Pain in the eye and periocular area is a very frequent and unfortunately non-specific symptom, as it can be associated with a variety of conditions ranging from eye-related to non-eye-related diseases, such as an inflammation of the trigeminal nerve.
Ocular pain may be intermittent or continuous, occur sporadically or have a chronic character.
Eye pain: causes and symptoms
Pain is the biological alarm signal which can be a sign of damage and is essential for our survival.
Our ocular pain system is uniqueand its main role is to stimulate a reaction aimed at protecting visual function.
Eye pain can directly affect the eyeball or theorbit.
How it arises
Eye pain may occur alone or in association with other symptoms, such as eye redness, excessive tearing, swelling of the eyelids.
Ocular pain may sometimes be experienced as a result of movement, i.e. when one shifts the gaze to stare at something.
Eye pain: causes
The ocular pain affecting the outer ocular structures may be due to:
Conjunctivitis
Conjunctivitis is an inflammatory disease that can be of the nature allergic, bacterialchemical or viral. It affects the conjunctiva, the delicate membrane that lines the inside of the eyelids and covers the anterior surface of the eyeball to the exclusion of the corneal portion. The pain associated with conjunctivitis is generally mild, most often itching, coupled with redness and drainage of secretions.
Corneal abrasions and ulcerations
Corneal abrasions occur as a result of scratches on the surface of the corneacaused, for example, by trauma, a foreign body in the eyes or excessive use of the contact lenses. Ulcerations occur as a result of infections or abrasions.
Chemical and flash burns
Chemical burns result from exposure of the eyes to acidic or alkaline substances, such as household cleaners or bleach. The flash burns occur due to exposure to intense light sources, such as arc welding or ultraviolet rays from tanning booths, if appropriate eye protection is not worn.
Blepharitis
Blepharitis is an inflammation of the ciliary edge of the eyelid, resulting in burning and a sensation of heat and, in the case of seborrheic blepharitisThis also leads to the formation of scabs of an oily consistency and, in this condition, the eyelids may itch.
Stye and chalazion
Stye and chalazion cause eye pain due to local irritation, in both conditions there is a nodulewhich may be visible or only felt, inside the eyelid.
Orbital pain: causes
The orbital pain is described as a deep, dull pain in or behind the eyes. This type of pain is often due to the presence of ocular pathologieslisted below.
Acute angle-closure glaucoma
This is a form of glaucoma caused by increased intraocular pressure that can induce damage to the optic nerve, lead to visual impairment and, untreated, eventually lead to blindness.
Irite
It is an inflammation of the iris (the coloured part of the eye), which causes deep eye pain, blurred vision and sensitivity to light.
Optic neuritis
Optic neuritis is an inflammation of the optic nerve caused by autoimmune diseases or viral and bacterial infections. Orbital pain, especially in gaze movements, is accompanied by rapid reduction of visual function.
Sinusitis
Sinusitis is a bacterial or viral infection of the sinuses, in which case pain from the sinus cavities can be interpreted as eye pain.
Migraines
Migraines are a very common cause of orbital pain. An accurate anamnesis establishing the frequency and duration of migraine attacks is very important, as well as identifying the cause, in order to then formulate the correct diagnosis and adopt the most effective therapy.
Toothache
Toothaches, especially localised in the upper dental arch, may present as pain under the eye or in the orbital area.
Traumatic events
Examples of trauma resulting in severe eye pain are a penetrating eye injury or a blow with a blunt object.
What to do
In case of eye pain, it is important consult the doctorespecially in the presence of the following conditions:
-eye pain is intense and/or persistent;
-Eye pain is accompanied by headache, fever, nausea or vomiting, unusual sensitivity to light or presence of visual halos;
-the visual function has changed suddenly;
-Eye pain is given by a foreign body or a chemical substance, penetrated into the eyes;
-in the presence of swelling in or around the eyes, difficulty in movement and opening of the eyes;
-in case one has soft contact lens wearers or those with a weakened immune system.
- Ocular and Orbital Pain for the Headache Specialist. Alexander L. Ringeisen et al. Curr Neurol Neurosci Rep
- American Society of Ophtalmology.