Eye pain has dozens of possible causes, ranging from something as simple as staring at a screen too long to something as serious as a pressure spike inside the eye. Most eye pain falls into two broad categories: pain on the surface (a stinging, burning, or gritty sensation) and pain deeper behind the eye (a dull ache or throbbing pressure). Where you feel the pain, what it looks like, and how quickly it came on are the biggest clues to what’s going on.
Surface Pain vs. Deep Pain
Surface eye pain usually comes with visible signs: redness, tearing, swelling, or discharge. It tends to feel like burning, itching, or the sensation that something is stuck in your eye. Common causes include dry eyes, pink eye, allergies, a scratched cornea, or contact lens irritation.
Deep pain, often described as aching or throbbing behind or around the eye, can signal problems inside the eye itself or have nothing to do with the eye at all. Sinus infections, migraines, and cluster headaches all produce intense pain that feels like it’s coming from the eye even though the eye is perfectly healthy. Pain in a “quiet eye,” one that looks completely normal, can occasionally be the first sign of conditions like acute glaucoma, increased pressure inside the skull, or problems with blood vessels in the head.
Digital Eye Strain
If your eyes ache after hours on a computer, phone, or tablet, digital eye strain is the most likely explanation. When you focus on a screen, your blink rate drops significantly, which dries out the surface of the eye and fatigues the small muscles that control focus. The result is a combination of soreness, dryness, blurred vision, and sometimes a headache that settles around the forehead or temples.
The most widely recommended strategy is the 20-20-20 rule: every 20 minutes, look at something about 20 feet away for 20 seconds. This gives your focusing muscles a break and encourages blinking. Reducing glare, improving room lighting, and positioning your screen slightly below eye level also help. It’s worth noting that while these guidelines are recommended by nearly every eye care organization, there’s limited clinical research proving exactly how effective each one is. They’re based on expert consensus and the basic mechanics of how the eye works, and most people do notice relief when they follow them consistently.
Dry Eye
Dry eye is one of the most common reasons for chronic, low-grade eye pain. It happens when your tears evaporate too quickly or your eyes don’t produce enough of them. The tear film becomes overly concentrated with salt, which irritates the surface of the eye, triggers inflammation, and damages the delicate outer layer of cells. That damage makes the tear film even less stable, creating a cycle where dryness feeds more dryness.
Symptoms include stinging, burning, a sandy or gritty feeling, redness, and paradoxically, watery eyes (your eyes overproduce low-quality tears in response to the irritation). Wind, air conditioning, heating, long flights, and screen use all make it worse. Allergies, preservatives in eye drops, and certain medications like antihistamines can also kick off or worsen the cycle.
Pink Eye and Deeper Inflammation
Pink eye (conjunctivitis) is an infection or allergic reaction in the thin membrane covering the white of your eye. It causes redness, tearing, a burning or gritty sensation, eyelid swelling, and sometimes pus or crusty discharge, especially if bacteria are involved. Most cases resolve on their own within 5 to 20 days.
A more serious and less common condition called uveitis involves inflammation of a deeper layer inside the eye. The symptoms overlap with pink eye but diverge in important ways: uveitis typically causes light sensitivity and floating spots in your vision but does not cause the burning, gritty feeling, tearing, or eyelid swelling that pink eye does. Uveitis also tends to be a long-term or recurring condition, sometimes cycling over months or years, and it requires treatment to prevent vision damage.
Corneal Scratches
A scratch on the cornea, the clear front surface of your eye, causes sharp pain, tearing, redness, and sensitivity to light. It can happen from a fingernail, a piece of dust or sand, a contact lens edge, or even rubbing your eyes too hard. Minor scratches typically heal within 24 to 48 hours. Larger scratches carry a higher risk of developing into a corneal ulcer, a more serious infection that can threaten your vision.
Contact Lens Problems
Contact lenses are a common source of eye pain, especially when worn too long or not cleaned properly. Overwear can cause a red, irritated eye, corneal scratches, and dry eye. More seriously, germs like bacteria, fungi, and parasites are more likely to invade the cornea when lenses are worn past their recommended schedule or stored in old solution. This type of infection, called microbial keratitis, can lead to permanent vision loss or even the need for a corneal transplant in severe cases.
Other contact lens complications include allergic bumps forming under the eyelid, new blood vessels growing onto the cornea from chronic oxygen deprivation, and general inflammation. If your eyes hurt and you wear contacts, removing the lenses is always the right first step. Many milder complications resolve just by giving your eyes a break from lenses for a few days.
Headaches That Feel Like Eye Pain
Some of the most intense eye pain has nothing to do with the eye itself. Cluster headaches and migraines can produce excruciating pain behind or around the eye, and the mechanism explains why. A network of nerve fibers called the trigeminal nerve carries pain signals from blood vessels and tissue around the brain. One major branch of this nerve runs directly through the eye socket area. When that nerve pathway activates during a headache, your brain interprets the signals as eye pain even though the eye is fine.
Cluster headaches are particularly dramatic. The pain is almost always on one side, centered behind or around the eye, and it comes with visible autonomic symptoms on that same side: a watering eye, a red eye, a drooping eyelid, or a stuffy nostril. Attacks last 15 minutes to 3 hours and can occur multiple times a day for weeks or months at a time. Migraines can also settle behind one eye, usually with light sensitivity and nausea. In both cases, the eye itself looks normal on examination.
Acute Glaucoma
Acute angle-closure glaucoma is one of the few eye emergencies where pain is the main symptom. It happens when fluid drainage inside the eye suddenly blocks, causing pressure to spike to three or four times normal levels, sometimes reaching 60 to 80 mmHg (normal is 10 to 21). The result is severe, sudden pain in one eye, blurred vision, halos around lights, a red eye with a hazy-looking cornea, and often nausea and vomiting intense enough that people sometimes think they’re having an abdominal emergency rather than an eye problem. This requires immediate treatment to prevent permanent vision loss.
Signs That Need Urgent Attention
Most eye pain is temporary and harmless. But certain patterns warrant a same-day or emergency visit:
- Sudden vision loss or blurring alongside pain, especially in one eye
- Pain after an injury, particularly if you were hit by something sharp or fast-moving, or if you felt a gush of fluid
- Severe pain with nausea and halos around lights (possible acute glaucoma)
- Flashes of light, new floaters, or a curtain-like shadow across your vision (possible retinal detachment)
- Eye pain with fever, swelling, and difficulty moving the eye (possible orbital infection)
- A painful red eye with contact lens intolerance and worsening vision (possible corneal ulcer)
- Double vision with a drooping eyelid and a dilated pupil
Eye pain that is mild, comes and goes, and improves with rest, lubricating drops, or a break from screens is generally not urgent. Pain that is severe, one-sided, sudden, or accompanied by any change in vision is a different situation entirely and should be evaluated quickly.