Headaches or a feeling of pain behind the eyes are common complaints. There can be several causes for this type of head pain depending on the exact location and associated symptoms. Understanding the potential causes and when to see a doctor can help find relief.
Quick Summary
Some quick potential causes for pain behind the eyes include:
- Migraines – Severe, throbbing headaches often with nausea, light sensitivity.
- Sinusitis – Sinus inflammation causing pressure and pain behind the eyes or face.
- Eye strain – Overuse of eyes causing fatigue and ache behind eyes.
- Cluster headaches – Intense, sharp pain around one eye repeating in clusters.
- Tension headaches – Tight, squeezing pain on both sides of the head.
- Trigeminal neuralgia – Electric shock-like facial pain from nerve irritation.
Seeing a doctor for an accurate diagnosis is recommended, especially for frequent or severe headaches behind the eyes. Treatment depends on the cause but may include medications, lifestyle changes, eyeglasses or treatments for underlying conditions.
What’s Located Behind the Eyes?
The area behind the eyes contains several important structures of the face and head:
- Sinuses – Air-filled cavities behind the forehead, cheeks and bridge of the nose.
- Eyes – The eyes themselves as well as muscles, nerves and blood vessels surrounding them.
- Brain – The frontal lobe located behind the forehead.
- Trigeminal nerve – A major facial nerve that senses pain in the face.
- Blood vessels – Arteries and veins that supply the head and brain with blood.
Problems with any of these structures can potentially contribute to pain felt behind the eyes.
Common Causes of Pain Behind the Eyes
1. Migraines
Migraines often cause severe head pain behind the eyes. The pain is commonly described as throbbing or pulsing and typically occurs on one side of the head. Other migraine symptoms may include:
- Nausea or vomiting
- Sensitivity to light and sound
- Auras or visual disturbances before the headache
Migraine headache pain can last anywhere from 4 to 72 hours. The exact cause is not fully known but may involve changes in brain chemicals and nerves.
2. Sinusitis
Sinusitis refers to inflammation or infection of the sinuses. It can cause congestion, facial pain and headaches behind the eyes, cheeks, forehead or bridge of the nose. Other symptoms may include:
- Stuffy or runny nose
- Post-nasal drip
- Tooth pain
- Sore throat
- Cough
- Fever
Sinusitis is often caused by a viral, bacterial or fungal infection. Allergies, air pollution or structural problems in the nose can also contribute to chronic sinus inflammation.
3. Eye Strain
Using the eyes extensively or for long periods can lead to eye fatigue and strain. Common symptoms include:
- Dull ache behind the eyes
- Watery, dry or irritated eyes
- Blurred vision
- Headache centered behind the eyes
- Increased light sensitivity
Eye strain most often occurs after prolonged reading, computer work, driving or watching screens. The exact mechanism involves overuse of the eye muscles leading to fatigue.
4. Cluster Headaches
Cluster headaches cause severe pain centered around one eye. The pain is commonly described as sharp, stabbing or burning. Other cluster headache features include:
- Pain focused on one side around the eye, temple or face
- Headaches occur in clusters or cycles
- Reddening and watery eyes on the affected side
- Nasal congestion or runny nose
The cause of cluster headaches is unclear but may involve abnormal signaling in the trigeminal nerve which senses facial pain. Genetics, hormones and circadian rhythms may play a role in triggering headache cycles.
5. Tension Headaches
Tension headaches cause bilateral head pain described as tightness or pressure, like the head is being squeezed. Other symptoms may include:
- Dull, pressing pain on both sides of the head
- Pain in the neck or behind the eyes
- Tenderness of the scalp or neck
Tension headaches are often triggered by stress, fatigue, anxiety or muscle strain from poor posture. The exact cause involves contractions of the head and neck muscles.
6. Trigeminal Neuralgia
Trigeminal neuralgia is a chronic pain condition of the trigeminal nerve which senses feeling in the face. It causes episodes of intense, electric shock-like pain, including behind the eyes. Other features include:
- Severe, stabbing facial pain lasting seconds to minutes
- Pain triggered by brushing teeth, eating, talking or touching the face
- Painful spasms come and go throughout the day
Compression of the trigeminal nerve root is often the cause. Multiple sclerosis, tumors or strokes damaging the nerve can also result in trigeminal neuralgia.
When to See a Doctor
Make an appointment with your doctor if you experience:
- Frequent or severe headaches behind the eyes
- Headaches that get worse or change
- New headache patterns or symptoms
- Headaches waking you from sleep
- Headaches with confusion, fever or neurological symptoms
- Headaches following a head injury
- Chronic headaches that interfere with your life
Seeking prompt medical care is crucial to determine the cause and get appropriate treatment. This is especially important if the headaches are severe, persistent or accompanied by other symptoms like weakness or confusion.
Diagnosing the Cause of Pain Behind the Eyes
To diagnose the exact cause of headaches behind the eyes, the doctor will:
- Ask about your symptoms and medical history
- Perform a physical exam focusing on the head and neck
- Check your vision and eye health
- Test nerve function in the face
- Order imaging tests – MRI or CT scan of the brain in some cases
Blood tests may help rule out infections or other medical conditions contributing to headaches. Keeping a headache diary noting triggers and symptoms can also help the doctor make an accurate diagnosis.
Treatments for Pain Behind the Eyes
Treatment depends on the specific cause but may include:
- Medications – Over-the-counter pain relievers, prescription medications for migraines or neuralgia.
- Alternative therapies – Acupuncture, biofeedback, massage therapy.
- Lifestyle changes – Getting enough sleep, reducing alcohol, managing stress.
- Dietary changes – Hydration, limiting caffeine, treating food triggers.
- Eye treatments – Corrective lenses, proper monitor positioning, limiting screen time.
- Surgery – Draining infected sinuses or procedures on nerves or blood vessels for some chronic headaches.
Preventing headaches behind the eyes is also an important part of management. Identifying and avoiding potential triggers is key. Keeping a consistent sleep schedule, eating regular balanced meals, reducing alcohol intake and managing stress can help prevent recurrent headaches.
When to Seek Emergency Treatment
Seek prompt emergency care if headaches are accompanied by:
- Sudden, severe head pain
- Fainting or loss of consciousness
- Seizures
- Confusion, difficulty speaking or understanding
- Weakness or numbness on one side of the body
- Vision changes or loss of vision
- High fever
- Stiff neck
- Nausea or vomiting
- Head injury or trauma
These can indicate a medical emergency like bleeding, stroke, aneurysm, or brain infection requiring urgent evaluation and treatment.
Conclusion
Headaches localized behind the eyes can stem from various conditions depending on the exact location and associated symptoms. Common causes include migraines, sinusitis, eye strain, neuralgia and tension headaches. Seeking prompt medical attention is crucial, especially if headaches are severe, persistent or accompanied by other concerning symptoms. With an accurate diagnosis, most causes can be successfully managed with medications, lifestyle changes and treatment of any underlying conditions.