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Causes and treatment options for sore eyes
Eye pain can have different causes. Often they occur one-sided and especially when moving the eye. The eye itself is not always affected, but its surroundings. For example, the symptoms also occur with headaches (e.g. migraines or cluster headaches). The most common triggers include conjunctivitis, bacterial infections, corneal infections and dry eyes. Foreign objects in the eye can also cause the symptoms. If the pain appears suddenly and does not go away on its own after a short time, a doctor should be consulted to clarify the cause.
Sore eyes with conjunctivitis (conjunctivitis)
Eye pain is often one of the symptoms of conjunctivitis (conjunctivitis). Other complaints can include reddening of the affected eye, itching, a feeling of a foreign body, burning eyes and an increased flow of tears. In addition, small protrusions, so-called follicles, can form in the conjunctiva.
A conjunctivitis with painful eyes is caused by infections with bacteria or viruses, allergies and other diseases such as rheumatism. If it is bacterial or viral conjunctivitis, conjunctivitis is contagious. On the other hand, if the conjunctiva is due to an allergy or external stimuli, it is not infectious.
If the rheumatic disease is the cause of the inflammation, there is no risk of infection.
Eye pain due to corneal inflammation (keratitis)
Inflammation of the cornea (keratitis) is an infection of one or more layers of the cornea (cornea). Bacteria are usually the cause of the inflammation, which is sometimes accompanied by considerable eye pain. Viruses, such as herpes simplex viruses (herpes keratitis) or - in very rare cases - fungi are sometimes triggers of keratitis. In addition, a very dry eye (keratoconjunctivitis sicca), acid or alkali burns, superficial eye injury from UV rays and damage to the trigeminal nerve can lead to corneal inflammation.
In addition to the pain, keratitis manifests itself - depending on the depth of the inflammation - through a slight to dense clouding of the affected area, which can appear as a whitish spot, reddening of the eyes and an increased flow of tears and secretions, since the conjunctiva is usually affected at the same time. It is not uncommon for corneal inflammation to develop from wearing contact lenses for too long. Soiled or defective lenses can also trigger an infection. Older people with a weakened immune system are more likely to suffer from keratitis.
Flashing of the eyes / snow sickness
If intense UV-B radiation hits the unprotected eyes, sunburn on the cornea and conjunctiva (photoconjunctivitis and keratitis) can occur, which can result in painful, minor injuries to the epithelium, loosening of the epithelium of the cornea and the death of epithelial cells goes along. Such flashing of the eyes can occur, for example, if you are in the snow or on the beach without sunglasses. The eyes can also be damaged when welding without protective glasses. Since snow, sand and water reflect UV radiation, the eyes are exposed to additional indirect radiation in such an environment.
Flashing of the eyes is usually delayed after about three to twelve hours after exposure to UV radiation. Those affected then have very severe eye pain on both sides, suffer from a foreign body sensation in the eye and have to close their eyes again and again, as they are extremely sensitive to light (eyelid cramp). In addition, the eyes water and visual disturbances can occur. The ophthalmologist also diagnoses conjunctivitis and corneal inflammation.
In most cases, the symptoms go away after a day or two without leaving any permanent damage. The patient is treated with eye ointment and pain relievers and should remain in bed.
Pain in dry eyes (Sicca syndrome)
Dry eyes (Sicca syndrome) can severely limit well-being. Those affected often report a foreign body sensation in the eye, burning eyes and eye pain, red eyes, itching and sensitivity to light.
The dryness is a result of inadequate wetting of the eye by tear fluid. The most common causes of Sicca syndrome include tobacco smoke, drafts from air conditioning or the blower in the car, VDU work (office eye syndrome) and hours of gaming on the computer (gamer eye). Dry eyes can also be the result of a disease such as diabetes mellitus, rheumatic diseases and thyroid diseases.
In addition, the use of certain medications, older age and female sex hormones favor the development of Sicca syndrome.
Inflammation of the inside of the eyes (uveitis)
Under the term uveitis, ophthalmologists summarize various diseases of the inside of the eye. Parts of the uvea (vascular skin) are inflamed, which is composed of three layers: iris (iris), radiation body (ciliary body) and choroid (choroid). Some of these inflammations can be accompanied by severe eye pain. Depending on which area of the inner eye is affected, further symptoms such as a marked deterioration in vision, seeing streaks, lint or flakes, reddening of the eye, photosensitivity and increased lacrimation may occur.
