The temporary sensation of pressure, fullness, or mild pain felt behind the eye when blowing your nose is a common physical phenomenon. This experience is a direct consequence of the interconnected air-filled cavities in the skull, demonstrating a momentary pressure imbalance. While the feeling may cause concern, it is usually harmless and is a simple mechanical response. This reaction occurs because the force of expelled air is transferred through the shared pathways linking the nasal passages to the orbital area.
Anatomy: The Sinus-Eye Connection
The feeling of pressure transfer is rooted in the close proximity of the paranasal sinuses to the eye socket, or orbit. The ethmoid sinuses are air-filled spaces situated directly between the eyes and the upper part of the nasal cavity. The maxillary sinuses are also located beneath the eyes, contributing to the shared pressure environment.
The air pressure generated when blowing the nose pushes against the thin bony walls separating these sinuses from the orbit. A second connection is the nasolacrimal duct, the natural drainage system for tears, which runs from the inner corner of the eye down into the nasal cavity. When both nostrils are forcefully blocked, the surge of air pressure presses against the sinus walls, causing the sensation behind the eye, or forces air/fluid backward up the nasolacrimal duct.
Factors That Increase Internal Pressure
The intensity of the pressure sensation is amplified by underlying conditions causing inflammation or blockage. Severe nasal congestion (due to a cold, allergies, or acute sinusitis) is a primary factor. When the nasal lining is swollen, passageways are narrowed, meaning less force is needed to create a significant internal pressure spike. Acute sinusitis fills the air cavities with mucus and fluid, reducing space for pressure equalization. Blowing forcefully to clear this blockage concentrates the pressure, increasing its impact on surrounding structures.
Pinching both nostrils shut mimics the Valsalva maneuver, which deliberately increases pressure in the chest and head. This prevents air from exiting the nasal cavity, causing a rapid spike in intranasal pressure transferred to the sinuses. This unnecessary force is the most common behavioral cause of the intense pressure sensation.
Serious Complications and Warning Signs
While the pressure sensation is generally benign, forceful nose blowing carries a rare but serious risk of complications. The most significant is Orbital Emphysema, a condition where air is forced from the sinus cavity into the soft tissues surrounding the eye. This occurs when high pressure finds a weak point or defect in the thin bone separating the sinus from the orbit, often the lamina papyracea.
Symptoms of Orbital Emphysema include sudden swelling around the eye, a crackling sensation when the area is gently touched (crepitus), and sometimes the eye may bulge slightly (proptosis). In severe cases, the trapped air can increase pressure on the delicate structures within the eye socket, leading to double vision (diplopia) or a decrease in visual acuity.
Warning signs requiring immediate medical attention include any sudden change in vision, severe or unrelenting eye pain, persistent swelling that does not quickly subside, or an inability to move the eye normally. Forceful blowing can also lead to severe nosebleeds (epistaxis) or pressure effects on the middle ear, causing pain or blockage. If these severe symptoms accompany the pressure sensation, a medical evaluation is warranted.
Techniques for Reducing Pressure
The safest and most effective way to minimize pressure transfer is to modify the technique used for blowing the nose. Instead of pinching both nostrils closed and blowing with maximal force, aim for a gentle, controlled expulsion of air. This lessens the pressure spike within the nasal and sinus passages.
The recommended technique involves closing only one nostril at a time by applying light pressure with a finger. Gently blow through the open nostril into a clean tissue, then repeat the process on the other side. This method ensures air has an escape route and prevents the nasal cavity from becoming a sealed, high-pressure chamber.
If congestion is the underlying cause, supportive care can help thin the mucus, reducing the need for forceful blowing. Over-the-counter saline nasal sprays or nasal irrigation systems help moisturize the nasal passages and loosen thick mucus. Using steam from a hot shower or humidifier can also help to thin secretions, supporting a low-pressure approach.