Why do my eyes hurt?

Summary

Mild eye pain can be a symptom of eyestrain or tiredness. The area around the eyes may also hurt during a migraine headache or sinus infection. In some cases, eye pain can also be a symptom of a more serious condition, such as uveitis.

The eyes can hurt in many different ways. A person may feel that their eyes are sore, aching, burning, or stinging, or that they have an object or other foreign body stuck in them.

This article will look at the potential causes of eye pain, some treatments and remedies, and when to see a doctor.

 

Causes

Looking at screens for an extended period of time may cause eyestrain.
Eyestrain
Eyestrain develops when the eyes get tired. This often occurs when someone is completing a task that involves focusing the eyes for long periods of time. This can result in aching, watery, or dry eyes.

Some potential causes of eyestrain include:

  • looking at screens
  • driving
  • reading
  • having exposure to bright lights

Resting the eyes can improve eyestrain. The National Eye Institute (NEI) recommend taking breaks from tasks such as reading every 20 minutes by looking at an object 20 feet away for 20 seconds.

Adjusting the brightness of screens, reducing glare from lights and windows, and taking regular breaks from driving may also help.

An incorrect prescription for eyeglasses can also cause eyestrain and headaches. Vision changes over time, so it is a good idea to undergo regular checkups with an eye doctor.

Dry eye

Dry eye is a common condition. It occurs when the tear ducts do not produce enough tears to keep the eyes moist.

Some symptoms of dry eye include:

  • scratchy eyes
  • burning or stinging eyes
  • sensitivity to light
  • blurry vision
  • redness

Dry eye is most likely to affect older adults, females, and people who do not get enough vitamin A or omega-3 fatty acids in their diet. People with certain autoimmune conditions, such as lupus or Sjogren’s syndrome, are also likely to develop dry eye.

Dry eye can also occur if someone spends a long time looking at a screen, as they may not blink as often. Air conditioning, smoke, and wind can also exacerbate this condition.

Treatment for dry eye includes hydrating eye drops and prescription medication that causes the body to make more tears. Undergoing a medical procedure to block the tear ducts can help if the cause of dry eye is tear ducts that drain too quickly.

Pink eye

Pink eye, or conjunctivitis, results from a virus or bacterium. The most common symptoms are:

  • pink or red eyes
  • itching or burning
  • watery eyes
  • discharge, which could be white, yellow, or green

Viral conjunctivitis usually resolves on its own without treatment. However, people with bacterial conjunctivitis may need antibiotic eye drops or eye ointment.

People with severe or persistent symptoms, and those who notice conjunctivitis symptoms in a newborn baby, should see a doctor.

It is easy to pass pink eye to other people. Therefore, anyone with symptoms of conjunctivitis should wash their hands regularly, especially after touching the eye area. It is also a good idea to temporarily:

  • stop wearing contact lenses
  • stop wearing eye makeup
  • stop sharing towels and other personal items
  • avoid swimming pools

People will be able to resume these activities when the infection has cleared up.

Fungal infection

Fungi can also cause eye infections.

People who work on farms or in gardens, plus those who wear contact lenses, have a higher risk of developing fungal eye infections. People with weaker immune systems, diabetes, and conditions that require corticosteroid treatment may also be more susceptible.

A fungal eye infection can cause:

  • eye pain
  • redness
  • blurred vision
  • sensitivity to light
  • tearing
  • discharge

It is important to seek medical treatment right away for these symptoms. According to the Centers for Disease Control and Prevention (CDC), all types of fungal eye infection require prescription medication. Treatment may involve antifungal eye drops, medication, or, in some cases, surgery.

Scratched cornea

The cornea is the clear layer of film that covers the front of the eye. A person may scratch their cornea when putting in contact lenses, applying makeup, or rubbing their eyes. The result is eye pain, along with:

  • a feeling that something is stuck in the eye
  • red, watery eyes
  • sensitivity to light
  • blurry vision

To treat a scratched cornea, a doctor may prescribe eye drops, a patch to protect the eye, or a special contact lens that can speed up healing.

According to the American Academy of Ophthalmology, mild scratches do not need treatment and will usually heal within 2 days. A larger scratch may take up to 1 week to heal.

