Headache Behind the Eye? Why It Happens and What Helps

A headache behind the eyes may feel like a dull ache, sharp stabbing pain, or even throbbing sensations.

What causes this kind of headache? Should you be concerned? And how can you find relief? Here, experts break down the common causes, treatments, and preventive strategies for headaches behind the eyes.

Headache pain behind the eyes can arise from conditions ranging from mild and commonplace to chronic neurological issues.

"Pain behind the eyes is a symptom, not a diagnosis," says Hope O’Brien, MD, a neurologist and the founder and CEO of Headache Center for Hope, a headache treatment clinic in Cincinnati. Evaluating other symptoms that occur alongside pain behind the eyes can pinpoint the underlying issue.

Here are the most common causes of headache pain behind the eye.

Tension Headaches

That band of pressure typically causes pain above the eyes, which can sometimes radiate behind the eyes, too, according to Sarah Benish, MD, a neurologist and the medical director of neurosciences at M Health Fairview Clinic and Surgery Center in Minneapolis. Typically, both eyes are affected.

Fortunately, tension headaches typically aren’t cause for concern. Though they can occur often and create discomfort, they’re not life-threatening and can be treated at home, says Dr. Benish.

Migraine

“What's happening in the brain is that a nerve located behind the eyes — the trigeminal nerve — is activated,” says Dr. O’Brien. When this nerve is triggered, it releases chemicals that can cause pain in the forehead or behind one or both eyes.

• Fatigue
• Nausea or vomiting
• Difficulty concentrating
• Mood changes
• Vision changes
• Muscle weakness
• Sensitivity to touch, light, sound, or smells
• Numbness and tingling
• Dizziness
• Stiff neck

Sinusitis

According to O’Brien, it’s easy to confuse sinus headaches and headaches that are a symptom of migraine, as some of the trigeminal nerve irritation that occurs during migraine-related headaches can also cause pain around the sinuses.

Cluster Headaches

“A cluster headache is a type of headache that causes intense stabbing pain behind the eye or in the eye,” says Benish. “This is a severe and debilitating type of headache that often causes people substantial disability,” she adds.

According to Benish, a cluster headache is often accompanied by additional symptoms like:

• Eyelid drooping
• Redness in one eye
• Tearing in one eye
• Runny nose on one side
• Flushing on one side of the face
• Agitation and trouble sitting still

Eyestrain

• Sore, burning, or itching eyes
• Sensitivity to light
• Blurred vision
• Watery or dry eyes

Other Possible Causes

Most cases of pain behind your eye can be attributed to headache or eyestrain. That said, there are less-common causes of headaches to note.

Similarly, eye conditions like optic neuritis (which occurs when inflammation causes damage to the optic nerve) and orbital inflammation (swelling of the tissues surrounding the eye) can contribute to headaches behind the eyes, says Khan.

Brain tumors or vascular issues are rare but serious conditions that may present with additional symptoms like vision loss, numbness, or persistent pain. But these conditions are so rare that it’s unlikely they’re the cause of your pain, according to O’Brien.

How you treat a headache behind your eyes depends on the underlying cause. Here are the most common approaches to easing this pain.

Natural Remedies

Over-the-Counter Medications

Prescription Medications

More severe or chronic headaches — like those caused by migraine and cluster headaches — may require treatment with prescription medications.

If these medications are ineffective for headaches associated with migraine, your doctor may recommend other options, such as targeted botulinum toxin injections (like Botox) in the head and neck, says Khan.

Antibiotics

Lifestyle Adjustments

Lifestyle changes can play a significant role in managing (or even preventing) headaches behind the eye, particularly if tension headaches or migraine-related headaches are to blame.

Stress Management

• Yoga
• Meditation
• Journaling
• Therapy
• Getting adequate sleep
• Exercising regularly
• Eating a nutritious, balanced diet
• Connecting with loved ones

While occasional headaches might not be cause for concern, certain symptoms could signal an underlying issue that needs medical attention. Here are the signs you should see a doctor about your headaches behind the eyes, according to Dr. Hoang-Tienor.

• You get headaches more than once a week.
• You have to take OTC pain relievers more than once a week.
• Your headaches impact your daily routine.
• Your headaches aren’t responding to treatments that were once effective.
• You’re over the age of 50 and experiencing a new type of headache or pain.

Certain symptoms may warrant a trip to the emergency room, says Hoang-Tienor. These include a sudden, severe headache accompanied by:

• Loss of vision, weakness or paralysis in parts of your body, or slurred speech
• Head injury or trauma
• Seizures
• Fever or vomiting

To prevent a headache behind the eyes, it’s important to identify and avoid your personal headache triggers (more on that shortly), per O’Brien.

According to O’Brien, common strategies to prevent a headache behind the eyes include:

• Stay hydrated.
• Eat regular meals.
• Exercise regularly.
• Get enough sleep.
• Reduce caffeine intake.
• Avoid excessive alcohol use.
• Manage stress.

Triggers are different for everyone, and can often be tricky to identify.

Still, there are some common headache triggers, says Hoang-Tienor. These include:

• Stress
• Alcohol use or withdrawal
• Caffeine withdrawal
• Sleep deprivation or over-sleeping
• Dehydration
• Hormonal changes
• Weather changes

Triggers can also be specific to the type of headache you have, particularly in the event of migraine and cluster headaches.

• A headache behind the eyes is usually a symptom of an underlying issue, like tension headaches, migraine headaches, cluster headaches, sinusitis, eyestrain, and other health conditions.
• Managing headaches often involves over-the-counter pain medications, prescription medications, rest, and hydration.
• Frequent headaches or those with neurological symptoms, like vision changes or numbness, should be evaluated by a doctor.
• Seek immediate care for sudden, severe headaches accompanied by alarming symptoms like loss of vision, slurred speech, or seizures.