Causes and Treatments For Pressure Behind Your Eye

Pressure behind the eye can be an uncomfortable and worrisome situation. However, eye pressure is a common side effect of many conditions and is usually very easy to treat.

Several conditions can result in pressure behind the eye, so proper diagnosis is essential to seeking the appropriate course of treatment.

Here’s a list of the most common causes for pressure behind the eyes, symptoms, and treatments.

Sinus Infection

A sinus infection (‘sinusitis’) is caused when your sinus cavity becomes infected with either a bacterial or viral infection. These infections often lead to swelling of the sinuses, which can result in added pressure to the face, including behind the eyes.

Sinus Infection Symptoms

• Pain behind eyes, nose and cheeks
• Stuffy, runny nose
• Excessive or abnormal mucus
• Cough
• Heavy or difficult breathing
• Headache
• Eye pain or pressure
• Fever
• Fatigue

Treatment

Sinus infections are generally very easy to treat, usually with a short course of antibiotics. Other treatments, like sinus irrigation, can help ease sinus symptoms while the antibiotics work through your system. Steroid shots, decongestants, and some over the counter medications can also ease discomfort. You should start to feel results within two to three days of treatment.

Headache

There are two types of headaches that are known to cause pressure behind the eyes — tension and cluster.

Generally associated with mild to moderate pain, a tension headache is often described as having a tight band around your head. Tension headaches are the most common type of headache, though the causes aren’t well defined. Symptoms include dull, aching head pain, a feeling of tightness or pressure across your forehead or the sides of your head, and tenderness to the scalp, shoulder and neck muscles.

Tension Headache Treatment

Various treatments are available for tension headaches. The first course of action is usually an over the counter pain remedy like aspirin, ibuprofen, or naproxen to reduce the pain. If over the counter medications are ineffective or the tension headaches persist, your doctor may recommend a magnetic resonance imaging (MRI) or computerized tomography (CT) scan to further troubleshoot any potential issues and recommend a course of prescription medications.

Cluster headaches tend to have a defined pattern of when they occur and are one of the most painful types of headaches. The bouts of attacks, also called ‘cluster periods’, can last for weeks or months and are usually followed by remission periods when the headaches stop for a few weeks or months before returning again. Cluster headaches often come in the middle of the night while sleeping and are characterized with intense pain around one eye on one side of your head, excessive tearing, sweating, redness in the eye affected, stuffy or runny nose on the affected side, and swelling around the eyes.

Cluster Headache Treatment

As one of the more painful and persistent types of headaches, proper diagnosis is essential for the treatment of cluster headaches. Diagnosis is achieved through a neurological examination by your physician, which usually includes either an MRI or CT scan, or both. Unfortunately, there is no cure for cluster headaches, so treatment plans aim to reduce the timeframe and severity of attacks. Treatments might include a pure oxygen regimen, triptans (an injection that is also used to treat migraines), octreotide (a synthetic version of the brain hormone somatostatin), and local anesthetics.

Tooth Pain

Although it might seem counterintuitive, issues with your bite or jaw alignment can cause tension in the muscles of your face, leading to tension headaches and pain behind the eyes.

Tooth pain can have a variety of causes, so proper diagnosis by a dentist or orthodontist can help identify the underlying cause.

For bite or jaw-specific issues, orthodontic work or surgery may be required for long-term relief.

Graves’ Disease

Graves’ disease is an autoimmune, resulting in the overproduction of thyroid hormones, called ‘hyperthyroidism’. Because thyroid hormones can affect a wide range of different body systems, symptoms associated with the disease can be varied and have a significant influence on your overall health and wellbeing.

Symptoms

• Weight loss
• Enlarged thyroid gland
• Anxiety and irritability
• Change in menstrual cycles
• Frequent bowel movements
• Fatigue
• Excessive sweating
• Rapid or irregular heartbeat
• Bulging eyes

Approximately 30% of people with Graves’ disease also suffer from a condition called Graves’ Ophthalmopathy where inflammation and other immune system disorders affect the muscles and tissues around the eyes. This can result in bulging eyes, puffy or retracted eyelids, light sensitivity, pressure or pain in the eyes, double vision, or vision loss.

Treatment

The primary goal of Graves’ disease treatments is to inhibit the production of thyroid hormones and to minimize the effect that the hormones have on the body. Common treatment plans include radioactive iodine therapy, anti-thyroid medications, beta blockers, and surgery.

For Graves’ ophthalmopathy specifically, mild symptoms can easily be treated with over-the-counter solutions like artificial tears and lubricating gels. For more serious symptoms, your doctor might recommend corticosteroids to reduce swelling, prisms in glasses to reduce double vision, orbital decompression surgery to give your eyes room to move back into proper placement, or orbital radiotherapy to fix tissue behind the eye.

Damage to the Optic Nerve

Optic neuritis, or swelling in the optic nerve, has several causes and can lead to long-term damage and vision loss if not treated.

Autoimmune disorders like lupus, neuromyelitis optica, or multiple sclerosis can lead to the deterioration of the body’s nervous system, including the optic nerve. Other causes of optic neuritis include infections, ocular herpes, sinusitis, nutritional deficiency, and neurological disorders.

Symptoms

• Pain
• Loss of color vision
• Visual field loss
• Vision loss in one eye
• Flashing lights

Proper diagnosis is essential for proper treatment of optic neuritis. Common tests to determine the condition and severity include a routine eye exam, ophthalmoscopy, and pupillary light reaction test. In some cases, your doctor might also recommend a magnetic resonance imaging (MRI) scan, blood tests, optical coherence tomography (OCT), or a visual evoked response.

Treatment

In many cases, optic neuritis will improve on its own. In some cases, steroid therapy may be recommended to reduce swelling in the optic nerve. Other treatments are specific to the underlying condition that is causing the attack of the optic nerve. In rare cases, when steroid therapy fails, and severe vision loss continues, plasma exchange therapy might be recommended to help recover some of the vision lost.

Injury to the Face

Injuries to the face, such as injuries sustained during a car accident or by playing sports, may result in varying degrees of pressure and pain behind the eyes. Specifically, any type of fracture to the eye socket can result in the feeling of pressure in addition to damage to eye muscles, nerves, and sinuses.

Symptoms

• Black eye
• Bulging eye(s)
• Double vision
• Blurry vision
• Numbness around the eyes
• Swelling around the eyes

Treatment for facial pressure due to facial injury will focus on healing the facial damage first. If eye pressure persists, other treatments may be explored to diagnose any additional damage or underlying issues.

When To See A Doctor

The feeling of pressure behind the eyes alone is not a serious medical condition and over the counter solutions could help ease the pain and discomfort. However, some symptoms, like loss of vision, fever, swelling, or frequent headaches should be evaluated by a physician for proper diagnosis.  

If you’re experiencing any of the above symptoms or think you might have an eye condition, contact your primary care physician for a medical review. Schedule a consultation with an eye specialist near you to get all your concerns addressed!