Eye pain has dozens of possible causes, ranging from a dry surface that stings after a long day at your computer to a pressure emergency inside the eye that needs treatment within hours. The type of pain you feel, where exactly you feel it, and what other symptoms come with it all point toward different explanations. Understanding the most common and most serious causes can help you figure out what’s going on and how urgently you need to act.
Surface Pain vs. Deep Pain
Eye pain generally falls into two categories. Surface pain feels like burning, stinging, itching, or a gritty sensation on the front of your eye. It usually involves the cornea (the clear outer layer) or the conjunctiva (the thin membrane covering the white of your eye). Deep or orbital pain feels like an ache, throb, or pressure behind or inside the eye. It can involve structures deeper in the eye socket, the optic nerve, or even originate from somewhere else entirely, like your sinuses or blood vessels.
This distinction matters because surface pain is more often caused by everyday irritants and minor injuries, while deep pain is more likely to signal something that needs prompt medical attention.
Corneal Scratches and Foreign Bodies
One of the most common causes of sudden, sharp eye pain is a corneal abrasion, a scratch on the surface layer of your cornea. Dust, sand, tiny metal or wood fragments, makeup applicators, and even your own fingernails can cause one. Contact lens wearers are especially vulnerable: wearing lenses with dry eyes, using poorly fitting lenses, or forcing contacts in or out can all scratch the cornea.
A corneal abrasion typically causes intense stinging, tearing, light sensitivity, and a feeling that something is stuck in your eye even after the object is gone. Most minor scratches heal within a few days with antibiotic drops or ointment to prevent infection. If you’re not improving after three days, that’s a sign the abrasion may need further treatment. Scratches that don’t heal properly can lead to infection or scarring, both of which can affect your vision permanently.
Dry Eyes and Screen Time
If your eyes burn, sting, or feel gritty by the end of the day, dry eye is a likely culprit. Your eyes depend on a stable tear film to stay comfortable, and anything that disrupts it causes irritation.
Screen use is one of the biggest modern contributors. When you look at a screen, you blink about a third less often than normal, roughly three to seven times per minute instead of the usual rate. Blinking is what spreads moisture across your eyes, so less blinking means a drier surface. On top of that, your eyes are constantly refocusing on the tiny pixels that make up on-screen text, and the low contrast between letters and background forces them to work harder. The result is a combination of dryness, strain, and achiness that can build up over hours.
The good news is that this type of pain typically improves once you change the habit driving it. Taking regular breaks, consciously blinking more, and using artificial tears can all help. Adjusting your screen’s brightness and positioning your monitor slightly below eye level also reduce strain.
Infections and Inflammation
Several types of infection cause eye pain, and they vary widely in severity.
Conjunctivitis (pink eye) is one of the mildest. It inflames the membrane over the white of your eye, causing redness, discharge, and a sandy, irritated feeling. Viral and bacterial forms are contagious but usually resolve on their own or with drops.
Far more serious is orbital cellulitis, an infection of the tissues deep behind the eye. It often starts from a nearby sinus infection that spreads through the thin bone separating the sinuses from the eye socket. Symptoms include swelling and redness of the eyelid, pain with eye movement, reduced vision, and a bulging eye. Fever is common, and headache or drowsiness can indicate the infection is spreading toward the brain. Orbital cellulitis can cause vision loss, restricted eye movement, or even life-threatening complications like blood clots in the veins near the brain or meningitis. It requires emergency treatment.
A milder version, preseptal cellulitis, affects only the eyelid and skin in front of the eye socket. The key difference is that once the swollen eyelid is opened, the eye itself looks normal: it moves freely, vision is unaffected, and there’s no bulging. This form still needs treatment but carries far less risk.
Acute Angle-Closure Glaucoma
This is one of the true eye emergencies. In angle-closure glaucoma, the iris bulges forward and physically blocks the drainage channel inside your eye. Fluid that normally flows in and out gets trapped, and pressure builds rapidly. Normal eye pressure ranges from 8 to 21 millimeters of mercury; during an acute attack, it can spike far above that range.
The symptoms are hard to miss: severe eye pain, a red eye, blurred vision, rainbow-colored halos around lights, headache, and nausea or vomiting. If you experience this combination, it requires emergency care. Without treatment, the sustained pressure can permanently damage the optic nerve and cause irreversible vision loss.
Optic Neuritis
Optic neuritis is inflammation of the optic nerve, the cable that carries visual information from your eye to your brain. It causes a dull ache behind the eye that characteristically gets worse when you move your eyes. Vision typically becomes blurry or dim in the affected eye, and colors may look washed out.
This condition is most common in adults between 20 and 40, and it’s frequently associated with autoimmune conditions that attack nerve insulation. It can be the first sign of such a condition, so getting evaluated is important even if the pain itself feels manageable.
Headaches That Feel Like Eye Pain
Some of the most intense pain felt “in the eye” actually originates elsewhere. Cluster headaches are a prime example. They cause extreme, sharp, stabbing pain in, behind, or around one eye, often with tearing, a droopy eyelid, and nasal congestion on the same side. Episodes typically last 15 minutes to three hours and can occur multiple times a day in clusters lasting weeks or months.
The pain is severe enough that cluster headaches are sometimes called “suicide headaches.” They appear linked to the hypothalamus, the brain region that regulates your internal clock, which may explain why attacks often strike at the same time each day. Women with cluster headaches are frequently misdiagnosed with migraines or sinus problems, which can delay appropriate treatment.
Sinus infections can also produce a deep, pressure-like ache around and behind the eyes, particularly when you bend forward. This pain is usually accompanied by nasal congestion, thick discharge, and sometimes fever.
Giant Cell Arteritis
In adults over 50, new-onset eye pain or vision changes should raise concern about giant cell arteritis, an inflammation of the blood vessels along the temples and scalp. Most people who develop it are between 70 and 80 years old. The condition can reduce blood flow to the eyes and cause sudden, permanent vision loss in one eye, sometimes without any pain at all.
Other warning signs include a new, persistent headache, scalp tenderness, jaw pain while chewing, and general fatigue or weight loss. Vision loss from giant cell arteritis is preventable with prompt treatment, but once it occurs, it’s rarely reversible. That urgency is why any older adult with new vision problems and headache should be evaluated quickly.
Red Flags That Need Immediate Attention
Most eye pain is temporary and benign. But certain combinations of symptoms signal something that can’t wait. Seek emergency care if you experience any of the following alongside eye pain:
- Sudden vision loss or gray or black areas in your vision
- Severe light sensitivity that makes it difficult to keep your eyes open
- A visible injury from a chemical splash, a blow to the eye, or a foreign object you can’t remove
- Halos around lights with nausea, vomiting, or headache (signs of acute glaucoma)
- Bulging of the eye with fever and pain on eye movement (signs of orbital cellulitis)
- Inability to open or close your eye
When you do get evaluated, a standard eye exam typically includes a slit-lamp examination, which lets a doctor look at the cornea and internal eye structures under magnification, and tonometry, which measures the pressure inside your eye. These two tests alone can identify or rule out many of the most serious causes of eye pain within minutes.