Headache can be located anywhere, from the base of your neck to your forehead, temples, or even behind your eyes. There are several types of headaches that involve pain behind one or both eyes. The pain can be accompanied by other visual disturbances like photophobia and watering from the eyes.
- Tension headache
- Cluster headache
- Sinus headache
- Eye strain headache
- SUNCT syndrome
- Paroxysmal hemicrania
- Giant cell arteritis
1- Tension headache
Tension headache is the most common cause of pain behind the eyes and is also the most common type of headache reported. Pain in a tension headache feels like building pressure around the head in form of a band.
Most common causes of a tension headache are anxiety, stress and depression.
- Dull pain that originates from the back of head and radiates towards the forehead
- Pain behind the eyes
- Tenderness at the occiput and skull vault
- Sleep disturbance and low mood.
Over-the-counter painkillers: Aspirin, acetaminophen, and ibuprofen can relieve the pain.
Home remedies: Hot showers and hot massages along with physiotherapy can prove as a long-term treatment for tension headaches.
Migraine is a powerful headache that can last from 4 hours to 3 days, this can be accompanied by nausea, vomiting, sensitivity to light, and some other signs. Throbbing pain, which is characteristic of a migraine usually occurs in one side of head but can also be experienced at one point in head, in the forehead, behind the eyes, or even in the whole head.
Several evidence suggests that auras in a migraine occur due to depolarization and hyperpolarization of dysfunctional ion channels at the cortical front.
- Sensitivity to light and sound
- Shimmering, silvery, zigzag lines marching across the visual field
- Development of a temporary blind spot
- Vomiting and nausea
- Irritability and low mood.
- For an acute attack: Analgesics, antiemetics, and triptans can be given to manage the symptoms.
- Excedrin is a drug used to combat severe migraine attacks and proves relief within half an hour.
3- Cluster headache
Characteristic attacks in cluster headaches are periodic in nature and they follow a specific duration. Pain is usually felt on one side of the head that goes as far as behind the eyes.
There is no apparent cause for cluster headaches but studies suggest that abnormal hypothalamic activity is responsible for cluster headaches.
- Nasal discharge and congestion
- Pressure in head behind eyes
- Sharp pain in head behind eyes
- Watery or swollen eyes.
Preventive treatment is usually helpful at the initiation of each cluster episode, this includes Calcium channel blockers, corticosteroids, and topiramate.
4- Sinus headache
Sinus headache is felt as a result of pressure exerted by accumulation of inflammatory products in the sinuses, due to an inflammation like sinusitis. The pressure and pain behind eyes is accompanied by pain in cheeks upper jaw and nasal bridge.
The mucosal surface of sinuses becomes so inflamed that it blocks the drainage ducts. Thus accumulating the inflammatory products in the sinuses, resulting in pressure to build up and causing pain.
- Decreased sense of smell
- Runny nose
- Constant feeling of pain and pressure in cheeks, forehead, around the eyes, and nasal bridge.
Pain behind the eyes and the underlying disease, which may be an allergy are treated side by side.
- For headache: Over-the-counter painkillers.
- For allergy: Anti-histamines.
5- Eye strain headache
Eye strain headache is commonly seen in people who work in front of laptops and computer screens all day. The Headache is typically felt behind the eyes, forehead, and temples.
Constant bright light, emitting from a computer screen can cause the eyes to dry out. This causes redness, itching, soreness, and increased friction in the eyes, the eyes tire out because of the difficulty to focus on the screen and result in pain behind the eyes and temples.
- Soreness and burning in eyes
- Difficulty to focus
- Muscle spasm in muscles around eyes
- Constant watering of eyes
- Headache in forehead and temples.
For eye strain headaches there are only prophylactic measures that should be taken. These include: Taking a break from looking at a computer screen, sitting farther away from the screen, and using anti-glare programs.
6- SUNCT syndrome
Short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) is a primary headache syndrome. The headache has characteristic unilateral pain and associated ipsilateral autonomic symptoms i.e. conjunctival tearing and pain in and behind the eyes.
- Headache on one side of the head and behind eyes
- Conjunctival tearing
- Migraine like symptoms
- Reduced sensations and numbness on the ipsilateral side.
There are several times that SUNCT is idiopathic and is included in trigeminal autonomic cephalgias. However other reasons can be:
- Intracranial lesions compressing the nerve roots
- Cerebellopontine arteriovenous malformation
- Autonomic symptoms may present because of the central disinhibition of the autonomic reflex of the trigeminal nerve by the hypothalamus.
There is no definitive treatment for SUNCT Syndrome but for an acute attack
- Botulinum toxin around the symptomatic areas
- Nerve block at Gasserian ganglion or first division of trigeminal nerve can provide temporary or permanent relief.
7- Paroxysmal hemicrania
Paroxysmal hemicrania is a rare headache disorder that belongs to the TACs (trigeminal autonomic neuralgia) group of disorders and includes sudden onset of debilitating headache on one side of the head that is short but re-occurs, in some cases, several times a day.
- Unilateral pain in the head
- Pain behind the eyes
- Headache is throbbing in character
- Resembles a cluster headache
- Pain is triggered by movement
- Responsive to indomethacin.
There is no known cause of paroxysmal hemicrania but according to some case studies, here is a list of possible causes
- Traumatic injury to your neck or head
- Arteriovenous malformation
- Pituitary gland tumor.
- Paroxysmal hemicrania responds very well to indomethacin, an NSAID
- Most people reported complete relief without any sort of treatment.
8- Giant cell arteritis
Giant cell arteritis is a disease that affects the arteries in the head, particularly temples. It is the most common type of vasculitis in people over 50 years of age thus the abrupt onset. The disease is curable with proper treatment but if left untreated this can lead to permanent blindness. Pain is particularly felt in the temples and behind the eyes because temporal arteries are affected.
- Headache in temples
- Tender to touch
- Bulging, nodular, pulsating, and twisted arteries in the temples
- Blindness in one eye.
The immune system of the body activates in response to an infection and invades the normal healthy cells causing a build-up of giant cells in the arteries. These Giant Cells further produce chemicals that destroy the arterial walls and cause inflammation. The inflammation in the temporal arteries results in constant pulsations and thus a throbbing headache.
- Mostly it is self-limiting but requires symptomatic treatment.
- High-dose steroid therapy is started in patients who have visual symptoms along with headaches.
When to consult a doctor?
If the frequency of headaches keeps on increasing and is making you take analgesics more than 15 times a month, consult a doctor.
I have a constant pain behind eyes, what are the possible causes?
Tension headaches, migraine, cluster headaches, sinus headaches, and eye strain headaches are some of the possible causes.
I have sinusitis, why do my eyes hurt?
The accumulation of inflammatory products in the sinuses exerts pressure and causes pain behind the eyes, in the cheeks, and forehead.
I feel as if there’s a tight band around my head, this is also causing pain behind eyes, what can it be?
Tension headaches are felt as increasing pressure and pain around the head in form of a band. The pain is sometimes felt in eyes as as well as forehead.
Can migraines be a possible cause of pain behind eyes?
Migraines usually come with visual symptoms. Also constant pain in half head (in most cases) ranges from the back of head up to forehead and behind the eyes.