Uveitis can develop as a result of another infectious disease. If measles or herpes viruses get into the eye, for example, they can infect the inside of the eye just like bacteria, fungi or other pathogens. Autoimmune diseases in which the immune system attacks the body's own structures - such as rheumatic diseases (e.g. ankylosing spondylitis, juvenile chronic arthritis or Reiter's disease) or inflammatory bowel diseases (e.g. Crohn's disease and ulcerative colitis) as well as sarcoidosis - often occur with uveitis.
Sometimes, however, the cause of inflammation of the inside of the eye cannot be clearly determined if it occurs independently of another disease.
Inflammation of the retina (retinitis) and inflammation of the iris and cilia (iridocyclitis)
Eye problems can be caused by retinitis. Usually not only the retina but also the choroid beneath it is affected (chorioretinitis). Inflammation of the retina often accompanies another disease, such as rubella, syphillis, cytomegaly, AIDS and rheumatic diseases.
Even with iridocyclitis (inflammation of the iris and cilia body), the eye finding is often based on another cause. In both cases, the underlying disease has to be treated in order to improve the eye inflammation.
Eye pain with inflammation of the outer skin of the eyeball (scleritis)
Inflammation of the so-called dermis (outer skin) of the eyeball is accompanied by sometimes severe eye pain - usually it is pressure pain - which can radiate into the half of the face of the affected eye. The inflammation can cause edematous (fluid-containing) swelling of the dermis in combination with eyelid edema and edema of the conjunctiva, which can lead to impaired vision.
The cause of dermatitis of the eyeball cannot always be clarified. Doctors then speak of idiopathic scleritis. About half of the cases are associated with an underlying systemic disease such as rheumatic diseases, Crohn's disease, gout or autoimmune diseases.
Inflammation of the vitreous (endophthalmitis)
Doctors call endophthalmitis an inflammation inside the so-called vitreous. It is to be regarded as a particularly severe form of eye inflammation, since it often leads to a complete loss of vision. Symptoms of vitreous inflammation include impaired visual acuity, eye pain, acute reddening of the eye and swelling of the conjunctiva. A bacterial infection is usually the cause of the disease, whereby the pathogens often get into the vitreous body during an eye operation or an injury, for example. Secondary inflammation of the vitreous body is less common due to a general systemic infectious disease.
If the inflammation spreads from the vitreous body to the entire eye, the disease is called panophthalmitis. It is the most serious form of eye inflammation because it often leads to complete vision loss and sometimes to the entire eye. Due to the strong infection, accumulation of pus builds up and the inflamed tissue gradually dies. The infection can spread to the other eye.
This disease is usually caused by germs that penetrate injuries. In rare cases, the pathogens can also reach the eye via the bloodstream and trigger panophthalmitis, such as as a result of blood poisoning.
Inflammation of the lacrimal sac (dacryocystitis) and the lacrimal gland (dacryoadenitis)
Eye pain can also be due to inflammation of the eye bag, which is usually noticeable by a clearly recognizable reddening of the tissue around the inner corner of the eye. The area is also swollen and painfully sensitive to pressure. Pus emerges from the so-called teardrops. In some cases, an abscess develops that can cause further complications, such as, at worst, the development of life-threatening encephalitis (inflammation of the brain). If the pus accumulates outside and this creates an open connection, it is a tear sac.
In most cases, dacryocystitis is due to a drainage disorder of the lacrimal fluid, which is accompanied by a strong increase in bacteria inside the lacrimal sac.
Inflammation of the lacrimal gland (dacryoadenitis) is noticeable through a swollen and painful upper eyelid. An abscess is not uncommon. A fistula can also form.
Pain in inflamed eyelids (blepharitis)
Inflamed eyelids are manifested by reddening and swelling of the affected areas, which is usually accompanied by pain, a burning sensation and sometimes itching. The eyelashes are glued together by dry secretions and can fall out. The causes of eyelid infections are diverse. For example, allergic reactions to cosmetics, infectious eye infections caused by bacteria or viruses and general skin diseases can trigger the symptoms. Sometimes an inflamed eyelid also occurs as a result of conjunctivitis.
