Headache Behind Eyes: 10 Common Causes & What to Do

Updated in December 2023

A headache behind the eyes or within the eyes can occur due to vision problems (like myopia or astigmatism), migraine, sinusitis, inflammation of the optic nerve or even COVID-19 infection. It can affect one or both eyes, and can be mild or intense. This pain can worsen with eye movement or straining to see. 

Pain behind the eyes can occur with other eye symptoms like redness, burning, increased light sensitivity, decreased vision, itching or headache. 

Therefore, if you experience pain behind the eyes, you should consult your doctor for assessment and to identify the cause so that adequate treatment can be started. Treatment may include using prescription glasses, eye drops or, in some cases, oral medication.

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The main causes of pain behind the eyes are:

1. Vision problems

A headache behind the eyes can be caused by vision problems, like myopia, hypermetropia, astigmatism, presbyopia, or strabismus. It generally occurs due to excessive straining when focusing on objects.

These vision problems can occur in anybody, and can occur soon after birth or develop over time. They can also occur due to trauma, injury, chronic illness or simply natural aging.

What to do: You should see an ophthalmologist and, if necessary, use prescription glasses or contact lenses. Laser surgery may also be recommended to improve focusing abilities.

2. Migraine

A migraine is a very intense and pulsating headache that can cause throbbing behind the eyes. It can also be accompanied by other symptoms like light sensitivity, tearing, or streaks in the vision field. Learn more about the classic symptoms of a migraine and who is most at risk for getting them.

A migraine can be triggered by hormonal changes, stress, strong smells, flashing lights or even food allergies. See the common causes of migraines and their different phases.

What to do: It is important to rest in a quiet, shady place to relieve your migraine and improve the pain behind your eyes, In addition, if you frequently experience migraines, you should see a doctor to identify the cause and initiate treatment with medication as necessary.

3. Sinus infection

Sinusitis, or a sinus infection, is an inflammation of the nasal cavities. It causes pain behind the eyes due to the close proximity of the nasal cavities to the ocular orbits. Sinusitis can cause pressure behind the eyes when there is an excess accumulation of discharge in the nasal cavity. 

Generally, a headache behind the eyes that is caused by sinusitis is accompanied by other symptoms, like general headache, pain around the eyes and a sensation of heaviness on the face. Learn about other symptoms and sssess your risk of a sinus infection with our online symptoms quiz.

What to do: A good way to relieve a headache behind the eyes in this case is to eliminate sinus discharge by performing nasal rinses with saline. If symptoms last for longer than 5 days, or if you also experience fever, thick discharge from the nose and intense facial pain, you should see your family doctor to initiate appropriate treatment. Treatment may involve the use of antibiotics, nasal sprays or flu medication. There are also several natural home remedies you can try to complement prescribed treatment.

5. Dengue

Dengue is a viral illness that is transmitted through insect bites, specifically of the Aedes aegypti mosquito. It can cause pain in the lower eyes that worsens with movement of the eyes or straining to see. 

In addition, dengue can cause other symptoms like high fever, fatigue, body aches, red skin rashes and general malaise. All of these can emerge about 3 days after the bug bite. Read more about dengue symptoms and how they vary with classic and hemorrhagic dengue.

What to do: If you suspect you have a dengue infection, you are advised to rest, drink plenty of fluids and apply warm compresses on your forehead. You can also drink ginger, sweet grass, lavender or chamomile tea. You should take any medications to relieve symptoms as advised by your doctor, like antipyretics or analgesics. Learn more about dengue treatment and how to recover quickly.

6. Dry eyes syndrome

Dry eyes syndrome, also known as keratoconjunctivitis sicca, is a disorder characterized by the decreased production or excess evaporation of tears which lubricate the eyeball. This can cause a headache behind the eyes, as well as burning, light sensitivity and blurred vision.

What to do: You are advised to use artificial tear eye drops to lubricate the eye balls, as advised by the doctor according to the severity of your symptoms. In more serious cases, the doctor may recommend the use of gels or ointments to lubricate and protect the eyes for longer. He or she may also prescribe antibiotic or corticosteroid eye drops to prevent cornea complications.

7. Optic neuritis

Optic neuritis is a condition involving inflammation of the optic nerve, which connects the eye to the brain. It can cause a headache behind one or both eyes and pain with movement. Generally, this pain is accompanied by other symptoms like changes to color perception or sudden decreased or total vision loss.

Optic neuritis can due to illnesses like multiple sclerosis, mumps, measles, Lyme disease, sarcoidosis, cat scratch disease, syphilis and herpes.

What to do: You are advised to see an ophthalmologist to diagnose the cause of optic neuritis and to initiate appropriate treatment.

8. Scleritis

Scleritis is characterized by swelling within the sclera, which is the outer part of the eyeball. It can cause pain with eye movement, redness and sensitivity to light.

Some other causes of scleritis are rheumatoid arthritis, lupus, Sjogren syndrome, scleroderma, Wegener's disease or inflammatory bowel disease. In addition, scleritis can emerge follow eye surgery, accidents, the presence of foreign bodies in the eyes or localized infections caused by microorganisms.

What to do: You should consult your doctor to diagnose the cause of the scleritis and initiate appropriate treatment. Antibiotics or immunosuppressants may be indicated.

9. Graves’ disease

Graves’ disease is a thyroid gland disorder that can cause swelling of the tissues, muscles and fat behind the eyes, causing deep eye pain or pressure in the eyes.

In addition, the headache behind the eyes can be accompanied by irritation, tearing or dry eyes, protruding eyes, sensitivity to light, double vision, vision loss or inability to move the eyes.

What to do: Treatment for this condition should be guided by an endocrinologist, which normally involves the use thyroid medication, radioiodine therapy or surgery, depending on symptom severity. To relieve pain behind the eyes or other eye symptoms, the doctor may recommend eye drops or ointments to relieve discomfort and hydrate the eyes.

10. COVID-19

Although COVID-19 is mostly a respiratory illness, with common symptoms being dry, persistent cough, fever or loss of taste and smell, coronavirus infection can cause eye symptoms like optic neuritis, conjunctivitis, keratoconjunctivitis or hemorrhagic conjunctivitis. Other symptoms felt with COVID-related eye pain are sensitivity to light and itching.

The reason for eyes changes caused by COVID is not totally clear, however worsening of a pre-existing eye condition can occur, as well as direct damage to the eye nerves, blood vessels or structures.

What to do: In this case, it is important to isolate completely and to consult your doctor, who may recommend rest and use of medication to relieve symptoms.