Eye pain has dozens of possible causes, ranging from something as minor as a dry, tired eye to something as serious as a sudden spike in eye pressure. The cause usually depends on where the pain is (surface vs. deep), how it started (gradually vs. suddenly), and what other symptoms came with it. Here’s a breakdown of the most common reasons your eye might hurt and what each one feels like.
Surface Pain vs. Deep Pain
The first thing to sort out is whether the pain feels like it’s on the surface of your eye or deeper behind it. Surface pain typically involves stinging, burning, grittiness, or the sensation that something is stuck in your eye. It’s usually caused by problems with the cornea (the clear front layer) or the conjunctiva (the thin tissue covering the white of your eye). Deep or aching pain that feels like it’s behind or around the eye points to problems inside the eye itself, in the eye socket, or even in nearby structures like the sinuses or nerves.
This distinction matters because surface issues are far more common and often resolve on their own, while deep pain is more likely to signal something that needs professional attention.
A Scratched Cornea
One of the most common causes of sudden, sharp eye pain is a corneal abrasion, a scratch on the surface of your eye. This can happen from a fingernail, a contact lens, dust, sand, or even rubbing your eye too hard. The pain is typically sharp and one-sided, and many people first notice it as a jolt of pain when they wake up in the morning.
Along with the pain, you’ll likely notice a strong feeling that something is in your eye, excessive tearing, sensitivity to light, redness, and sometimes slightly blurred vision. The good news is that small scratches often heal within 24 to 48 hours, and most uncomplicated abrasions recover completely within three to five days. Larger or deeper scratches take longer and carry a higher risk of infection, so if the pain doesn’t start improving within a day, it’s worth getting it checked.
Dry Eyes and Screen Strain
If your eye pain is more of a dull ache, burning, or irritation that builds throughout the day, dry eyes or digital eye strain are likely culprits. Hours of nonstop screen time can cause irritated eyes, blurry vision, headaches, and aching behind the eyes. You might also feel stiffness in your neck, shoulders, and back. This combination is sometimes called computer vision syndrome, and it doesn’t cause permanent damage, but it can make your eyes feel genuinely sore.
The discomfort typically improves once you step away from the screen and give your eyes a break. Following the 20-20-20 rule (every 20 minutes, look at something 20 feet away for 20 seconds) helps reduce strain. Artificial tears can relieve the dryness that makes the irritation worse, especially in air-conditioned or heated rooms where humidity is low.
Pink Eye and Other Infections
Infections of the eye’s surface, commonly grouped under “pink eye” (conjunctivitis), cause redness, discharge, and varying degrees of discomfort. Viral conjunctivitis tends to produce watery discharge and a gritty feeling. Bacterial conjunctivitis often causes thicker, yellow-green discharge and can feel more painful. Both types are contagious and usually clear up within one to two weeks, though bacterial infections may need antibiotic drops.
More serious infections can develop deeper in the tissues around the eye. An infection affecting the eyelid and skin around the front of the eye is called preseptal cellulitis, while one that spreads into the tissue behind the eye is orbital cellulitis. Orbital cellulitis causes deep pain, swelling, fever, and sometimes difficulty moving the eye. It requires urgent treatment.
Inflammation Inside the Eye
Uveitis is inflammation of the middle layer of the eye wall. The most common form, anterior uveitis, affects the front of the eye and causes redness, pain, light sensitivity, and blurred vision. You might also notice dark floating spots in your vision. Symptoms can come on suddenly and worsen quickly, or in some cases develop gradually.
About half the time, uveitis has no identifiable cause and is thought to be an autoimmune reaction limited to the eye. When a cause is found, it’s often linked to autoimmune or inflammatory conditions elsewhere in the body, such as Crohn’s disease, lupus, or ankylosing spondylitis (a form of spinal arthritis). Uveitis needs treatment to prevent lasting damage to your vision, so pain combined with light sensitivity and floaters is a signal to get seen promptly.
Pain That Worsens With Eye Movement
If your eye hurts more when you look around, optic neuritis is one possible explanation. This is inflammation of the optic nerve, the cable that carries visual information from your eye to your brain. About 92% of people with optic neuritis experience pain in or around the eye, and 87% specifically notice that the pain gets worse when they move their eyes. The pain typically starts two to three days before any change in vision, lasts less than a week, and then gradually fades.
Optic neuritis is sometimes the first sign of multiple sclerosis, though it can also occur on its own. If you’re experiencing pain with eye movement along with dimming or loss of vision in one eye, that combination warrants a prompt evaluation.
Sudden Pressure Buildup (Acute Glaucoma)
Normal pressure inside the eye ranges from about 10 to 21 mmHg. In acute angle-closure glaucoma, that pressure can spike to 60 to 80 mmHg in a matter of hours. This causes severe pain in one eye, a sudden headache, blurred vision, rainbow-colored halos around lights, nausea, and vomiting. The eye often looks red and the pupil may appear fixed or mid-dilated.
This is one of the true emergencies in eye care. Without rapid treatment to bring the pressure down, permanent vision loss can happen quickly. If you’re experiencing intense eye pain with nausea, vomiting, or halos around lights, treat it as urgent.
Cluster Headaches and Referred Pain
Not all eye pain originates in the eye. Cluster headaches cause extreme, stabbing pain in, behind, or around one eye, and they’re considered the most painful type of headache. The pain can spread to other areas of the face, head, and neck. Episodes typically last 15 minutes to three hours and often occur in cyclical patterns, hitting at the same time of day for weeks or months before going into remission.
Sinus infections can also cause aching pain that feels like it’s coming from behind or below the eye, especially when you bend forward. Migraines frequently involve pain around one eye along with light sensitivity and nausea. In all these cases, the eye itself is healthy; the pain is being referred from nearby structures.
Symptoms That Need Urgent Attention
Most eye pain is temporary and not dangerous. But certain combinations of symptoms point to conditions that can permanently damage your vision if they’re not treated quickly. Take any of the following seriously:
- Sudden decrease in vision alongside eye pain, which raises concern for acute glaucoma, a severe infection inside the eye, or optic neuritis
- Halos around lights with nausea or vomiting, a hallmark of acute angle-closure glaucoma
- Severe pain with a visibly red eye and sensitivity to light, which may indicate uveitis or a corneal ulcer
- Pain after an injury, especially if something hit your eye at high speed or a chemical splashed into it
- Swelling and fever with pain around the eye, which could signal orbital cellulitis
For general eye pain, either an optometrist or an ophthalmologist can evaluate you and point you in the right direction. If the condition turns out to need more specialized treatment, such as surgery or management of uncontrolled glaucoma, an ophthalmologist typically takes over from there.