Ophthalmalgia; Eye pain
Pain in the eye (that is not due to injury) may be described as a burning, throbbing, aching, or stabbing sensation in or around the eye. It may also be characterized as a foreign-body sensation.
A feeling of tiredness in the eyes or some discomfort after a long period of work (eye strain) are generally minor problems and do not really qualify as eye pain. This may be due to an improper prescription for glasses.
Pain in the eye, while not a common complaint, can be an important symptom that should be treated if pain does not improve. It is important to try to characterize the pain as much as possible.
A wide variety of disorders can cause pain in or around the eye. In general, if the pain is persistent, severe or associated with decreased vision get medical attention. Also, try to characterize the type of pain and location as discussed.
- a problem in the eye itself (an infection, irritation or injury such as a corneal abrasion)
- a migraine headache (severe pain behind the eye)
- sinus problems (pain either over or below the eye)
- contact lenses
- eye surgery
- a stye (hordeolum) can create eye pain that increases as the stye grows
- conjunctivitis (pink eye) or any inflammation of the upper and lower lids
- pain in both eyes, particularly upon exposure to bright light (photophobia) that is common with many viral infections such as flu and will go away as the infection improves.
- glaucoma (so called narrow angle glaucoma can be very painful)
Resting the eyes, taking an over-the-counter analgesic, and avoiding bright light are generally recommended.
If you think your eye pain is due to wearing contact lenses, avoid wearing the lenses for a few days and see if the pain goes away.
Call your health care provider if
- there is pain, redness, swelling, discharge, or pressure in the eye(s) that persists - particularly if it affects vision.
- the pain is severe or prolonged beyond 2 days.
- eye pain is not associated with a viral illness or eyestrain.
- associated medical or eye problems i.e., history of herpes infections or new rash.
What to expect at your health care provider’s office
The medical history will be obtained and a physical examination performed. If there is major concern, see an ophthalmologist (who specializes in eye problems).
Medical history questions documenting your symptom in detail may include:
- distribution o Are both eyes affected? o in eye, around eye
- type of pain o foreign body, burning, throbbing
- time pattern o Did it begin suddenly?
- aggravated by o Is it worse after eye movement? o What other symptoms are also present?
Physical examination will include an examination of the eyes. The doctor will check vision, eye movements, and the back of the eye with an ophthalmoscope.
Diagnostic tests that may be performed are:
- A slit-lamp examination
- If glaucoma is suspected, eye pressure will be checked.
AFTER SEEING YOUR HEALTH CARE PROVIDER:
If a diagnosis was made by your health care provider as the cause of your symptoms, you may want to note that diagnosis in your personal medical record.
by Sharon M. Smith, M.D.