Uveitis

According to the NEI, uveitis is a term that describes a range of inflammatory eye conditions. Uveitis can destroy eye tissue and may cause vision loss.

The symptoms include:

  • eye pain
  • blurry vision
  • dark, floating spots in vision
  • sensitivity to light
  • redness

The cause of uveitis is not always clear. It may develop due to an eye injury, infection, tumor, or autoimmune condition. It can be an acute condition that goes away or a chronic condition that reoccurs.

Uveitis needs medical attention. Treatment is usually with prescription eye drops or medication. The aim is to reduce pain and inflammation, prevent tissue damage, and restore vision.

 

Eye pain and other symptoms

If eye pain occurs alongside other symptoms, it may indicate that the person has a different condition causing their eye pain.

Potential conditions include:

  • Sinus infection: Pain that affects the cheeks, forehead, and eyes, along with a blocked nose and fever, may indicate a sinus infection. A doctor can treat a sinus infection with antibiotics.
  • Migraine: Migraine is a condition that causes severe headaches, often on one side of the head. Migraine may cause a sharp pain in or behind the eyes or brow bone, sensitivity to light, and nausea or vomiting.
  • Cervicogenic headache: This type of headache can cause pain around the eyes, on one side of the face or head, and in the neck or shoulders. Nausea, blurred vision, and sensitivity to light or sound can also occur.
Home remedies

Home remedies cannot cure serious eye conditions or infections, such as a fungal infection or uveitis. However, they can provide symptom relief for people with tired, sore, or dry eyes.

Some home remedies include:

  • Resting: Eye pain due to strain and an incorrect prescription can ease when a person rests their eyes. Taking regular breaks from reading or screen work may prevent eyestrain.
  • Using a humidifier: Humidifiers can increase the moisture in the air, which can help people with dry eyes and those who live in dry climates.
  • Trying over-the-counter drops: Hydrating eye drops add moisture to the eyes and can help people with tired or dry eyes feel better.
  • Reducing exposure to irritants: Smoke, high winds, and air conditioning can exacerbate eye dryness. If possible, it may help someone to reduce their exposure to these irritants.
    Stopping smoking: Cigarette smoke irritates the eyes. According to the NEI, smoking also increases the risk of eye disease and optic nerve damage.

The NEI recommend reducing the risk of eye conditions by eating dark, leafy greens, oily fish such as salmon and halibut, and foods that contain vitamin A, such as carrots and broccoli.

 

When to see a doctor

If a person’s eye pain is severe, persistent, or accompanied by other symptoms — such as pus or sensitivity to light — they should see a doctor. Any loss of vision is also a reason to seek medical advice.

People at risk of developing eye disease or complications should also see an optician if they experience any eye pain. This includes people with diabetes, high blood pressure, and conditions that weaken the immune system.

Newborn babies can develop serious conditions as a result of eye infections. Parents and caregivers should take infants with puffy eyelids, red eyes, or eye discharge to a doctor right away.

Summary

Mild eye pain and discomfort are common. These symptoms can develop due to eyestrain or dryness, both of which can occur when someone spends a long period of time focusing the eyes on screens or books.

More severe eye pain may occur due to migraine, a scratched cornea, or an infection. If possible, a person should speak to a doctor about their symptoms.

 

Sources:

https://www.medicalnewstoday.com/articles/why-do-my-eyes-hurt#seeing-a-doctor

Dry EyeEye Health / BlindnessHeadache / Migraine
9 sourcesexpanded

Boyd, K. (2020). Corneal abrasion and erosion.
https://www.aao.org/eye-health/diseases/what-is-corneal-abrasion
Conjunctivitis (pink eye). (2019).
https://www.cdc.gov/conjunctivitis/
Dry eye. (2019).
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye
Fungal eye infections. (2017).
https://www.cdc.gov/fungal/diseases/fungal-eye-infections/index.html
Keep your eyes healthy. (2020).
https://www.nei.nih.gov/learn-about-eye-health/healthy-vision/keep-your-eyes-healthy
Pink eye. (2019).
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/pink-eye
The complete headache chart. (n.d.).