Painful stye (hordeolum)
The grain of barley (hordeolum) is also an eyelid infection. Here too there is a clearly recognizable and painful swelling with reddening of the eyelid. Doctors distinguish between an external hordeolum (inflammation of the minor glands, sweat glands in the area of the eyelid, or the Zeis glands, sebum glands in the area of the eyelid) and the internal hordeolum, in which the meibomian glands, the sebum glands on the edge of the lid, in particular , are affected.
With a grain of barley, pus forms, which can break through to the outside in the case of an external hordeolum and inwards in the case of an internal hordeolum. The grain of barley is mostly due to a local bacterial infection with staphylococci or less often with streptococci. As a rule, the disease progresses without complications or serious health problems. The barley grain usually breaks open within a few days and heals on its own. If the barley grain does not break open, an eyelid abscess can form. In such a case, the ophthalmologist will therefore perform a surgical opening and remove the pus.
People who repeatedly suffer from a stye may have a weakened immune system. Among other things, the eye disease can be an indication of diabetes. The use of cosmetics in the eye area and wearing contact lenses can also promote recurring stye.
Sore eyes with inflammation of the optic nerve (neuritis nervi optici) If acute dull pain occurs behind the eye or in the area of the eye socket, the cause can be inflammation of the optic nerve. Those affected also often suffer from a decrease in visual acuity to complete vision loss.
Optic nerve inflammation (neuritis nervi optici) can be due to diseases of the central nervous system, such as multiple sclerosis, toxic influences, for example due to excessive alcohol consumption, or infectious diseases such as typhoid, diphtheria and typhus. An expansion of inflammation of the middle eye skin (uveitis) to the optic nerve is also possible. In addition, certain diseases of the cardiovascular system and extreme hypertension are seen as risk factors for optic nerve inflammation.
Pain when moving eyes due to inflammation of the eye muscles (ocular myositis)
With muscle inflammation in the eye, the muscles that are responsible for the movement of the eye are affected. As a result, eye movements in ocular myositis are very painful. The eye can also emerge. Many sufferers also have swollen conjunctiva.
Inflammation of the muscles is usually accompanied by scleritis or uveitis. However, it can also occur in Graves' disease (autoimmune thyroid disease) or less often in the case of flu or other infections. A so-called "pseudotumor" of the eye socket (inflammatory tissue of unknown origin) can also cause eye myositis.
Pain around the eyes can also be due to tumors. However, these are less likely to be malignant than other cancers. Choroidal melanoma is the most common malignant eye tumor in adults, and retinoblastoma usually occurs in children.
Depending on where exactly the tumor occurs, it can cause different symptoms. Often, those affected do not notice him for a long time. Tumors on the outer lid, on the other hand, are usually already visible to the eye doctor with the naked eye. If a tumor is suspected to be inside the eye, the fundus must be examined using ophthalmoscopy. In addition, ultrasound examinations and other imaging methods help with diagnosis.
Glaucoma can cause eye pain
Glaucoma can cause various symptoms depending on its type.
In so-called primary open-angle glaucoma, there are usually no complaints over a long period of time. In a later stage of the disease, visual field loss occurs when seeing. Without timely treatment, those affected face blindness.
In the case of an acute glaucoma attack, on the other hand, symptoms immediately arise. The eye is red and the eyeball feels unusually hard when the closed eye is pressed lightly. The pupil stops responding to light and eye pain may occur. There are also visual disturbances. Many patients also suffer from headaches, nausea and vomiting.
Foreign body in the eye
If a foreign body gets into the eye, it can cause an uncomfortable feeling or even severe pain. The "troublemaker" is often an eyelash, a tiny insect or a speck of dust. These foreign bodies are either rinsed out of the eye with the tear fluid without support or can be carefully removed, for example with a handkerchief.
If the symptoms persist, an ophthalmologist should be consulted. If a piece of wood, glass or metal gets caught in the eye, immediate medical attention is necessary. Treatment is also required immediately for other sharp-edged foreign bodies in the eye, because in the worst case the injury from the object is so serious that there is a risk of vision loss. Under no circumstances should such a foreign body be removed on your own.
