Eye pain can be alarming. Here's how to know when it might be worth calling your eye doctor, and when you're probably safe to treat the issue at home.
Your eye hurts. Maybe it’s a gritty, irritating pain that doesn’t sideline you — but it just won’t go away, nonetheless. Or maybe it’s one that sends you to the couch for some rest.
Whatever it feels like, eye pain can be alarming.
“As optometrists, we see eye pain all the time,” says Robert Africano, O.D., F.A.A.O., an optometrist and clinical preceptor at North Carolina Primary Vision Care Associates, located inside America’s Best Contacts & Eyeglasses in Charlotte, North Carolina.
Because eye pain can have a variety of causes, Dr. Africano likens his role as an optometrist to that of detective — investigating potential problems and coming up with solutions. Still, there are some situations in which you should not wait to figure out what’s going on.
Here are the red flags that indicate your eye pain is an emergency and you need to be treated right away:
- Severe or sudden eye pain
- Loss of vision with eye pain
- Eye pain that’s worsening after several days
As long as your eye pain doesn’t meet the above criteria, read on to learn more about the clues your symptoms are leaving for you.
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Eye Pain Clue #1: Heavy, Achy, Irritated Eyes
Prime suspect: Dry eye
“The number one culprit with eye pain is traditionally one of the least worrisome — but the most chronic — and that’s dry eye,” says Dr. Africano.
When eyes are dry, they become irritated and inflamed, which will feel like discomfort and pain to you.
According to the National Eye Institute, other symptoms of dry eye include:
- A scratchy feeling, like you’ve got something stuck in your eye that shouldn’t be there
- Sensitivity to light
- Blurry vision
Importantly, this type of eye pain, says Dr. Africano, tends to be mild and gradually worsens over time, and the feeling of discomfort comes and goes.
Solution: Dry eye can be treated at home with over-the-counter eye drops. Changes to your daily habits — such as taking breaks from staring at your computer and phone, hydrating well, and sleeping seven to eight hours per night — can also help relieve symptoms.
Eye Pain Clue #2: A Sharp Sting After Contact
Prime suspect: A corneal abrasion, or scratch
A swipe of your fingernail, walking into a branch, flying debris — these are just a few things that can scratch the cornea of your eye, says Dr. Africano.
In addition to the sharp pain, your eyes may water excessively and your vision may become blurry, according to the American Academy of Ophthalmology.
“A scratched eye is immensely painful, since you have a tremendous amount of pain receptors in the cornea,” Dr. Africano says.
Solution: The good news is that corneal abrasions tend to heal within a couple of days. Still, it’s a good idea to call and schedule an exam with your eye doctor. They can check the cornea and recommend eye drops to encourage healing and prevent an infection, Dr. Africano says.
If you were recently doing an activity where debris was flying (such as working with metal or wood, or playing volleyball in the sand), you could have something stuck in your eye. In those cases, call your eye doctor right away, says Dr. Africano. Leaving a foreign body in your eye puts you at risk for infection, he notes.
Eye Pain Clue #3: Pain That Is Worse in the Morning
Prime suspect: Recurrent corneal erosion
Occasionally, a corneal abrasion can lead to what’s called recurrent corneal erosion, says Dr. Africano. That’s when your cornea swells at night. In the morning, he explains, as you open your eyes, the layer of cells that lives on top of the cornea will lift.
“If a patient says they wake up with eye pain, that’s what we think of,” he says.
Solution: Follow the same treatment that you would with a corneal abrasion: Call your eye doctor and try to get seen as quickly as possible.
Eye Pain Clue #4: Redness and Tearing Are Part of the Equation
Prime suspect: You slept in your contacts or left them in for too long
Do you happen to wear contacts? And if so, do you sleep with them in?
“The majority of contact lenses shouldn’t be slept in. While there is a lot of advanced technology in contact lenses now, sleeping in them when you shouldn’t be increases the risk of infection dramatically,” says Dr. Africano.
In fact, sleeping or napping in contact lenses — something that one-third of contact lens wearers admit to doing — increases the odds of infection by six to eight times, according to a report from the Centers for Disease Control and Prevention.
These infections can lead to the development of a corneal ulcer, which would then need to be treated with medicated eye drops. Corneal ulcers scar the eye and can affect vision, according to the Merck Manual.
“These ulcers can heal on their own sometimes, but if they progress, they can increase in size, are incredibly painful, and cause devastating damage to vision,” says Dr. Africano.
Solution: If you’re a contact lens wearer and you experience this symptom, alert your eye doctor and make an appointment to have them look for signs of an infection.
Eye Pain Clue #5: Floaters on Top of Pain
Prime suspect: Uveitis, an inflammatory eye condition
Floaters are when you see dark spots or squiggly lines in your field of vision. They are one symptom — along with pain, blurry vision, redness, and light sensitivity — that suggests uveitis, an inflammatory eye condition, notes the National Eye Institute.
“We should not see this inflammation in a normal, healthy eye,” Dr. Africano says.
Inflammation inside the eye, which happens with uveitis (or scleritis, which is when the white part of the eye is swollen), can indicate a chronic health condition, such as an autoimmune disease, several of which can show up in the eyes, says Dr. Africano.
Solution: When Dr. Africano detects uveitis, he will treat the eye symptoms, but he also connects with the patient’s primary care physician to coordinate care and treatment. “It’s important to treat and manage the underlying condition,” he adds.
For more about the different causes of floaters, read “Ask an Optometrist: Floaters” here and watch this video.
Eye Pain Clue #6: Moving Your Eye Triggers Pain
Primary suspect: Inflammation of the optic nerve, or optic neuritis
Discomfort only when you move your eye often points to optic neuritis, an inflammation — or swelling — of the optic nerve. The optic nerve is essential for sight. It’s responsible for delivering messages from your eyes to your brain so that your brain recognizes what you’re looking at.
“You also typically would have some level of vision loss,” says Dr. Africano.
The good news, according to the Mayo Clinic, is that vision loss from optic neuritis often improves on its own. Sometimes steroid medication is prescribed to reduce inflammation in the optic nerve.
Solution: If your eye doctor diagnoses optic neuritis, they will refer you to a neurologist. That’s because multiple sclerosis (MS) is a common cause of optic neuritis, according to Johns Hopkins Medicine, which also notes that about 50% of people with MS will develop optic neuritis.
“Often, these eye symptoms can be the first sign of MS,” says Dr. Africano. “It can be a good identifier to help you find the right care.”
Other autoimmune conditions and bacterial infections, such as Lyme disease, have also been associated with optic neuritis.
The Bottom Line With Eye Pain
Yes, eye pain is a symptom you don’t want to brush off. But don’t automatically assume the worst, says Dr. Africano.
Call to let your eye doctor know what’s going on and try to stay calm. After all, sometimes all it takes are some eye drops to feel better.