Uveitis. (2019).
https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/uveitis
Vimont, C. (2020). Eye strain: How to prevent tired eyes.
https://www.aao.org/eye-health/diseases/what-is-eye-strain


Dry Eye Treatment: Getting Relief From Dry Eyes

 

Dry eye syndrome is a chronic and typically progressive condition. Depending on its cause and severity, it may not be completely curable. But in most cases, dry eyes can be managed successfully, usually resulting in noticeably greater eye comfort, fewer dry eye symptoms, and sometimes sharper vision as well.

Because dry eye disease can have a number of causes, a variety of treatment approaches are used.

The following is a list of dry eye treatments that are commonly used by opticians to reduce the signs and symptoms of dry eyes. Your optician may recommend only one of these dry eye treatments or a combination of treatments, depending on the cause(s) and severity of your condition.

Artificial Tears

For mild cases of dry eyes caused by computer use, reading, schoolwork and other situational causes, the best dry eye treatment may simply be frequent use of artificial tears or other lubricating eye drops.

dry-eye

Artificial tears usually are the first step in dry eye treatment.

There are many brands of artificial tears that are available without a prescription. The challenge with using artificial tears is not lack of product availability — it’s the confusing number of brands and formulations available to choose from.

Artificial tears and other over-the-counter (OTC) lubricating eye drops are available in a wide variety of ingredients and viscosity (“thickness”).

Artificial tears with low viscosity are “light” and watery. They often provide quick relief with little or no blurring of your vision when you apply them. But often their soothing effect is very short-lived, and sometimes you must use these drops very frequently to get adequate dry eye relief.

On the other hand, artificial tears that have a high viscosity are more gel-like and can provide longer-lasting lubrication. But typically these drops cause significant blurring of your vision for several minutes immediately after you apply them. For this reason, these drops often are not a good choice for use during your work day or when you need immediate clear vision for tasks such as driving. Instead, high-viscosity artificial tears are recommended only for bedtime use.

Also, the ingredients in certain brands of artificial tears may determine which type of dry eye condition they are better suited for. For example, one brand might work better for aqueous-deficiency dry eyes, while another brand may be more effective for an evaporative dry eye condition.

If your optician recommends that you use one or more brands or formulations of artificial tears, be sure to follow the directions he or she gives you concerning when and how often you use the drops.

Steriod Eye Drops

Over the past several years, doctors have discovered the importance of inflammation as a cause of dry eyes. Inflammation frequently causes the redness and burning associated with dry eye disease; but in many cases, it may be present without any visible signs or symptoms at all.

Artificial tears usually do not adequately address these inflammatory changes, and your doctor may recommend steroid eye drops to better manage the underlying inflammation associated with dry eyes.

Often there’s no “quick fix” for dry eyes. Follow your eye doctor’s instructions and be patient for results from dry eye treatment.

Steroid eye drops are generally used short-term to quickly manage symptoms. They are often used in conjunction with artificial tears as a complement to these more long-term treatment strategies.

While a small amount of the steroid may get absorbed systemically, in the right candidate, the effects of steroid eye drops are generally not noticed beyond the eye. Still, it’s important to discuss your medical history with your eye doctor before starting steroid eye drops.

Many different types of steroid drops are available and differ in their potency. Most doctors prefer to start with mild steroids that are quickly degraded inside the eye. In some cases, however, more potent drops are required to address more severe symptoms.

Steroid eye drops can increase the risk of developing high eye pressure or even cataracts if used for extended periods of time. But these risks are low when the drops are used only on a short-term basis for dry eye treatment.

Punctal Plugs

Punctal plugs are sometimes used in dry eye treatment to help tears remain on the surface of the eye longer.

oasismed-lacrimal-glands-ed-660x440
This drawing shows the lacrimal glands and tear ducts. A lacrimal plug (or punctal plug) has been inserted into the lower tear duct to keep the eye’s moisture from draining away too quickly. Image: Oasis Medical, Inc


This drawing shows the lacrimal glands and tear ducts. A lacrimal plug (or punctal plug) has been inserted into the lower tear duct to keep the eye’s moisture from draining away too quickly. Image: Oasis Medical, Inc. [Enlarge]

A punctal plug is a small, sterile device that is inserted into one of the small openings (puncta) of tear drainage ducts that are located in the inner corner of the upper and lower eyelids.

