Some Causes and Features of Eye Pain
Some Causes and Features of Eye Pain
Cause |
Common Features* |
Diagnostic Approach† |
Disorders that affect the cornea primarily |
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Contact lens keratitis (inflammation of the cornea—the clear layer in front of the iris and pupil—caused by wearing contact lenses for long periods of time) |
Usually affecting both eyes Eye ache and a feeling of grittiness in the eye Eye redness, tearing, and sensitivity to light In people who wear contact lenses for long periods of time |
A doctor's examination alone |
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Corneal scratch (abrasion) A foreign object (body) |
Symptoms that begin after an eye injury or high-risk activity (for example, grinding metal), which may not be noticed in infants and young children Pain in the affected eye when blinking and a foreign body sensation Eye redness, tearing, and usually sensitivity to light |
A doctor's examination alone |
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Often a grayish patch on the cornea that later becomes an open, painful sore Eye ache and a foreign body sensation Eye redness, tearing, and sensitivity to light Sometimes in people who have had an eye injury or who have slept with their contact lenses in |
A doctor's examination Culture of a sample taken from the ulcer, done by an ophthalmologist |
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Epidemic keratoconjunctivitis (Pink Eye—inflammation of the conjunctiva, the membrane that lines the eyelids and covers the front of the eye, and the cornea caused by an adenovirus) |
Usually in both eyes Eye ache and a feeling of grittiness in the eye Eye redness, tearing, and usually sensitivity to light Often eyelid swelling and swollen, tender lymph nodes in front of the ears Rarely temporary, severe blurring of vision |
A doctor's examination alone |
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Herpes simplex keratitis (infection of the cornea caused by the herpes simplex virus) |
Usually affecting only one eye Early: Symptoms that begin after an episode of conjunctivitis Blisters on the eyelid, sometimes with crusting Late or recurring: Eye redness and watering, eye pain, impaired vision, and sensitivity to light |
Usually only a doctor's examination Sometimes, testing for the virus in scrapings obtained from the surface of the cornea or from blisters around the eye |
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Herpes zoster ophthalmicus (shingles that affects the face and eye, caused by the varicella-zoster virus) |
Usually affecting only one eye Early: A rash with blisters and/or crusts on one side of the face, around the eye, on the forehead, and sometimes on the tip of the nose Late: Eye redness, tearing, usually sensitivity to light, and eyelid swelling |
Usually only a doctor's examination Sometimes, testing for the virus in scrapings obtained from blisters around the eye |
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Welder’s (ultraviolet) keratitis (inflammation of the cornea caused by exposure to excessive ultraviolet light) |
Usually affects both eyes Symptoms that begin hours after exposure to excessive ultraviolet light (as is produced during arc welding, by a sunlamp, or by bright sun reflecting off snow, particularly at high altitudes) Eye ache and a feeling of grittiness in the eye Eye redness, tearing, and sensitivity to light |
A doctor's examination alone |
Other eye disorders |
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Severe eye ache and redness Headache, nausea, vomiting, and pain with exposure to light Disturbances in vision such as halos seen around lights and/or decreased vision |
Tonometry (measurement of pressure inside the eye)‡ Examination of the eye's drainage channels with a special lens (gonioscopy), done by an ophthalmologist |
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Anterior uveitis (inflammation of the anterior chamber—the fluid-filled space between the iris and cornea) |
Eye ache and sensitivity to light Eye redness (particularly around the cornea) Blurring or loss of vision Often in people who have an autoimmune disorder or who recently had an eye injury |
A doctor's examination alone |
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Endophthalmitis (infection inside the eye)§ |
Affecting only one eye Eye ache, intense eye redness, sensitivity to light, and severely decreased vision Often in people who have had recent eye surgery, a serious eye injury, or bloodstream infection |
A doctor's examination Cultures of fluids inside of the eye, done by an ophthalmologist |
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Optic neuritis (inflammation of the optic nerve), which can be related to multiple sclerosis§ |
Usually mild pain that may worsen when eyes are moved Partial or complete loss of vision Eyelids and corneas that appear normal |
A doctor's examination Often, MRI with contrast of the brain and orbit |
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Orbital cellulitis (infection of the tissue within the eye socket, or orbit)§ |
Affecting only one eye Bulging of the eye, eye redness, pain deep within the eye, and aches in and around the eye Red and swollen eyelids Inability to fully move the eye in all directions Impaired vision or loss of vision Fever Sometimes preceded by symptoms of sinusitis (see below) |
A doctor's examination Usually, CT or MRIs of the orbit |
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Orbital pseudotumor (a noncancerous accumulation of inflammatory and fibrous tissue in the eye socket)§ |
Aches in and around the eye, which may be very severe Often bulging of the eye Often inability to fully move the eye in all directions Swelling around the eye |
A doctor's examination Usually, CT or MRI of the orbit Sometimes, biopsy |
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Scleritis (inflammation of the white of the eye called the sclera) |
Very severe pain, often described as boring, and sensitivity to light Watering of the eyes Red or violet patches on the white of the eye Often in people who have an autoimmune disorder |
A doctor's examination Sometimes, ultrasound or CT of the orbit Rarely, biopsy |
Other disorders that cause eye pain |
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In people who have had previous episodes of severe headaches Cluster headaches: Headaches that Migraines: Headaches that |
A doctor's examination Sometimes, MRI or CT of the brain |
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Sometimes swelling around the eye but no other eye symptoms A yellow or green thick nasal discharge (sometimes with bleeding), headache, or eye or facial pain that varies with head position Fever, tenderness of the face, sometimes a productive cough during the night, and bad breath |
A doctor's examination alone Sometimes, CT of the sinuses |
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* Features include symptoms and the results of the doctor's examination. Features mentioned are typical but not always present. Disorders usually affect only one eye unless otherwise specified. † Although a doctor's examination is always done, it is mentioned in this column only if the diagnosis can sometimes be made by the doctor's examination alone, without any testing. If an ophthalmologist's examination is specifically required, that is mentioned separately. ‡ Doctors almost always do a slit-lamp examination with fluorescein staining and measure the pressure inside the eye (called tonometry). § These causes are uncommon. CT = computed tomography; MRI = magnetic resonance imaging. |
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