Eyes are sensitive not only to light, but also to pressure and other irritants. Unlike rest of the body organs that have skin to cover and protect it, eyes only have eyelids which provide only partial protection and covering. Due to this reason, the eyes are very prone to injuries and pain.
What is eye pain?
Eye pain may result from a direct damage to the eyes, or it can arise from injuries to the areas or other organs near it. It is therefore important to understand the structure of eye. An eye is made up of the following parts: iris (the pigmented or colored part), pupil (small opening in the centre of the iris), cornea (a clear layer all over the iris), sclera (white part), and conjunctiva (a thin layer covering the whole eye except the cornea). The lens is behind the iris and pupil, and the inside lining of the eye is called retina. The nerve carrying the information from retinal cells is called optic nerve.
The eye is protected by a thin layer of skin called eyelid. Eyelashes on the rim of eyelids also provide protection from dust and other irritants. A damage or injury to any parts of eyes or areas surrounding it can result in eye pain. It can be a constant, dull pain or a sharp, jabbing pain. It may or may not be accompanied with blurred vision, sensitivity to light, and redness.
What causes eye pain?
Eye pain is mostly a symptom of some associated condition, and not really a disease on its own. It can result from various conditions like:
Injury or inflammation
Trauma to the eye like a blow is an obvious cause of eye pain and often accompanied by bruising like a ‘black eye’. Corneal inflammation (also called as keratitis), inflammation of the sclera (scleritis), inflammation of the iris (iritis), inflammation of the optic nerve (neuritis), or inflammation of the eyelid (blepharitis) can cause eye pain with or without swelling.
This is a common cause of eye symptoms like redness, excessive tearing or dry eyes and eye pain. The strain is usually associated with prolonged hours of eye use particularly when staring at objects at a fixed distance, like looking at a screen or reading a book. It is further compounded by bright or dull light as well as existing vision problems without the use of corrective eye wear.
Damage to cornea and conjunctiva
The cornea and conjuctiva are involved in most number of cases of eye pain. When the eyelid is open, both conjunctiva and cornea are prone to injuries and infection, resulting in eye pain. Corneal ulceration can result from longstanding, untreated corneal infections or those of eyelids. Conjuctivitis or pink eye is a very common condition involving inflammation of conjunctiva resulting from a bacterial or viral infection. It results in itching, inflammation, swelling, redness and pain in the eyes. Allergic conjunctivitis is often seen in people who have related allergic conditions like allergic rhinitis.
Improper use of contact lenses can also damage them and cause irritation or eye pain. Contact lens keratitis is the term for the inflammation of the cornea associated with contact lenses. Corneal abrasion is another example of damage to the cornea arising from the use of torn contact lenses. Prolonged contact lens use can also resemble eyestrain.
The use of lenses not cleaned properly or washed using plain water instead of the recommended solution can also result in infections, for example Acanthamoeba infection. Fungal infections leading to inflammation and subsequent eye pain are less common in normal population but are reported at a higher rate in immunocompromised individuals.
Exposure to light
Very bright light can also damage the eyes and cause eye pain. Exposure to both sunlight and artificial light sources can cause damage to the light-sensitive part of the eye known as the retina.
Severe eye pain can also result from glaucoma, a condition characterized by pressure inside the eye which can damage the optic nerve. Pain does not occur with all types of glaucoma and it is important to have regular eye exams, especially when vision-related symptoms arise.
Styes on the eyelids are commonly seen in children and can also result in eye pain. They are easy to diagnose, don’t generally require medical attention, and can be treated at home with hot compress.
Infection of the sinuses may also result in eye pain. This is often described as a pain pushing on the eye from above or below the eye or from the root of the nose.
Eye Pain Diagnosis
The reasons of eye pain are diagnosed in a clinical setting and some of the routine examinations include:
- Slit-lamp exam, which includes the use of bright light to assess the condition of all the parts.
- Pupil dilation, using dilating drops to perform a thorough examination of retina.
- Instruments like a tonometer, to assess the pressure inside the eye ball to confirm glaucoma.
How to treat eye pain?
Acute eye pain may go away on its own but a longstanding or persistent eye pain may be an indication of some serious condition. Eye pain associated with change in vision should always be taken seriously and treated promptly. Treatment of eye pain involves removing the reason causing it and thus varies. The most common treatment modalities can be listed as:
- Eye drops: Most infections of the eye and its parts are treated with antibiotic drops. The pain reduces upon adequate treatment and goes away completely in some time.
- Eye inflammation is treated with anti-inflammatory drugs, and the choice of drugs depends upon the type, site and extent of inflammation. In some cases, corticosteroids can be used to provide relief from inflammation and eye pain.
- Surgery: glaucoma is a serious condition and is treated with either eye drops or surgery to balance the eye pressure. The eye pain goes away once the correct eye pressure is restored.
- Ointments: Corneal abrasions might heal on their own in the absence of irritants but in severe cases, may require antibiotic ointments.