Eye pain due to visual defects and incorrect glasses / contact lenses
Visual defects affect vision and affect it in different ways. Often the eyes are constantly strained, so that they hurt and burn. Examples of this include squinting, farsightedness and presbyopia. Even in the case of nearsightedness, the eyes are often strained so that objects in the distance can be better recognized. The problem can usually be solved with glasses or contact lenses with the correct prescription.
Conversely, eye pain - often in conjunction with a headache - can also be attributed to an unsuitable visual aid. Among other things, the sphere (diopter values), the cylinder (in the case of astigmatism) and the axis (position of the cylinder and direction in which astigmatism should be compensated for) can change, so that the values of the previous lenses or contact lenses no longer cause ametropia correct sufficiently.
PC eye pain
Seeing on the screen places high demands on our eyes. Without being aware of it, people with a computer workstation look back and forth thousands of times between the monitor and keyboard or documents. The eyes have to “adjust” each time. As a result, many people suffer from headaches, eye pain, red eyes, blurred vision and double vision, rapid fatigue, muscle tension and a decrease in performance during the day.
To prevent these complaints, you should take a ten-minute break regularly after working for about 50 minutes on the screen. In the meantime you can move, have a drink and let fresh air into the office. The view of the countryside also offers relaxation for the eyes and the head. An eye rim massage can also provide relaxation. For this, the thumb tips are placed on the temples. The bone edge of the eye sockets is then gently massaged with the index fingers, starting at the root of the nose at the upper edge of the eye socket. Inhale and exhale deeply during the massage.
Treatment of eye pain
The therapy depends on its cause. If a foreign body triggers the symptoms, the treatment consists first of all in removing the foreign body with special instruments. For this, the patient receives a local anesthetic through eye drops.
If the cornea is superficially injured, eye ointments and cooling compresses provide relief until the minor injuries have healed on their own after a few days. If there are major injuries that do not heal, the ophthalmologist can remove the surface of the cornea with fine devices so that the top layer can heal better.
If the pain is due to inflammatory, bacterial processes, such as frequent conjunctivitis, antibiotic ointments or drops provide relief from the symptoms. If an infection is caused by viruses, cortisone-containing eye drops can also be used, as these contribute to reducing the inflammation.
In the case of flashes caused by intensive UV radiation, the therapy consists primarily of eye ointments containing antibiotics, which are given to both eyes several times a day. Since those affected usually suffer from very severe eye pain, pain relievers can also be used. Cooling compresses also provide relief. Patients should also avoid eye movements and protect their eyes from light. The symptoms usually subside after a few days.
Eye pain can also occur as a symptom of another underlying disease, such as multiple sclerosis. In such a case, the actual disease must be treated in order to alleviate the eye discomfort.
Naturopathy for eye pain
Eye pain can often be treated with simple home remedies and naturopathic procedures. For example, the medicinal plant eyebright (euphrasia) can be used for mild eye infections. The extracts of Euphrasia provide relief especially for conjunctivitis and corneal inflammation. They are available in the form of homeopathic eye drops, among other things. Aconitum napellus, Arsenicum album, Dulcamara and Hepar sulfuris calcareum are other homeopathic remedies used for conjunctivitis. In addition to Apis and Silicea, Hepar sulfuris is also used to treat a grain of barley. In addition, fennel tea compresses can relieve the symptoms of inflammation, whereby strict hygiene is required to avoid spreading the pathogen.
If the symptoms are due to dry eyes, experience with Ayurveda aloe vera gel and rose water can be used externally for cooling. At the same time, they provide moisture. Licorice is suitable for internal use, which should also have a moisturizing and cooling effect.
Traditional Chinese medicine (TCM) relies on medicinal herbs for eye pain, which are related to the liver meridian, among other things. The treatment of acupuncture points on this meridian can also compensate for causal energy weaknesses, according to the TCM. If there is a functional cause, craniosacral osteopathy can provide relief by making the inflow paths permeable to all vessels with mechanical pressure or tension.
Naturopathy can relieve pain with a harmless cause. However, an eye doctor should always be consulted if the eye is injured or symptoms persist. (No)
Author and source information
This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.
Dipl. Social Science Nina Reese
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ICD codes for this disease: H57.1ICD codes are internationally valid encodings for medical diagnoses. You can find e.g. in doctor's letters or on disability certificates.