What is it about ?
Pain in the eye (intraocular) and around the eye (periocular) may be due, for example, to
- a condition of the eye itself,
- a glaucoma acute at a closed angle,
- a herpetic keratitis,
- a iritis,
- a condition other than the eye. This is referred to as ‘referred pain’, i.e. a pain felt in one place but which comes from elsewhere. Pain in the eye to come from, for example,
- neck or shoulder muscles,
- the nerve above the eye (supraorbital nerve),
- an abnormal closure of the jaw (dental malocclusion),
- sinuses (chronic sinusitis),
- from migraines,
- a trigeminal neuralgia,
- inflammation of an artery on the side of the head (temporal arteritis).
How to recognize it?
Headaches due to migraine often radiate behind or to the side of the eye.
In case of’cluster headache, you have severe pain in one eye, in the form of recurring attacks.
You feel pain in or around the eye, but also sometimes at the same time in the muscles of the neck or shoulder.
It may be a tension headache. These are headaches caused by muscle tension and stress. The pain is constant, like a feeling of noose, and gradually worsens as the evening goes on. It is localized on the sides (temples), behind (occiput) and above (cranial vault) of the head, usually on both sides, but sometimes on only one side.
Pain originating in the deep neck muscles usually radiates outward from the eyes.
Pain from a superficial neck muscle or trapezius (a muscle that covers the neck, shoulder, and upper back areas) usually radiates to the side of the head (temples).
Pain originating in the sternocleidomastoid muscle (a muscle rather in the front of the neck) usually causes pain in the eyebrow on the same side.
These symptoms may go away or improve with movement or after a hot shower.
Have you caught a cold? Do you have an allergy? Symptoms such as a runny nose, a feeling of tightness near the nose or in the forehead, and the need to swallow phlegm in the throat may indicate a sinusitis. The pain is usually behind the eye. Leaning forward increases the pain, while putting pressure on the eye reduces it. Sometimes you can’t focus your gaze on an object.
If you have recently had orthodontic treatment, a change in the position of the teeth may explain the pain. If the top and bottom rows of tines are not properly aligned (dental malocclusion), it can also cause pain in the eye area.
How is the diagnosis made?
Your doctor will start by asking you very specific questions about your symptoms. Then, he will examine the eye to rule out an eye condition (such as a foreign body, redness, and signs of inflammation of the conjunctiva (conjunctivitis) or the eyelid (blepharitis). Then, he will perform a clinical examination of other structures:
- he will ask you to tighten the muscles of the neck and back of the neck to trigger the pain,
- he will examine the nose, throat, ears and teeth,
- it will also test the sinuses.
If necessary, the doctor will refer you to the ophthalmologist for a measurement of the pressure in the eye (intraocular pressure). Sometimes an X-ray or CT scan of the sinuses is also helpful.
What can you do ?
If the pain is caused by tightness in the neck muscles, it may be helpful to take a hot shower to relax the sore muscles. Several sessions with the physiotherapist can also be useful.
Maintain good posture at work and during your daily activities. For example, adjust the height of your work table or use a good chair.
What can your doctor do?
Treatment varies depending on the cause of the problem. A sinus infection is treated with a nasal spray. Sometimes you will be referred to an otolaryngologist (ENT), ophthalmologist, neurologist or orthodontist to adjust the teeth.
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