Nearly everyone has eye pain or sore eyes at some point in life. Eye pain may be something that resolves on its own. But it also can be a sign of something more serious.

Eye pain can originate from many different places within the eye, orbit (the bony eye socket), and around the orbit. Almost any eye problem that causes some discomfort can also cause eye pain, if the condition is bad enough. Many of the conditions causing severe eye pain are associated with underlying medical conditions.

Eye pain can be sharp or dull, internal or external, constant or intermittent, stabbing or throbbing. As a general rule, if you have eye pain along with redness, you should consider this an emergency and either see your eye doctor or go to an emergency room or urgent care center right away.

What causes eye pain?

A feeling of discomfort or pain in the eye can be caused by a problem in the eye itself. It can also be caused by a problem involving any of the structures around the eye. The pain might stem from problems with any of the following:

• Cornea – the clear outermost disc covering the eye that allows in focused light
• Conjunctiva – the very thin covering of the front of the eye and inside of the eyelid
• Iris – the coloured part of the eye, with the pupil in the middle
• Orbit or globe – the round eyeball itself
• Muscles of the eye (extraocular muscles) – which perform the eye’s precise movements
• Nerves – which carry visual information from the eyes to the brain
• Eyelids – which protect and continually rub against the eyes
• Sinuses – pain around the eyeball may result from adjacent sinusitis

Eye-strain is the diagnosis given in the majority of cases in which a patient has pains in normal-looking eyes without any visual loss. These are forms of stress headache that occur in the region of the eye.

Very occasionally there may be an organic basis for the patient’s complaint.

Constant eye pain, especially when moving your eyes or gently pushing on your eyes, can sometimes indicate an inflammation of some of the inner eye parts. This means you should try and see your eye doctor as soon as possible for diagnosis and treatment.

What symptoms are associated with eye pain?

Eye pain can occur by itself, or there may be various other symptoms present:

• Decreased vision
• Discharge, which can be clear, or thick and colored
• Foreign body sensation – the feeling that something is in the eye, whether or not anything actually is
• Headache
• Light sensitivity (photophobia)
• Nausea or vomiting
• Red eye or pink eye
• Tearing
• The eye being crusted shut after sleep due to discharge

Other symptoms accompanying sore eyes can be a clue to what is causing the eye pain.

How Is Eye Pain Diagnosed?

Severe eye pain needs medical attention, especially if decreased vision, headache, or nausea and vomiting are present.

A doctor can diagnose some common eye conditions, such as conjunctivitis. For any potentially serious cause of sore eyes, your doctor will refer you to an Ophthalmologist.

Ophthalmologists use a variety of tools to diagnose eye pain, all generally used in a clinic setting:

• A slit-lamp examination uses bright light to look into the eye to see all the structures of the eye.
• Dilating drops expand the pupil to allow the doctor to see deep into the eye.
• A pressure-gauging instrument (Tonometer or Tonopen) can detect high pressures from glaucoma.

How Is Eye Pain Treated?

Just as the causes of eye pain vary widely, so do the treatments. Treatments are tailored to the specific cause of eye pain

The only way to sort out the various potential causes of eye pain and to get appropriate treatment is to see a doctor. Your vision is precious — protect it by taking eye pain seriously.