- Sudden vision loss, double vision, or trouble moving the eyes should be assessed urgently.
- Eye pain that worsens with movement may be a sign of optic nerve inflammation or other eye conditions.
- Fever, thick nasal discharge, severe facial pain, or symptoms of dengue or COVID-19 should be assessed by a doctor.
A headache behind the eyes can be caused by vision problems, migraines, sinus infections, dry eyes, optic nerve inflammation, or even infections like COVID-19. This type of pain may affect one or both eyes and often worsens with eye movement or when trying to focus.
A headache behind the eyes may also occur with symptoms like redness, burning, light sensitivity, blurred vision, or itching. In some cases, it can be related to infections like dengue or COVID-19, thyroid disorders like Graves’ disease, or eye inflammation.
Treatment for a headache behind the eyes depends on the cause and may include prescription glasses, artificial tears, medications, or treatment for underlying conditions. Identifying the cause is important to relieve symptoms and prevent complications.
The main causes of a headache behind the eyes include:
1. Vision problems
Headaches behind the eyes can be caused by vision problems such as nearsightedness (myopia), farsightedness (hyperopia), astigmatism, age-related vision changes (presbyopia), or eye misalignment (strabismus). These headaches often result from eye strain when your eyes work too hard to focus.
Vision problems can affect anyone. They may be present from early childhood or develop over time, and can also result from injury, certain medical conditions, or the natural aging process.
What to do: Schedule an eye exam with an ophthalmologist or optometrist. If needed, corrective lenses such as glasses or contact lenses can help reduce strain. In some cases, laser vision correction may be an option.
2. Migraines
A migraine is a severe, throbbing headache that often causes pain behind or around the eyes. It may also come with symptoms such as sensitivity to light, tearing, or visual disturbances like streaks or flashing lights.
Migraines can be triggered by factors such as hormonal changes, stress, strong odors, bright or flickering lights, and certain foods.
What to do: To help relieve migraine symptoms, rest in a quiet, dark room and avoid sensory triggers. If you experience migraines frequently, it’s important to consult a healthcare provider to identify potential causes and discuss appropriate treatment options, including medication if needed.
3. Sinus infections
Sinusitis, commonly called a sinus infection, is inflammation of the sinuses. Because the sinuses sit close to the eye sockets, this inflammation can cause pain or pressure behind the eyes. This pressure often occurs when mucus builds up and cannot drain properly.
A sinus-related headache is often accompanied by facial pain or tenderness, along with a sense of pressure or fullness in the face.
What to do: For headaches caused by sinusitis, relieving sinus congestion can help. Nasal rinses with saline may reduce mucus buildup and ease pressure.
Contact your primary care provider for symptoms lasting longer than five days, or if you develop a fever, thick nasal discharge, or severe facial pain. Treatment may include prescription medications such as nasal sprays or, in some cases, antibiotics.
4. Dengue
Dengue is a viral infection transmitted through the bite of an infected Aedes aegypti mosquito. It can cause pain behind or around the eyes, which may worsen with eye movement or visual strain.
According to the CDC, dengue symptoms commonly include fever with aches and pains, nausea, vomiting, rash, or warning signs, and symptoms can range from mild to severe.
These symptoms typically appear about 3 days after the mosquito bite. Read more about dengue symptoms and how they differ between classic dengue and dengue hemorrhagic fever.
What to do: If you suspect dengue, rest and drink plenty of fluids to stay hydrated. You can use warm compresses on the forehead for comfort.
Herbal teas such as ginger, lemongrass, lavender, or chamomile may also help with symptom relief. Take medications such as antipyretics or analgesics only as directed by your healthcare provider. Learn more about dengue treatment and recovery.
5. Dry eye syndrome
Dry eye syndrome, also called keratoconjunctivitis sicca, is a condition in which the eyes do not produce enough tears or the tears evaporate too quickly, reducing lubrication of the eye surface. This can lead to pain or headache behind the eyes, as well as burning, light sensitivity, and blurry vision.
What to do: Your doctor may recommend artificial tear eye drops to help lubricate your eyes, based on the severity of your symptoms.
According to the American Academy of Ophthalmology, dry eye treatment may also include lubricating ointments or thicker drops, anti-inflammatory treatments, and avoiding dry or windy environments.
In more severe cases, your doctor may prescribe medication eye drops to reduce inflammation and help prevent complications affecting the cornea.
6. Optic neuritis
Optic neuritis is inflammation of the optic nerve, the nerve that connects the eye to the brain. It can cause pain behind one or both eyes, often worsening with eye movement, and may feel like a headache centered behind the eye.
This pain is usually accompanied by other symptoms, such as changes in color vision or a sudden decrease in vision, which can sometimes progress to complete vision loss.
Optic neuritis can be associated with conditions such as multiple sclerosis, mumps, measles, Lyme disease, sarcoidosis, cat scratch disease, syphilis, and herpes.
What to do: See an ophthalmologist as soon as possible to determine the cause of optic neuritis and start appropriate treatment.
7. Scleritis
Scleritis is inflammation and swelling of the sclera, the white outer layer of the eyeball. It can cause eye pain that worsens with movement, as well as redness and sensitivity to light.
Common underlying causes include rheumatoid arthritis, lupus, Sjögren syndrome, scleroderma, granulomatosis with polyangiitis (formerly Wegener’s disease), and inflammatory bowel disease. Scleritis can also develop after eye surgery or trauma, or due to a foreign body in the eye or a localized infection.
What to do: See your primary care provider or an ophthalmologist to determine the cause of scleritis and start appropriate treatment. Depending on the cause, treatment may include anti-inflammatory medications, immunosuppressants, or, less commonly, antibiotics prescribed by your healthcare provider.
8. Graves’ disease
Graves’ disease is a thyroid disorder that can cause swelling of the tissues, muscles, and fat behind the eyes, leading to deep eye pain or a feeling of pressure in the eyes.
A headache behind the eyes from Graves’ disease may also occur with eye irritation, tearing or dryness, bulging eyes (exophthalmos), sensitivity to light, double vision, vision loss, or difficulty moving the eyes.
What to do: Treatment should be managed by an endocrinologist and may include thyroid medications, radioiodine therapy, or surgery, depending on how severe the disease is.
To help relieve pain or other eye symptoms, the doctor may recommend lubricating eye drops or ointments to reduce discomfort and keep the eyes moist.
9. COVID-19
Although COVID-19 mainly affects the respiratory system, it can also cause eye symptoms in some people, such as conjunctivitis, redness, itching, tearing, light sensitivity, or eye pain. Less commonly, COVID-19 has been linked to other eye problems, such as keratoconjunctivitis, optic neuritis, or hemorrhagic conjunctivitis.
The exact reason COVID-19 affects the eyes is not fully understood, but it may be related to inflammation, worsening of an existing eye condition, or effects on the nerves, blood vessels, or other structures in the eye.
What to do: If COVID-19 is suspected or confirmed and eye symptoms develop, contact a doctor or eye specialist for guidance. Rest, symptom-relief medication, and treatment for the specific eye problem may be recommended.