Surface pain
The cornea is the most sensitive tissue in the body, and anything on or in it hurts: a scratch from a fingernail or branch, a foreign body under the lid, a contact lens worn too long, an ingrown lash, a corneal infection or ulcer, recurrent corneal erosion with its sharp pain on waking, and severe dry eye, which is felt as burning and grit. Surface pain is typically sharp, worse with blinking, and accompanied by watering and light sensitivity. Abrasions heal in days; infections need same-day treatment.
Deep pain
A dull, deep ache in or behind the eye, worse in bright light, with a red eye and sometimes a small pupil is iritis, inflammation inside the eye, which needs prompt steroid treatment. Severe pain with headache, nausea, halos and a hazy cornea is acute angle-closure glaucoma, an emergency. Deep, boring pain that wakes you at night in a violet-red eye is scleritis, often linked to autoimmune disease. Pain on moving the eye with dimmed or washed-out vision is optic neuritis, inflammation of the optic nerve, which needs urgent neurological assessment.
Pain that is not from the eye
Much 'eye pain' originates nearby. Sinusitis aches behind or around the eyes. Tension headache and eye strain from uncorrected prescription or long screen work cause a tired ache. Migraine can center on one eye. Cluster headache produces severe pain around one eye with tearing and a runny nose. Trigeminal neuralgia causes stabbing facial pain. Shingles can cause pain before the rash appears. The examination distinguishes these from eye disease, and the right specialist is involved when the eye is not the source.
When to be seen the same day
- Pain with light sensitivity, redness or reduced vision
- Pain in a contact lens wearer
- Severe pain with headache, nausea or halos
- Pain on moving the eye with a change in vision
- Pain after an injury or chemical exposure
- Pain with a rash on the forehead or nose
The examination
Vision, pupils and eye movements; eye pressure; slit lamp examination of the cornea with dye, the front chamber for inflammation, and the lids; and a dilated examination of the optic nerve where the pain suggests it. Most causes are diagnosed at the first visit and treated then.
Is this right for your eyes?
Nothing on this page is a diagnosis. Whether this is what is affecting your vision is decided by a full examination at one of our 4 offices: Pasadena, Huntington Beach, Woodland Hills and Beverly Hills.
About this content: This page was written with the assistance of AI tools and reviewed for medical accuracy by Dr. Bavand Youssefzadeh, DO. It is general information, not medical advice, and does not replace an eye examination. Individual results vary. Read our medical disclaimer.
