Common Causes of Eye Pain
Surface eye pain is one of the most frequent reasons people visit an eye care provider. This type of pain usually feels like stinging, burning, or a gritty sensation on the front of the eye. It often involves the cornea, the clear layer that covers the colored part of your eye.
A corneal abrasion is a scratch on the surface of the cornea. This can happen from rubbing your eyes too hard, getting poked by a fingernail, or wearing contact lenses for too long. Corneal abrasions cause sharp pain, tearing, redness, and light sensitivity. Most small scratches heal within a few days, but deeper ones may need medical treatment to prevent infection.
Dry eye is another common source of surface pain. When your eyes do not make enough tears, or when your tears dry up too quickly, the surface becomes irritated. Dry eye can cause burning, blurred vision, and a sense that something is stuck in your eye. Screen time, dry climates, and certain medications can make it worse.
A foreign body in the eye can cause strong surface pain. Dust, sand, metal shavings, or small pieces of wood can land on the eye and scratch it. According to the American Academy of Ophthalmology in 2023, more than 2.4 million eye injuries occur in the United States each year, and many of these involve foreign objects. If you feel something in your eye, try not to rub it. Rubbing can push the object deeper or cause more damage.
People who work with power tools, yard equipment, or machinery face a higher risk. Wearing protective eyewear during these activities can lower the chance of injury. If a particle does not come out with gentle rinsing, see a provider right away.
Pain that feels like it comes from inside or behind the eye can signal more serious conditions. Glaucoma is a condition where pressure builds up inside the eye. Acute angle-closure glaucoma can come on suddenly and cause severe eye pain, headache, nausea, and blurred vision. This type is a medical emergency.
Uveitis is inflammation of the middle layer of the eye, called the uvea. It can cause deep, aching pain along with redness, light sensitivity, and floaters. Uveitis may be linked to autoimmune conditions, infections, or eye injuries. Without treatment, it can lead to vision loss over time.
Optic neuritis involves inflammation of the optic nerve. It can cause pain that gets worse when you move your eyes, along with vision loss in one eye. Scleritis is inflammation of the sclera, the white outer wall of the eye. It causes a deep, boring pain that can wake you up at night and is often connected to autoimmune disorders.
Not all eye pain starts in the eye itself. Migraine headaches often cause throbbing pain around one eye, along with sensitivity to light and sound. Cluster headaches cause intense pain around or behind one eye and can occur several times a day for weeks.
Sinus infections can create pressure and pain around the eyes, forehead, and cheeks. When the sinuses become swollen and filled with fluid, the pressure pushes against the bones near your eye sockets. This pain usually gets worse when you bend forward. Tension headaches can also cause a dull ache around both eyes, often triggered by stress or prolonged close-up work.
How Eye Pain Treatment Works
Treatment for surface eye pain depends on the cause. For corneal abrasions, your provider may prescribe antibiotic eye drops to prevent infection while the scratch heals. A bandage contact lens may be used to protect the eye and reduce pain. Most corneal abrasions improve within one to three days.
Dry eye treatment can include artificial tears that add moisture to the surface of the eye. For more serious dry eye, your provider may recommend prescription drops that reduce inflammation or help your eyes produce more tears. Warm compresses and eyelid cleaning can improve tear quality. Tiny plugs can also be placed in the tear ducts to keep tears on the eye longer.
Foreign body removal is done carefully using specialized tools. Your provider will use a microscope to find the object and remove it safely. After removal, you may need antibiotic drops and a follow-up visit.
For glaucoma, the goal is to lower the pressure inside the eye. This can be done with prescription eye drops, laser treatments, or surgery, depending on the severity. Regular monitoring is important because glaucoma can cause vision loss if pressure stays too high.
Uveitis is typically treated with anti-inflammatory medications. Steroid eye drops are often the first step. For severe cases, your provider may recommend injections or oral medications. Optic neuritis may improve on its own, but steroid treatments can help speed recovery. Your provider may work with a neurologist to check for related conditions. Scleritis treatment involves oral anti-inflammatory medications and sometimes stronger immune-suppressing drugs.
When eye pain is caused by headaches or sinus problems, treating the underlying condition usually brings relief. Migraine treatments may include pain-relieving medications, preventive medications, and lifestyle changes.
Sinus-related eye pain often responds to decongestants, nasal sprays, or antibiotics if a bacterial infection is present. If sinus problems keep coming back, your provider may suggest seeing an ear, nose, and throat specialist.
For chemical burns, the first step is thorough rinsing with clean water for at least 15 to 20 minutes. At the clinic, the care team will continue flushing the eye and check for damage to the cornea and other structures.
For acute angle-closure glaucoma, medications are given to lower eye pressure quickly. Once the pressure is controlled, a laser procedure called an iridotomy may be performed to create a small opening in the iris and prevent future episodes. Penetrating eye injuries are handled in a sterile setting. If you have such an injury, cover the eye gently and seek care right away.
