Eye pain can vary from mild discomfort to severe, throbbing sensations that may signal various underlying causes. Approximately one-third of the adult population in the UK suffers from Dry Eye Disease (DED), a common condition contributing to persistent eye discomfort.
In this article, we’ll explore common causes of eye pain and treatment options, from simple non-surgical remedies to advanced procedures like laser eye surgery and Intense Pulsed Light (IPL) therapy for dry eyes.
What is Eye Pain?
Eye pain refers to any discomfort, soreness, or sharp pain felt in or around the eye. It can manifest in various forms, ranging from a mild ache to intense, sharp sensations. The pain can be localised to specific parts of the eye, such as the cornea, retina, or eyelids, or felt as a general ache around the eye area.
There are different types of eye pain, each associated with various causes:
- Sharp Pain: Sudden, sharp eye pain is often intense and usually localised to one eye. This type may worsen with eye movement and can indicate corneal issues that might benefit from specialist assessment.
- Stabbing Pain: Stabbing pain in the eye can feel like intermittent, sharp discomfort. It may be caused by irritation, inflammation, or even dry eyes, which is particularly common among contact lens wearers.
- Throbbing Pain: Throbbing or pulsing pain, often accompanied by headaches, can radiate to the eye area. This may indicate a tension headache or a more serious condition that requires medical evaluation.
- Burning Sensation: This type of pain is typically accompanied by a feeling of dryness and is often associated with DED, contact lens complications, eye fatigue, or infections such as conjunctivitis.
- Foreign Body Sensation: This occurs when something feels like it’s in the eye, even if nothing is visible. It is a common complaint among patients with chronic dry eye or contact lens-related issues.
Various factors can cause eye pain, including contact lens complications, infections, injuries, or underlying health conditions. Depending on the cause, it may be accompanied by other symptoms such as redness, tearing, blurred vision, or light sensitivity. Proper diagnosis and treatment are essential to determine the source of the pain and provide effective relief.
Where Does It Hurt in the Eye?
The location of eye pain provides important diagnostic clues:
- Front of the Eye (Cornea): Sharp or stabbing pain often from contact lens issues, abrasions, infections, or dryness.
- Behind the Eye (Orbit): A deep pain, typically associated with sinus infections, nerve issues, or migraines.
- Around the Eye (Periorbital Area): Usually caused by muscle strain, tension headaches, or inflammation.
Common Causes of Eye Pain
Eye pain can stem from various issues, ranging from minor irritations to more serious medical conditions. Identifying the cause is key to addressing the discomfort effectively. Here’s a closer look at some of the most common causes:
1. Dry Eye Disease
A lack of sufficient moisture or poor tear quality can lead to chronic dryness, irritation, and significant discomfort. Approximately one-third of the adult population in the UK suffers from DED, with higher prevalence among women, older adults, and contact lens wearers.
Dry Eye Disease can be categorised into:
- Aqueous Deficient Dry Eye: Not enough tears are produced.
- Evaporative Dry Eye: The tears evaporate too quickly due to poor oil quality. This is the most common type and responds well to IPL therapy.
Specialist eye clinics offer comprehensive dry eye assessments and specialised treatments, including advanced IPL therapy.
2. Blepharitis
Blepharitis is the inflammation of the eyelid margins. This is often caused by bacterial infections or skin conditions like rosacea. Symptoms include:
- Redness and swelling of the eyelids
- Burning or stinging sensation
- Crusty or flaky skin near the eyelashes
- Gritty feeling in the eyes
Chronic blepharitis is a common cause of dry eye symptoms and may require long-term management, including lid hygiene, warm compresses, and, in some cases, antibiotics.
3. Contact Lens Complications
Long-term contact lens wear can lead to several painful eye conditions, including:
- Contact Lens-Induced Dry Eye: Contact lenses can disrupt the tear film, leading to chronic dryness, irritation, and discomfort. This affects approximately 30% of contact lens wearers in the UK.
- Giant Papillary Conjunctivitis: This allergic reaction to contact lens proteins causes itching, mucous discharge, and discomfort. It affects up to 20% of soft contact lens wearers.
- Corneal Ulcers: Contact lens wear, especially overnight use or poor lens hygiene, is a leading cause of corneal ulcers. These painful, open sores on the cornea can cause intense pain, redness, and light sensitivity and can lead to vision loss if not treated promptly.
- Corneal Neovascularisation: Extended contact lens wear can cause abnormal blood vessel growth into the normally clear cornea, resulting in redness, discomfort, and potentially vision changes.
Many patients seek laser eye surgery specifically to eliminate these contact lens-related problems, allowing them to enjoy clear vision without the daily discomfort and complications of lenses.
4. Conjunctivitis (Pink Eye)
This common infection or inflammation causes redness, swelling, and discomfort in the eye. It can be:
- Bacterial Conjunctivitis: Characterised by yellow-green discharge and crusting, typically requiring antibiotic treatment.
- Viral Conjunctivitis: Usually accompanied by watery discharge and often associated with upper respiratory infections. It’s highly contagious and generally resolves on its own within 1-2 weeks.
- Allergic Conjunctivitis: Caused by allergens such as pollen, dust mites, or pet dander, resulting in itching, redness, and watery eyes.
5. Corneal Abrasions and Issues
Corneal problems are a significant source of eye pain and include:
- Corneal Abrasions: Scratches or injuries to the cornea. It is often caused by foreign objects, contact lenses, or accidental trauma. These can lead to sharp, intense pain, light sensitivity, and blurred vision.
