There can be various reasons why you may experience eye pain. Whether it's a sharp or dull pain, knowing where it is coming from can often help determine what could be causing it.

Certain types of eye pain can indicate conditions which can be easily treated after being picked up during an eye exam, while others may be more serious and require immediate attention. 

Why does eye pain occur?

The cause of your eye pain will depend on the type of eye pain you experience, as well as where and when you feel it. 

Sharp pain behind my eye

Migraines and, occasionally, sinus infections can be two common causes of pain behind one or both eyes. 

There are occasions where pain behind the eye may indicate a more serious problem, such as scleritis (inflammation of the white part of your eye), optic neuritis (inflammation of the optic nerve), or acute angle-closure glaucoma. There are treatments available for these conditions, so it’s important not to ignore the symptom and to get your eyes tested as soon as possible.

Regardless of what you feel may be the cause of pain behind your eye, it’s always important to visit your optometrist for peace of mind.

Sudden sharp pain in my eye

A common cause of sudden sharp pain in the eye is debris. When dirt, dust, or a foreign object gets into the eye, it can cause irritation and sharp pain. To resolve this at home, try flushing your eye with clean water. If you wear contact lenses, remove them and rinse them out with the cleaning solution. If there is something sharp visible in your eye, don’t try to remove it yourself, but call your optometrist for advice. They might recommend you pop in and see us for some help. 

If you can’t see anything in your eye but pain persists, it’s a good idea to see your optometrist to get to the bottom of what’s going on.

Pain in my eye and temple

Tenderness over the temples and sharp pain in the eyes can be caused by a relatively harmless condition such as a headache. 

Some types of headaches, like cluster headaches, can be painful, sudden experiences that can have eye-related symptoms such as eye swelling, light sensitivity, constricted pupil and eye redness.1 

Cluster headaches are detected through identifying blood vessel dilation around your face and brain. As optical coherence tomography (OCT) can be used for retinal imaging (detecting and mapping the health of the retina), ophthalmologists will be able to detect any early conditions and issues such as cluster headaches early by analysing the eye’s blood vessels. As such, if you are prone to cluster headaches or migraines, it could be worth asking your optometrist for an OCT scan during your regular eye test. 

What conditions can cause sharp eye pain?

Sharp eye pain is a common symptom that occurs with many eye conditions. Some of the most common causes of sharp pain in the eyes are:

Sharp eye pain and acute angle-closure glaucoma

Acute angle-closure glaucoma should be treated as a medical emergency. This condition is caused by a rapid increase in pressure inside your eye, leading to severe eye pain and other symptoms such as blurred vision, nausea, vomiting, headache, and seeing halos around lights.2

Acute angle-closure glaucoma can be treated with medication or laser surgery. If you’re experiencing these symptoms, you should see a doctor immediately. 

Other forms of glaucoma can be detected through OCT, but are not usually associated with sharp eye pain. 

Sharp eye pain and microbial keratitis (corneal infection)

Microbial keratitis can be a painful infection that affects the cornea, which is the transparent layer at the front of your eye. It’s often related to contact lens wear or due to a scratch on the surface of the eye, but there are many other potential causes.

If not treated, it can lead to complications with your vision and may scar. Your eye may also become increasingly red and painful due to the development of an ulcer on the surface of the cornea.3 Occasionally, you can see this ulcer. It looks like a small white spot on the cornea. The condition is usually treated with antibiotic eye drops and, in some cases, a sample from the ulcer is taken to find out which bacteria has caused the infection. In serious cases, you may be admitted to hospital to see an ophthalmologist. If you have symptoms of keratitis, you should contact your optometrist as soon as possible.

Sharp eye pain and scleritis

An inflammation of the white part of the eye (sclera) can cause sharp eye pain, redness, blurred vision, watery eyes, and extreme light sensitivity.4 Scleritis is often caused by an eye infection and it has been associated with various autoimmune disorders. The condition can be treated with non-steroidal anti-inflammatory drugs, corticosteroids, and antibiotics.4 People with scleritis will see an ophthalmologist in order to prevent any further complications. Like iritis, scleritis can be detected through a slit lamp test during your eye exam.

Conditions that can cause eye pain not categorised as ‘sharp’

Eye pain and iritis 

Swelling and inflammation of the iris (the coloured ring around the pupil) can lead to pain in the eyes, redness, light sensitivity, and decreased vision. This condition is also called anterior uveitis and is usually detected through the use of a microscope called a slit lamp.

Steroid and dilating eye drops can help relieve pain and inflammation. Without treatment iritis can lead to complications such as vision loss, glaucoma, and cataracts. If you have symptoms of iritis, you should get your eyes tested as soon as possible. 

Eye pain and optic neuritis

Optic nerve inflammation can lead to damage to the nerve fibres that carry visual signals from the eye to the brain. Symptoms of this condition, which is sometimes linked to multiple sclerosis, include eye pain and temporary vision loss. 

Steroid medications can reduce the inflammation and speed up recovery of vision.5 Most people regain close-to-normal vision after an episode of optic neuritis, but it is important to seek medical care. Optic neuritis can be detected through an OCT scan.

Can OCT scans detect the causes of eye pain?

Yes and no. OCT scans are just one part of a range of other valuable tests your optician will use to assess your eyes and to help them narrow down the cause of your eye pain. As such, the training Specsavers’ optometrists go through and the equipment they have to hand will enable them to discover the cause of your sharp eye pain — whether it’s debris or eye inflammation.

To learn more about the symptoms, diagnosis, and treatment of eye conditions, visit our OCT resources. Alternatively, book an appointment to get answers to all your questions.

References

1. NHS. (No date). Cluster Headaches. [Online]. Available at: https://www.nhs.uk/conditions/cluster-headaches/ [Accessed 22 January 2020].

2. E-Medicine Health. (no date). Acute Angle-Closure Glaucoma. [Online]. Available at: https://www.emedicinehealth.com/acute_angle-closure_glaucoma/article_em.htm [Accessed 14 November 2019].

3. Moorfields Eye Hospital. (No date). Microbial Keratitis. [Online]. Available at: https://www.moorfields.nhs.uk/sites/default/files/Microbial%20Keratitis.pdf [Accessed 4 February 2020]

4. American Academy of Ophthalmology. (no date). What is Scleritis? [Online]. Available at: https://www.aao.org/eye-health/diseases/what-is-scleritis [Accessed 14 November 2019].

5. Saxena, R., Misra, R., Phuljhele, S. and Menon, V. (2011). Management of optic neuritis. Indian Journal of Ophthalmology, 59(2), p.117.