What to know about a headache behind the eyes

Headaches behind the eyes are common, and they may result from underlying health issues ranging from eye strain to migraine.

Pain behind the eyes can affect one or both sides, and it may occur with light sensitivity and other types of discomfort. A doctor can identify the cause of a headache behind the eyes and recommend the best course of treatment.

Keep reading for more information about the causes of pain behind the eyes and how to treat them.

Eye strain

a man experiencing a headache behind the eyes because of staring at a screen for too long.

Staring at a screen for too long may cause eye strain.

Focusing and refocusing on a screen for long periods can cause eye strain, which can also result from problems with vision.

Fatigue from eye strain can cause pain behind one or both eyes. A person may also experience pain in their eyes or blurry vision.

Causes

Some underlying health issues that cause eye strain include:

  • optic neuritis, which is inflammation of the optic nerve.
  • scleritis, which is severe inflammation of the white part of the eye
  • glaucoma, a disease that affects the optic nerve
  • Graves’ disease, an autoimmune disorder

Staring at a computer, TV, or phone screen for long periods can also cause eye strain.

Migraine

Migraine is a very common condition, affecting about 12% of people in the United States.

A migraine headache can cause extreme pain behind the eyes, and it can last for up to 72 hours.

In addition to a migraine headache, a person may experience:

  • eye pain
  • dizziness
  • weakness
  • nausea
  • sensitivity to light and sound
  • mood changes
  • vomiting
  • impaired vision

Causes

While doctors are unsure what, precisely, causes migraine, they recognize several common triggers. These are not the same for everyone.

Migraine triggers may be:

  • emotional, such as stress or anxiety
  • dietary, such as chocolate or alcohol
  • physical, such as a lack of sleep or poor posture
  • hormonal, such as menstruation
  • environmental, such as strong smells, smoke, or flickering lights
  • medication-related, involving sleeping pills or hormone therapies, for example

Sinusitis

a woman experiencing a headache because of Sinusitis

Nasal congestion is a common symptom of sinusitis.

Sinusitis is inflammation or congestion of the sinuses. This can create pressure, causing pain behind the eyes.

It can also cause pain and pressure in other parts of the face, such as the forehead and cheeks.

Some common symptoms of sinusitis include:

  • nasal congestion
  • fatigue
  • pain that worsens when the person is lying down
  • aching in the upper teeth

Causes

Sinusitis could result from bacteria, fungi, or a virus becoming trapped in the sinuses because of congestion. The congestion may have stemmed from allergies or a respiratory infection, for example.

Nasal polyps and dental surgery can also cause sinus pain and pressure.

Cluster headaches

When a person experiences between one and eight short, very painful headaches over the course of a day, they have had a cluster headache.

Cluster headaches often occur in cycles — a person may experience regular cluster headaches for a few weeks or months, followed by a period of relief.

These headaches are extremely painful and occur on one side of the head. Often, additional symptoms develop on the same side as the headache. These symptoms can include:

  • a stuffy or runny nostril
  • a teary or red eye
  • flushing
  • sweating

Causes

Doctors are unsure of the cause of cluster headaches, and there has not been extensive research, though these headaches are not uncommon.

Researchers generally believe that more males than females experience cluster headaches. There may also be a genetic component, and some people may have a higher risk than others.

Tension headaches

Tension headaches are the most common type of headache, and they are more common in females than males.

Some people experience tension headaches one or two times per month, while others experience them more often. If this continues for 3 months or longer, doctors classify these headaches as chronic.

Tension headaches usually cause pain behind the eyes and a feeling of pressure around the forehead.

Also, a tension headache may cause tenderness in the scalp. The pain of a tension headache may be dull, occur in the forehead, and extend to the neck.

Causes

Tension headaches develop for a variety of reasons, including:

  • cold temperatures
  • staring at a screen for a long time
  • driving long distances
  • muscle contractions in the neck or head

Treatment

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Avoiding the various factors below can often help relieve or prevent pain behind the eyes:

  • loud noises
  • strong perfume and other odors
  • infections
  • alcohol use
  • hunger
  • stress
  • changes in hormones
  • fatigue
  • bright lights
  • a lack of sleep

Over-the-counter pain medication can often relieve mild or moderate headaches, but when the pain is severe, prescription medication may be necessary.

A doctor may prescribe antidepressants, to help regulate hormone levels, or muscle relaxants, when another issue is responsible for the pain.

Trying the following things at home can also help:

  • limiting or avoiding caffeine
  • avoiding alcohol
  • refraining from using tobacco products
  • exercising regularly
  • avoiding processed foods

A person may find relief from a migraine episode by resting in a darkened room. Placing a cool, damp towel over the eyes may help, as well.

Meanwhile, antibiotics are a fairly standard treatment for sinusitis when bacteria are responsible. Nasal decongestant sprays can also help. Do not use these sprays for more than 3–4 days at a time, however, or there is a risk that the nasal passages may swell shut.

People can often relieve eye strain by using the 20-20-20 rule.

When to see a doctor

If a person experiences headaches behind the eyes frequently, they should see a doctor. The doctor may recommend an eye examination and prescribe treatments that are not available over the counter.

Making lifestyle adjustments may also prevent the pain from recurring.

Summary

Headaches behind the eyes can be quite painful and occur with other symptoms. They can stem from a variety of health issues, and identifying the cause is the first step toward treatment.

It may also help to avoid certain triggers, such as alcohol, caffeine, and tobacco products, and make other lifestyle adjustments.

A doctor can identify the underlying cause and provide additional support, including medication.

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