What to Expect During Your Visit
When you visit Washington Eye Institute for eye pain, your provider will start by asking about your symptoms. They will want to know when the pain started, what it feels like, and whether anything makes it better or worse. Be sure to mention any recent injuries, vision changes, or other health conditions.
A visual acuity test will check how well you can see at different distances. Your provider will then examine the outside of your eye for redness, swelling, or discharge.
The slit lamp exam is one of the most important tools for evaluating eye pain. A slit lamp is a special microscope that lets your provider look at the front of your eye in great detail. It can reveal scratches, signs of infection, inflammation, and foreign objects. A dye called fluorescein may be placed on your eye to highlight any surface damage.
Tonometry measures the pressure inside your eye. High pressure can be a sign of glaucoma. The test is quick and painless. Your provider may use a small device that touches the surface of your eye or a gentle puff of air.
If your provider suspects a deeper problem, they may dilate your pupils with eye drops to see the retina, optic nerve, and blood vessels at the back of the eye. Dilation may make your vision blurry for a few hours afterward.
Optical coherence tomography, or OCT, uses light waves to create detailed images of the layers inside your eye. Visual field testing checks your side vision and is useful for monitoring glaucoma. Blood tests may be ordered if an autoimmune condition or infection is suspected. After testing, your provider will explain the findings and discuss treatment options.
Your Journey Through Eye Pain Care
The path to relief begins with an accurate diagnosis. At Washington Eye Institute, our fellowship-trained specialists use a step-by-step approach to identify the cause of your discomfort. Your first visit will include a thorough examination, and your provider will explain each test before it is performed. Most evaluations take about 60 to 90 minutes. Bringing your current medications list and relevant medical records can help your visit go smoothly.
If treatment is needed, your provider will walk you through the options. Many causes of eye pain respond well to simple treatments like eye drops or warm compresses. More complex conditions may require a series of treatments or referrals to other specialists.
Some causes of eye pain, such as dry eye, glaucoma, and uveitis, may need ongoing management. Your provider will work with you to find a plan that fits your lifestyle. Regular eye exams are an important part of maintaining eye health, even after your pain has resolved. According to the National Eye Institute in 2022, early detection and treatment of eye conditions can significantly reduce the risk of long-term vision problems.
Washington Eye Institute offers convenient appointment times at our Greenbelt, Rockville, and Cumberland locations to make ongoing care as easy as possible. You can support your recovery by following your treatment plan and reporting any new symptoms right away.
There are several things you can do at home to protect your eyes. Wearing safety glasses during activities that could cause injuries, such as yard work, home repairs, and sports, is one of the most effective steps. Taking regular breaks from screens helps reduce strain and dryness. Try looking away from your screen every 20 minutes, focusing on something about 20 feet away, and holding your gaze for 20 seconds.
If you wear contact lenses, follow the care instructions from your provider. Replace your lenses on schedule, clean them properly, and avoid sleeping in them unless your provider says it is safe. Good lens care helps prevent infections and corneal abrasions.
Questions and Answers
If you wake up with sudden or severe eye pain, especially with vision changes, redness, or nausea, contact Washington Eye Institute or visit your nearest emergency room as soon as possible. Sudden eye pain can be a sign of a serious condition like acute angle-closure glaucoma. If the pain is mild and stable, you can call our office during business hours to schedule a same-day or next-day appointment.
Yes, dry eye can cause more than mild discomfort. In moderate to severe cases, it can lead to burning, grittiness, and sharp pain. Chronic dry eye can damage the corneal surface, making the eyes more sensitive. If over-the-counter artificial tears are not providing relief, your provider can recommend prescription treatments or procedures that may help.
Most minor corneal abrasions heal within one to three days. Larger or deeper scratches may take up to a week or more. Your provider may prescribe antibiotic drops to prevent infection and lubricating drops to keep the surface moist. Avoid rubbing your eye while healing. If pain does not improve after a couple of days, contact your provider for a follow-up exam.
Eye pain can be a sign of glaucoma, but it depends on the type. Open-angle glaucoma, the most common form, usually develops slowly and often causes no pain early on. Acute angle-closure glaucoma, however, can cause sudden, severe pain along with headache, nausea, blurred vision, and halos around lights. Regular eye exams with pressure checks are important for early detection.
Seek emergency care if you experience sudden vision loss, a penetrating injury, a chemical splash in the eye, or severe pain with nausea and vomiting. A red, painful eye with a sudden drop in vision could indicate a condition that needs immediate treatment. If you are unsure whether your situation is an emergency, call Washington Eye Institute. Our team can help you determine the right level of care.
Prevention depends on the underlying cause. Wearing protective eyewear during risky activities is one of the most helpful steps. For dry eye, using a humidifier, taking screen breaks, and using artificial tears regularly can help. For conditions like glaucoma or uveitis, following your treatment plan and attending regular follow-up visits are key. Your provider at Washington Eye Institute can give you personalized recommendations based on your diagnosis and lifestyle.