After these openings have been plugged, tears can no longer drain away from the eye through these ducts. In this way the tear film stays intact longer on the surface of the eye, relieving dry eye symptoms.

So where do the tears go? Usually they will simply evaporate from the eye surface without symptoms. But if insertion of punctal plugs causes the eyes to “water,” one or more of the plugs can be removed.

Meibomian Gland Expression

A very significant percentage of dry eye cases are caused by inadequate oil (meibum) being secreted from meibomian glands located along the margin of the eyelids.

The openings of these glands are near the base of the eyelashes, and if these openings get clogged, the oil that is critical to keeping the tear film from evaporating too quickly cannot do its job. This is called meibomian gland dysfunction (MGD), which leads to a condition called evaporative dry eye.

To treat MGD and evaporative dry eye, your eye doctor may perform an in-office procedure called meibomian gland expression. In this procedure, warm compresses may or may not first be applied to your eyelids; then a forceps-type device is used to squeeze the clogged contents (hardened meibum and possibly other substances) from the meibomian glands.

To fully express the contents of the meibomian glands and get them functioning properly, significant pressure must be applied to the eyelids, which can be uncomfortable. But the results usually are worth putting up with the short-term discomfort of the procedure.

Warm Compresses

An alternative (and potentially more comfortable) way to help open clogged meibomian glands to treat dry eyes is to simply apply warm compresses to the closed eyelids to soften the hardened meibum.

Unfortunately, for warm compresses to work well, some researchers say you have to use a compress that can maintain a temperature of 108 degrees Fahrenheit for more than 10 minutes, and the compresses have to be applied for this length of time at least twice a day.

Most people are unable or unwilling to perform this type of dry eye treatment correctly, and shorter and less frequent use of variable-temperature warm compresses typically is ineffective.

Nutritional Supplements

Doctors sometimes recommend nutritional supplements as part of a holistic dry eye treatment plan. Studies have found that supplements containing omega-3 fatty acids can decrease dry eye symptoms.

Good sources of omega-3s include cold-water fish such as salmon, sardines, herring and cod. For a vegetarian source of omega-3s, some eye doctors recommend flaxseed oil to relieve dry eye.

Drinking more water can help, too. Mild dehydration often makes dry eye problems worse. This is especially true during hot, dry and windy weather. Simply drinking more water sometimes reduces the symptoms of dry eye syndrome.

Home Remedies for Dry Eyes

If you have mild dry eye symptoms, there are several things you can try to get relief

  • Blink more frequently. When using a computer, smartphone or other digital device, we tend to blink our eyes less frequently than normal, which can cause or worsen dry eye symptoms. Make a conscious effort to be aware of this, and blink more often when using these devices. Also, perform full blinks, gently squeezing your eyelids together to wash your eyes fully with a fresh layer of tears.
  • Take frequent breaks during computer use. A good rule of thumb here is to look away from your screen at least every 20 minutes and look at something that is at least 20 feet from your eyes for at least 20 seconds. Some eye care practitioners call this the “20-20-20 rule,” and abiding by it can help relieve both dry eyes and computer eye strain.
  • Remove eye makeup thoroughly. Eyeliner and other eye makeup can clog the openings of the meibomian glands at the base of the eyelashes, leading to meibomian gland dysfunction and evaporative dry eye. At the end of the day, be diligent about remove all traces of makeup from your lids and lashes.
  • Clean your eyelids. When washing your face before bedtime, gently wash your eyelids to remove bacteria that can cause blepharitis and meibomian gland problems that lead to dry eye symptoms. Apply a warm, moist washcloth to your closed lids for a minute or two. Then gently scrub your lids and lashes with a mild cleanser, such as diluted baby shampoo or premoistened eyelid wipes sold in drugstores.
  • Wear quality sunglasses. When outdoors during the day, always wear sunglasses that block 100 percent of the sun’s UV rays. It’s best if they feature a wrap-style frame to protect your eyes from wind, dust and other irritants that can cause or worsen dry eye symptoms.

Book an eye examination if you want a full eye health check.

Source Richard Adler, MD