- Recurrent Corneal Erosion: This painful condition occurs when the outermost layer of the cornea (epithelium) fails to attach properly to the underlying tissue, causing repeated episodes of severe pain, particularly upon waking.
6. Foreign Bodies
Foreign objects in the eye, such as dust, eyelashes, or small particles, can cause significant discomfort, tearing, and redness. Symptoms typically include sharp pain that may worsen when blinking, a persistent sensation that something is in the eye, excessive tearing, and sensitivity to light.
7. Glaucoma
This condition causes increased pressure within the eye, which can lead to sharp pain and vision changes. In acute angle-closure glaucoma, the pain onset is sudden and severe, often accompanied by headache, nausea, or vomiting, requiring urgent medical attention.
The number of people in the UK with glaucoma is expected to rise by 44% between 2015 and 2035, making early detection and management increasingly important.
8. Other Causes
- Uveitis: Inflammation of the middle layer of the eye, causing pain, redness, and light sensitivity. Often requires specialist treatment.
- Optic Neuritis: Inflammation of the optic nerve, causing pain with eye movement and potential vision changes. May be associated with multiple sclerosis.
- Sinusitis: Inflammation of the sinuses, causing referred pain around and behind the eyes. Usually accompanied by nasal congestion and headache.
Treatment Options for Eye Pain
Treatment for eye pain depends on its underlying cause, ranging from simple home remedies to advanced medical and surgical interventions. Here are the treatment options we offer at our clinic:
Simple Non-Surgical Treatments
Several approaches can offer relief for mild to moderate eye pain:
- Artificial Tears and Lubricants: These can alleviate dryness or mild irritation, particularly for contact lens-related discomfort or mild dry eye.
- Warm Compress Therapy: Applying warm compresses can help ease pain associated with meibomian gland dysfunction, blepharitis, or eyelid inflammation by improving oil gland function.
- Prescription Medications: For infections or inflammation, doctors may prescribe antibiotics, antivirals, or anti-inflammatory medications to address the underlying cause of pain.
Advanced Dry Eye Treatments
For patients suffering from chronic dry eye that doesn’t respond adequately to simple remedies, several specialised treatments are available:
- Punctal Plugs: These tiny devices, inserted into the tear duct, help retain natural tears on the eye surface, increasing moisture levels and reducing discomfort.
- Intense Pulsed Light (IPL) Therapy: A treatment that uses controlled light pulses to improve oil gland function and reduce inflammation in dry eye patients.
- Meibomian Gland Expression: Often performed in conjunction with other therapies, this procedure manually removes obstructions from the oil glands, providing relief for many patients.
Surgical Solutions
For patients experiencing eye pain related to refractive errors or contact lens complications, surgical interventions can provide long-term relief:
- Laser Eye Surgery (LASIK/LASEK): These procedures can eliminate the need for contact lenses, resolving associated complications such as contact lens-induced dry eye, giant papillary conjunctivitis, and corneal neovascularisation. Clinical studies show that approximately 95% of suitable patients achieve 20/20 vision or better following laser eye surgery with modern technology.
It’s worth noting that while some patients may experience temporary dry eye symptoms immediately after laser surgery, modern techniques have significantly reduced this risk. Most patients report better overall comfort compared to contact lens wear within 3-6 months post-surgery. - Cataract Surgery with Premium Lenses: For patients with cataracts contributing to glare, light sensitivity, and associated discomfort, modern cataract surgery with premium intraocular lenses can address both vision correction and reduce eye strain.
- Corneal Procedures: For specific corneal conditions causing pain, procedures such as phototherapeutic keratectomy (PTK) can smooth irregular corneal surfaces, reducing pain from recurrent corneal erosion and other surface abnormalities.
At The Vision Surgeon, we offer personalised treatments to relieve eye pain and improve your quality of life. Whether you’re considering LASIK/LASEK surgery, seeking cataract surgery with premium lenses, or looking for relief from dry eye symptoms, we are here to guide you every step of the way. Book a consultation today!
When to Seek Medical Attention
While mild eye pain is often harmless and can be treated conservatively, certain signs and symptoms may indicate a more serious underlying condition. Here are some red flags that should prompt you to seek professional help immediately:
- Severe or Sharp Pain: If the pain is sudden, intense, or sharp, it could indicate a serious issue like acute glaucoma, corneal ulcer, or severe infection requiring urgent treatment.
- Vision Changes: Pain accompanied by blurred vision, double vision, or vision loss may indicate a serious condition requiring immediate attention.
- Persistent Pain: If eye pain lasts for more than two days or progressively worsens despite home remedies, professional evaluation is necessary.
- Light Sensitivity with Pain: Severe photophobia (light sensitivity) accompanied by pain may indicate inflammation or infection requiring prompt treatment.
- Contact Lens Complications: If you experience increasing discomfort, redness, or vision changes while wearing contact lenses, remove them immediately and seek professional advice.
Conclusion
Eye pain can have various causes, ranging from contact lens complications and dry eye to more serious conditions requiring surgical intervention. While many causes can be managed with simple treatments, more complex issues may need professional assessment and advanced therapies such as IPL for dry eye or laser vision correction for contact lens-related problems.
Specialist eye clinics can identify the root cause of eye discomfort and offer personalised treatment plans, from conservative approaches to advanced surgical solutions.
If you’re experiencing eye pain or discomfort, particularly if related to contact lens wear or chronic dry eye, consulting with an ophthalmologist specialising in laser and cataract surgery is recommended.
At The Vision Surgeon, we offer a comprehensive range of treatments tailored to your specific needs. Our team will conduct a thorough assessment to determine the underlying cause of your symptoms and recommend the most effective treatment options available.