Eye pain is a common symptom for which an individual may consult a doctor. Eye pain characteristic can vary from burning, sharp, dull, gritty (feeling of something in the eye), aching, throbbing, or stabbing. Eye pain can be confused with symptoms, such as a headache or sinus pain as well.
Pain in or around the eye can be caused by several diseases. However if your eye pain is persistent, severe, or associated with decreased vision, consult your doctor immediately.
Some common causes of eye pain are:
- Conjunctivitis (pink eye) or any inflammation of the upper and lower lids
- Contact lens complications
- Foreign body in the eye
- Eye problems such infection, irritation, or injury
- Injury to the corneal (foreign body, abrasion)
- Eye surgery
- Glaucoma (rise of pressure in the eye)
- Migraine headache
- Sinus problems
- Stye (hordeolum)
Eye pain intensity is variable, and every person may interpret pain differently. The symptoms experienced by people with eye problems include:
- Pain in or around the eye
- Loss of vision (Partial or complete)
- Sensitivity to light
- Double vision
- Halos (coloured circles or halos around lights)
- Floaters (spots, strings, cobwebs, or shadows seen before the eyes)
- Limitation of eye movement
- Painful eye movement
- Feeling of flashes or streaks of light
- Severe headache along with eye pain
Tests and diagnosis
Your doctor will take a comprehensive history to make a diagnosis of the cause of your pain. The doctor will ask questions regarding when the pain started, the location of pain, the duration of pain, the characteristics of pain, what makes the pain better or worse, do you use contact lens, and any history of eye injuries or surgeries. Your doctor will do a complete physical examination including examination of your eyes such as testing your vision, visual inspection of the eye and its surrounding tissue, eye movements, visual fields (peripheral vision), and the pupil's reaction to light. Depending on your history, and examination findings your doctor may consider some or all of the following:
- Examination of your eyes using an ophthalmoscope----to see the back of the eye and to view the optic disc and blood vessels.
- Slit lamp examination: This is a microscope that helps to view the surface of the eye in detail such as to look for corneal abrasions and ulcerations.
- Check the pressure of your eyes using a tonometer on the slit lamp or a device known as a Tono-Pen, if glaucoma is suspected.
- Fluorescein test: In this test a dye fluorescein is put into the eye to look for abrasions, ulcerations, or any corneal defect.
Treatment of pain will depend on the cause of the pain and can vary from application of warm compresses on a sty or a chalazion to taking you into emergency surgery for acute glaucoma.
- Conjunctivitis (pinkeye): As it may be difficult to tell the difference between bacterial versus viral infections if infection is suspected it is treated with antibiotic eyedrops, eye ointment, and pain medication. Allergic conjunctivitis is normally treated with antihistamines, or other anti-allergic eye drops.
- Corneal abrasions and ulcerations: Antibiotic eye drops (to prevent infection), eye ointment, and pain medication are used.
- Foreign body in the eye: Any foreign body in the eye needs to be removed immediately. Your doctor may wash your eyes (irrigate the eyes), remove with a cotton tip applicator, remove with a small needle, or remove using an ophthalmologic drill. Any trauma to the eye after removing the foreign body is treated accordingly.
- Chemical eye burns and corneal flash burns: In chemical burns eye is washed with great amounts of water to wash out any residual chemical and anesthetic eye drops are put to relieve pain. Following thorough washing a complete evaluation by an ophthalmologist is done to decide on further treatment, depending on the extent of burn. Flash burns need antibiotic eyedrops, eye ointment, and pain medication.
- Blepharitis: Washing your eyelid edges with mild shampoo like baby shampoo on a soft washcloth twice a day to remove excess oil may be recommended.
- Styes or chalazions: Initially conservative treatment by placing warm compresses, such as a washcloth that has been warmed with hot water, on the eye or eyes for 15 to 20 minutes, four times a day and a antibiotic ointment is recommended. If the chalazion persists after three to four weeks, you may need surgery to drain out the infection.
- Iritis: Iritis or inflammation of iris is may be treated with certain eyedrops that dilate the pupils (cause the pupils to become bigger) and with topical steroid eyedrops. Oral steroids may be given if the iritis is severe.
- Optic neuritis: Optic neuritis is associated with gradual loss of vision and painful eye movement. There may be signs of a disease throughout the body, which needs to be diagnosed and treated. An ophthalmologists and neurologists help determine the cause of optic neuritis and treat it accordingly.
- Sinusitis: Bacterial sinusitis needs to be treated with antibiotics.
- Migraines: If migraine is the cause of eye pain an over-the-counter medication such as ibuprofen or acetaminophen, may relieve the pain or you may need a prescription migraine medications.
- Trauma to the eye: If eye pain is caused by an injury or in case of a penetrating injury it best managed by ophthalmologists and requires immediate evaluation in the emergency department.
Consult your doctor if you have eye pain. A few measures at home that can ease pain include:
- Rest your eyes if the discomfort is due to eye strain.
- Avoid wearing contact lenses if you think the pain is due to lenses
- If the pain started after something entered your eyes wash your eyes thoroughly with water.
- If a foreign body is in your eye, avoid rubbing your eyes as this can increase the damage.
Eye protection is an important step in prevention of eye pain.
- Protect your eyes with goggles or safety glasses when you are working with hand tools, power tools, industrial chemicals, or when there is a chance of getting chemicals, debris, or small particles in the eye.
- Wear safety glasses may be used to protect eye when you play sporting activities, such as basketball, racquetball, and tennis.
- Use headgear such as a safety helmet at work if required or wear a helmet while playing baseball, hockey.
- In children close parental supervision can often prevent eye injuries.
- Be careful when you are doing activities that can potentially injure your eyes
- If you use contact lenses, practice good eye care to prevent contact lens-related eye injuries.
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