Headache pain behind the eyes can arise from conditions ranging from mild and commonplace to chronic neurological issues.
“Pain behind the eyes is a symptom, not a diagnosis,” says Hope O’Brien, MD, a neurologist and the founder and CEO of Headache Center for Hope, a headache treatment clinic in Cincinnati. Evaluating other symptoms that occur alongside pain behind the eyes can pinpoint the underlying issue.
Here are the most common causes of headache pain behind the eye.
Tension Headaches
Tension headaches are the most common type of headache, often described as a band of pressure around the head, says Fawad Khan, MD, a neurologist at Ochsner Medical Center in New Orleans. You may also experience tight neck and shoulder muscles or sensitivity to light and sound.
That band of pressure typically causes pain above the eyes, which can sometimes radiate behind the eyes, too, according to Sarah Benish, MD, a neurologist and the medical director of neurosciences at M Health Fairview Clinic and Surgery Center in Minneapolis. Typically, both eyes are affected.
While the exact cause is unknown, there may be several factors that can trigger a tension headache, including stress and muscle tension. Lifestyle factors like hunger and dehydration can also contribute to these headaches, says Ann Hoang-Tienor, MD, a neurologist at Hennepin Healthcare in Minneapolis.
Fortunately, tension headaches typically aren’t cause for concern. Though they can occur often and create discomfort, they’re not life-threatening and can be treated at home, says Dr. Benish.
Migraine
A migraine is a neurological disease that can cause severe headaches, often with intense throbbing pain on one side of the head.
“What’s happening in the brain is that a nerve located behind the eyes — the trigeminal nerve — is activated,” says Dr. O’Brien. When this nerve is triggered, it releases chemicals that can cause pain in the forehead or behind one or both eyes.
Here are other common migraine symptoms to look out for:
Fatigue
Nausea or vomiting
Difficulty concentrating
Mood changes
Vision changes
Muscle weakness
Sensitivity to touch, light, sound, or smells
Numbness and tingling
Dizziness
Stiff neck
Though the severity and length of headaches associated with migraine can vary from person to person, they’re typically more serious than a tension headache and often recur throughout your life. Triggers also vary, though common ones include stress, poor sleep, and skipping meals.
Sinusitis
An infection in your sinuses — also called sinusitis — can cause a sinus headache, often felt as pressure or pain behind your eyes, cheeks, and forehead.
According to O’Brien, it’s easy to confuse sinus headaches and headaches that are a symptom of migraine, as some of the trigeminal nerve irritation that occurs during migraine-related headaches can also cause pain around the sinuses.
Unlike headaches from migraine, however, sinus headaches occur when inflammation and congestion changes the pressure in your sinuses, leading to head pain.
To tell the difference between a headache associated with migraine and a sinus headache, watch out for additional symptoms like nausea, vomiting, and light or sound sensitivity — these are all signs that your headache is due to migraine.
Cluster Headaches
“A cluster headache is a type of headache that causes intense stabbing pain behind the eye or in the eye,” says Benish. “This is a severe and debilitating type of headache that often causes people substantial disability,” she adds.
According to Benish, a cluster headache is often accompanied by additional symptoms like:
Eyelid drooping
Redness in one eye
Tearing in one eye
Runny nose on one side
Flushing on one side of the face
Agitation and trouble sitting still
In addition to causing symptoms on one side of your face, cluster headaches stand out because of their distinct patterns of occurrence. They often strike in cycles called “cluster periods,” marked by repeated attacks separated by longer, headache-free intervals. These headache attacks can last anywhere from 15 minutes to three hours and recur throughout the day, says Dr. Khan.
The cause of cluster headaches is unclear. It may have to do with genetics, dysfunction in your brain’s hypothalamus (an area of the brain that produces hormones that regulate body temperature, heart rate, mood, and hunger), or irritation of the trigeminal nerve.
Eyestrain
Sometimes pain behind the eye can signal issues with the eye itself, says O’Brien. Staring at screens for prolonged periods, poor lighting, or uncorrected vision problems can strain the eye muscles, leading to headaches.
Other symptoms of eyestrain include:
Sore, burning, or itching eyes
Sensitivity to light
Blurred vision
Watery or dry eyes
This type of headache behind the eye usually isn’t serious and can be resolved by resting your eyes, taking a break from screens, or wearing appropriate prescription lenses.
Other Possible Causes
Most cases of pain behind your eye can be attributed to headache or eyestrain. That said, there are less-common causes of headaches to note.
Glaucoma, for example, is a condition that causes increased pressure in the eye, damaging your optic nerve (which carries information from the eye to the brain) and leading to vision loss. Headaches and severe eye pain are two common symptoms.
Thyroid eye disease can also cause pain behind the eyes. This autoimmune condition causes inflammation in your eye tissues, leading to pain in or behind your eye that’s worse when looking up, down, or sideways.
Similarly, eye conditions like optic neuritis (which occurs when inflammation causes damage to the optic nerve) and orbital inflammation (swelling of the tissues surrounding the eye) can contribute to headaches behind the eyes, says Khan.
A pinched nerve in your neck (often the result of whiplash or a fall) can sometimes cause pain behind your eye, says Khan. Myofascial pain syndrome — a condition that causes pain in your head and neck muscles, likely due to muscle overuse or injury — can also cause pain behind your eye.
Brain tumors or vascular issues are rare but serious conditions that may present with additional symptoms like vision loss, numbness, or persistent pain. But these conditions are so rare that it’s unlikely they’re the cause of your pain, according to O’Brien.
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