urgent pressure reduction in glaucoma
- Safety glasses when working with tools
