Pain behind the eye usually comes from one of a handful of common causes: tension headaches, migraines, sinus pressure, or eye strain from screens. Less often, it signals something more serious like a nerve condition or a spike in eye pressure. The location of the pain, whether it affects one eye or both, and what other symptoms come with it all help narrow down what’s going on.
Eye Strain From Screens
If you spend hours looking at a computer, phone, or tablet, digital eye strain is the most likely explanation. The pain tends to feel like a dull ache or pressure behind both eyes, and it gets worse as the day goes on. You may also notice dry eyes, blurred vision, or neck and shoulder tension alongside it.
Your eyes have to constantly refocus when reading on screens, and you blink far less often while doing it. Over time, the muscles controlling focus fatigue, and the reduced blinking dries out your eye surface. Both contribute to that deep, tired ache behind the eyes. A few adjustments can make a real difference: sit about 20 inches from your screen, position it so you’re looking slightly downward (about 15 to 20 degrees below eye level), and match your screen brightness to the lighting in the room. The 20-20-20 rule is a good habit to build. Every 20 minutes, look at something 20 feet away for 20 seconds. It gives your focusing muscles a brief reset.
Migraines and Cluster Headaches
Migraines are one of the most common reasons for recurring pain behind the eye. The pain can settle behind one eye, across the forehead, or wrap around the entire head. It often comes with light sensitivity, nausea, or visual disturbances like zigzag lines or blind spots. Both sides of the face may tear up or feel congested during a migraine episode.
Cluster headaches are less common but more intense. They strike one side of the head, typically right at the temple or around one eye. The pain is sharp and severe, often described as a stabbing or burning sensation. A key difference from migraines: cluster headaches cause eye redness, tearing, and nasal congestion on only the affected side. They tend to occur in bouts lasting weeks or months, often hitting at the same time each day, then disappearing for long stretches.
If you get pain behind one eye repeatedly, paying attention to whether the symptoms are one-sided or two-sided, and whether you get nausea versus eye redness, can help you and your doctor figure out which type you’re dealing with.
Sinus Pressure and Infection
Your sinuses are air-filled cavities that sit behind your forehead, cheeks, and eyes. When they become inflamed or infected, the swelling creates pressure that you feel as a deep ache behind or around the eyes. This type of pain usually comes with a stuffy nose, thick nasal discharge, facial tenderness, and sometimes a low fever.
The sphenoid sinus sits especially close to the structures behind the eye. In fact, the optic nerve runs right alongside it, separated by a bony wall that can be paper-thin or even have small gaps in some people. When this particular sinus gets infected, the pain is often described as deep, retrobulbar (behind the eyeball), and may radiate to the top or front of the head. Sphenoid sinusitis is less common than infections in the other sinuses, but it’s the type most likely to produce that specific behind-the-eye sensation. Most sinus-related eye pain resolves as the infection clears, but persistent symptoms deserve medical attention.
Optic Neuritis
Optic neuritis is inflammation of the nerve that carries visual signals from your eye to your brain. It typically causes a dull ache behind one eye that gets noticeably worse when you move your eyes. Alongside the pain, you may notice blurred vision, loss of side vision, dimming of colors, or flashing lights when your eyes shift direction.
This condition is most common in adults between 20 and 40 and is sometimes an early sign of multiple sclerosis, though it can occur on its own. Vision loss can develop over hours to days. Most people recover much of their vision over weeks to months, but the pattern of pain plus worsening vision plus pain with eye movement is distinct enough that it’s worth recognizing.
Acute Glaucoma
A sudden spike in eye pressure, called acute angle-closure glaucoma, is an emergency. Normal eye pressure sits between 10 and 21 mm Hg. In an acute attack, pressure can shoot to 50 or even 80 mm Hg, which damages the optic nerve rapidly and can cause permanent vision loss if not treated within hours.
The symptoms are hard to miss: severe pain in or around one eye, a red eye, blurred vision, seeing rainbow-colored halos around lights, and often intense nausea or vomiting. Some people initially think they have a stomach bug or a bad headache because the nausea can be so prominent. If you experience sudden eye pain with vision changes and nausea, especially if you see halos around lights, this needs same-day emergency care.
Thyroid Eye Disease
People with overactive thyroid conditions (particularly Graves’ disease) can develop swelling in the tissues behind the eyes. The immune system produces antibodies that target thyroid hormone receptors, and some of those same receptors exist in the fat and muscle tissue behind your eyeballs. When those tissues swell, they push the eyes forward, creating pressure, pain, and sometimes a visibly bulging appearance.
Other signs include dry or watery eyes, difficulty moving the eyes, double vision, puffy or retracted eyelids, and light sensitivity. This condition develops gradually over weeks to months. If you already have a thyroid diagnosis and start noticing eye pressure or changes in how your eyes look, that’s a connection worth raising with your doctor.
How to Tell What’s Causing Yours
A few patterns help distinguish the causes:
- Both eyes, worse later in the day, tied to screen use: likely digital eye strain.
- One or both eyes with nausea, light sensitivity, lasting hours: likely migraine.
- One eye with redness, tearing, and nasal congestion on that same side: likely cluster headache.
- Both eyes with facial pressure, congestion, and thick nasal discharge: likely sinus-related.
- One eye with pain on eye movement plus vision changes: possible optic neuritis.
- Sudden severe pain, halos around lights, nausea, red eye: possible acute glaucoma, which needs immediate care.
Occasional, mild pain behind the eyes that resolves with rest or a break from screens is common and rarely dangerous. Pain that comes with sudden vision changes, seeing halos around lights, severe headache with vomiting, or fever alongside eye symptoms falls into a different category. Those combinations point to conditions where timing matters, and getting evaluated quickly can protect your vision.