If your eyes hurt, the first step is figuring out whether the pain is on the surface of your eye or deeper behind it, because the cause and the right response differ significantly. Surface pain, often described as scratching, burning, or stinging, usually points to something irritating the outer layers of your eye. Deeper, aching pain that feels like it’s behind the eye can signal problems with internal structures or even conditions unrelated to the eye itself, like a sinus infection or migraine.
Most eye pain resolves on its own or with simple home care. But certain combinations of symptoms require emergency attention. Here’s how to sort out what you’re dealing with and what to do about it.
Start With These Immediate Steps
If you’re in pain right now, a few things can help while you figure out the cause. Stop what you’re doing, especially if you’ve been staring at a screen, reading, or working in bright light. Close your eyes and let them rest for several minutes. If your eyes feel dry or gritty, use preservative-free artificial tears to flush and lubricate the surface. If you use artificial tears more than four times a day, stick with preservative-free versions, which have fewer additives that can irritate sensitive eyes over time.
Remove contact lenses immediately if you’re wearing them. Contact lens wear is a common source of eye pain, and continuing to wear lenses when your eyes hurt raises the risk of a corneal infection called keratitis. Symptoms of keratitis include pain, redness, blurred vision, light sensitivity, and discharge. Don’t put your contacts back in until the pain fully resolves or your eye doctor clears you.
Chemical or Object in Your Eye
If a chemical has splashed into your eye, flush it immediately with large amounts of clean water for at least 15 minutes. Tilt your head so the affected eye is lower, and gently lift your upper and lower eyelids while rinsing to make sure water reaches all surfaces. Use a gentle stream from a faucet, a clean cup, or a shower. Don’t rub the eye. After flushing, seek emergency care even if the pain subsides, because chemical burns can cause delayed damage.
If you feel something stuck in your eye, try blinking several times to let tears wash it out naturally. You can also rinse with clean water or saline. Don’t try to remove an object that’s embedded in the eye or stuck under the lid with your fingers or tools. If flushing doesn’t work, keep the eye closed and get medical help.
When Eye Pain Is an Emergency
Certain symptoms alongside eye pain mean you should call emergency services or go to an ER right away:
- Sudden vision changes or vision loss
- Severe pain with headache, fever, or extreme light sensitivity
- Nausea or vomiting accompanying the eye pain
- Halos or rainbow-colored rings around lights
- Blood or pus coming from the eye
- Swelling in or around the eye
- Inability to move the eye or keep it open
This combination of severe eye pain, nausea, halos around lights, and sudden vision loss is the hallmark of acute angle-closure glaucoma, a condition where pressure inside the eye spikes dangerously. It requires treatment within hours to prevent permanent vision damage. The pain is often intense and can come with a headache that makes people think they’re having a different kind of emergency entirely.
Common Causes of Surface Eye Pain
Digital Eye Strain
If your eye pain comes after hours at a computer, phone, or TV, you’re likely dealing with eye strain. You blink less when focusing on screens, which dries out the surface of your eyes and causes aching, burning, or a tired feeling. The fix is straightforward: follow the 20-20-20 rule. Every 20 minutes, look at something 20 feet away for at least 20 seconds. This relaxes the focusing muscles inside your eye and encourages normal blinking. Adjusting screen brightness to match your surroundings and reducing glare also help.
Dry Eyes
Dry eye pain tends to feel gritty, sandy, or like something is in your eye when nothing is there. It’s often worse in air-conditioned rooms, on airplanes, or during windy weather. A warm compress held over closed eyes for about five minutes can help by softening oils in the glands along your eyelid margins. These glands produce an oily layer that keeps tears from evaporating too quickly, and they frequently become clogged. The warmth needs to raise eyelid temperature to around 40°C (104°F) to be effective, so a washcloth reheated a couple of times works better than one that cools quickly. Artificial tears provide immediate relief between compress sessions.
Corneal Abrasion
A scratched cornea causes sharp, sudden pain that gets worse with blinking. It often happens from a fingernail, a piece of debris, or rubbing your eyes too hard. The pain can be intense enough to make your eye water constantly and become very sensitive to light. The good news is that minor scratches heal fast, typically within 24 to 48 hours, because the cells on the eye’s surface reproduce quickly. Larger abrasions take longer. A doctor can confirm the diagnosis by placing a yellow dye in your eye that highlights any breaks in the surface under a special light. Avoid rubbing the eye, and don’t wear contacts until it’s fully healed.
Pink Eye vs. More Serious Inflammation
A red, painful eye with discharge is often conjunctivitis (pink eye), which is an inflammation of the clear membrane covering the eye. It’s caused by viruses, bacteria, or allergies, and it typically brings burning, tearing, eyelid swelling, and a gritty sensation. Bacterial cases can produce pus or thick mucus, especially overnight. Most conjunctivitis resolves on its own within 5 to 20 days, though bacterial cases sometimes need antibiotic drops.
Uveitis looks similar at first glance, with redness, pain, and light sensitivity, but it affects deeper structures inside the eye. The key differences: uveitis tends to cause floaters (small spots drifting in your vision) and blurred vision but typically does not cause the burning, tearing, eyelid swelling, or discharge that pink eye does. Uveitis can persist for months or recur in cycles over years, and it requires prescription treatment to prevent damage to internal eye tissue. If you have a red eye with floaters and blurry vision but no discharge or crusting, that pattern points toward uveitis rather than simple pink eye, and you should see an eye doctor promptly.
Pain Behind the Eye
Deep, aching pain that feels like it’s behind or around the eyeball has a different set of causes. Sinus infections are one of the most common, producing pressure and tenderness around the eyes, forehead, and cheeks that gets worse when you bend forward. Migraines and cluster headaches can also concentrate pain behind one eye, often with light sensitivity and nausea.
When the eye itself looks normal (no redness, no irritation, clear cornea), doctors refer to this as a “quiet eye” presentation. The pain is real, but the source may be the sinuses, the nerves around the eye, or referred pain from tension in the head and neck. A cold compress over closed eyes can help with inflammation-related pain behind the eye, while a warm compress is better for surface dryness and gland issues. If deep eye pain recurs frequently or comes with vision changes, it needs professional evaluation to rule out conditions affecting the optic nerve or eye socket.
Warm Compress vs. Cold Compress
Choosing the wrong one won’t hurt you, but choosing the right one works better. Use a warm compress for dry eyes, crusty eyelids, styes, or any condition where the oil glands in your eyelids feel blocked. The heat loosens thickened oils and improves tear quality. Five minutes with a warm, damp cloth is the standard approach, reheating it as needed to maintain the temperature.
Use a cold compress for swelling, allergic reactions, or pain from an injury. Cold reduces inflammation and numbs the area. Wrap ice or a cold pack in a thin cloth rather than placing it directly on the skin. Ten to fifteen minutes at a time is enough.
What to Expect at an Eye Appointment
If your eye pain doesn’t improve within a day or two with home care, an eye doctor will start by asking what you were doing when the pain began and whether you’ve had similar episodes before. They’ll examine your eye under a slit lamp, a microscope that lets them see the surface and internal structures in detail. If they suspect a scratch, they’ll place a yellow fluorescent dye in your eye that makes any breaks in the surface glow under blue light. They may also flip your eyelids inside out to check for debris trapped underneath.
For deeper pain, they may measure the pressure inside your eye and examine the back of the eye through a dilated pupil. Most causes of eye pain are treatable and resolve without lasting effects when addressed early. The biggest risk comes from ignoring pain that’s accompanied by vision changes or the emergency symptoms listed above, where hours can make the difference between full recovery and permanent damage.