Eye pain has dozens of possible causes, ranging from something as minor as dry air to emergencies like acute glaucoma. The most common reasons people show up to an eye emergency department are conjunctivitis, corneal abrasions, and dry eye, which together account for roughly 18% of all visits. Understanding where your pain is, what it feels like, and what other symptoms come with it can help you figure out what’s going on and whether you need care quickly.
Surface Pain vs. Deep Pain
The first useful distinction is whether the pain feels like it’s on the surface of your eye or deeper behind it. Surface pain, often described as stinging, burning, scratching, or a feeling that something is stuck in your eye, usually points to problems with the cornea (the clear front layer) or the outer tissues. Deep, aching pain that feels like it’s behind the eye or worsens when you move your eyes suggests something involving the orbit, the optic nerve, or surrounding structures.
Surface causes include dry eye, corneal scratches, infections, and foreign bodies like dust or metal flakes. Deep or orbital causes include inflammation inside the eye, sinus pressure, nerve inflammation, and, rarely, tumors or orbital infections. Both categories can produce redness, but some conditions cause significant pain with very little visible change to the eye, which can be misleading.
Dry Eye
Dry eye is one of the most common explanations for ongoing eye discomfort. It typically produces a stinging, burning, or scratchy sensation that affects both eyes. You might also feel like something is in your eye even when nothing is there, or notice that your eyes water excessively as they try to compensate.
Certain environments make dry eye noticeably worse: air-conditioned rooms, airplane cabins, windy or smoky conditions, desert climates, and long stretches of screen time. If your eye pain comes and goes depending on where you are or what you’re doing, dry eye is a likely culprit. It’s not dangerous, but chronic dry eye can become genuinely painful and interfere with daily life if left unmanaged. Lubricating eye drops, humidifiers, and regular screen breaks are the first-line fixes most people try.
Corneal Abrasions and Foreign Bodies
A scratched cornea is one of the sharpest, most sudden forms of eye pain. It can happen from a fingernail, a contact lens, a piece of grit, or even rubbing your eyes too hard. Symptoms include intense pain, watery eyes, blurred vision, redness, light sensitivity, and swelling of the eyelid. Some people describe it as feeling like there’s a grain of sand permanently lodged under the lid.
The good news is that minor corneal abrasions heal fast. Most people feel significantly better within 24 to 48 hours, and the scratch typically closes within a few days without lasting damage. Larger or deeper scratches take longer and carry a small risk of infection, so it’s worth getting them evaluated. If you can see or feel a foreign object on your eye, resist the urge to rub. Flushing with clean water or saline is safer.
Infections, Especially With Contact Lenses
Bacterial keratitis is a corneal infection that causes eye pain, redness, blurred vision, light sensitivity, excessive tearing, and discharge. Contact lens wearers face the highest risk, particularly if you sleep in your lenses, rinse or store them in tap water, reuse old solution by “topping off” instead of replacing it, skip cleaning your lens case, or share decorative lenses.
A corneal infection needs prompt treatment because it can progress to a corneal ulcer, which may permanently scar the cornea and affect your vision. If you wear contacts and develop pain with discharge or worsening redness, remove the lenses and get seen the same day if possible.
Sinus Pressure
Sometimes eye pain isn’t coming from the eye at all. The sinuses sit directly behind and around the eyes, and when they become inflamed or congested, the pressure can radiate into the eye area. Sinus-related eye pain typically involves a feeling of pressure or tenderness around the eyes, cheeks, nose, or forehead that gets worse when you bend forward. The area around the eyes may also feel swollen.
If your eye pain came on alongside nasal congestion, thick nasal discharge, or facial pressure, sinusitis is a strong possibility. The eye itself will usually look normal, with no redness or vision changes.
Uveitis: Inflammation Inside the Eye
Uveitis is inflammation of the middle layer of the eye wall. It causes eye pain, redness, light sensitivity, blurred vision, and sometimes dark floating spots in your vision. Symptoms can come on suddenly and worsen quickly, though in some cases uveitis is found incidentally during a routine eye exam with no symptoms at all.
What makes uveitis important is that it’s often linked to conditions elsewhere in the body. Autoimmune and inflammatory diseases like Crohn’s disease, lupus, and sarcoidosis can trigger it. Ankylosing spondylitis, a type of inflammatory spinal arthritis, lists uveitis as one of its most common complications. Infections including shingles, syphilis, and tuberculosis can also be responsible. In about half of cases, no specific cause is identified. Uveitis requires treatment to prevent vision loss, so persistent pain with light sensitivity and floaters warrants a prompt eye exam.
Optic Neuritis and Pain With Eye Movement
If your eye hurts mainly when you move it, optic neuritis is one possibility worth knowing about. This condition involves inflammation of the optic nerve, the cable that carries visual information from the eye to the brain. The pain is typically felt in or behind the eye, around the eye socket, or as a frontal headache, and it gets noticeably worse when you look side to side or up and down.
Optic neuritis has a well-established connection to multiple sclerosis. It’s the first sign of the disease in about 20% of patients and occurs at some point in nearly half of people with MS. This doesn’t mean that everyone with optic neuritis has or will develop MS, but it’s a connection that doctors take seriously. Vision may become blurry or dim in the affected eye, and colors may look washed out. Most episodes improve on their own over weeks, though some people need treatment to speed recovery.
Acute Angle-Closure Glaucoma
This is the eye pain emergency most people have heard of, even if they don’t know the name. Acute angle-closure glaucoma happens when the drainage system inside the eye suddenly blocks, causing pressure to spike rapidly. It produces severe eye pain, headache, nausea and vomiting, vision loss, redness, and a distinctive symptom: seeing rainbow-colored halos around lights.
The combination of intense eye pain with nausea, vomiting, and visual halos is a pattern that should send you to an emergency room immediately. Without treatment to lower the pressure, permanent vision loss can occur within hours. This condition is far less common than most other causes of eye pain, but it’s the one where speed matters most.
When Eye Pain Needs Urgent Attention
Most eye pain resolves on its own or with simple measures. But certain patterns signal that something more serious is happening. The American Academy of Ophthalmology flags eye injuries, sudden vision changes or vision loss, and significant eye pain as symptoms that can require emergency attention.
Specifically, seek same-day or emergency care if your eye pain is severe or came on suddenly, if you notice any change in your vision, if you see halos around lights, if you have pain with eye movement combined with vision changes, if there’s discharge along with worsening pain, or if the pain followed an injury or chemical exposure. Eye pain that’s mild, comes and goes with screen use or dry environments, and isn’t accompanied by vision changes is far less likely to be dangerous, but persistent discomfort lasting more than a day or two still deserves a professional look.