Feeling pressure behind the eyes is a common issue I see with patients and doesn’t necessarily correlate
with a problem with the eye itself. There are many causes for feeling this pressure sensation and some
can be sight threatening so it is important to let your optometrist know if you notice this.
Migraines and tension headaches can cause a pressure sensation behind the eyes. Tension headaches
are the most common headaches with 80% of people experiencing them. So, if you are reading this, it’s
likely that you know exactly what I’m talking about! Migraines are less common and can be very severe.
With migraines you can experience strange visual phenomena that are called auras that look like
colorful zig zags. I have patients in frequently for these and they are very scary! But these issues have
nothing to do with the eyes themselves. I usually direct these patients to their primary physician for
relief from headaches.
Sinus infections are cause by bacteria or viruses that get trapped in the spaces (sinus cavities) behind the
eyes. The sinus cavities are above, below, behind, and between the eyes. When infected, the sinuses
expand and cause a feeling of pressure around the eyes. Other symptoms usually go along with sinus
infections like fever, cough, fatigue, headache, sore throat, runny nose, and loss of smell.
In Graves’ disease, an overactive thyroid gland causes the tissue, muscles, and fat behind the eyes to
enlarge. This causes the eyeball to protrude forward which can then cause dry eye and inability to move
the eye. It may also cause the sensation of pressure. Other ocular symptoms with Graves’ disease
include tearing, light sensitivity, double vision, loss of vision, and ulcers on the eye. Your doctor can
measure thyroid levels with blood testing to determine if the pressure behind the eyes is related to
The optic nerve connects the eye to the brain. Optic neuritis is a condition where this nerve becomes
inflamed and swollen. It can cause pain to the eye as well as vision loss. Optic neuritis is commonly
associated with multiple sclerosis and is often the first sign of MS that patient’s experience. I have
unfortunately seen this already a few times in my career. Studies say around 50% of patients with MS
experience optic neuritis at some point. Other symptoms could include color vision issues, blurry vision
when hot, pain with eye movement, and the pupil not reacting how it should.
Toothaches can lead to “referred pain” which is where the pain feels like it is in another area of the face
rather than in the mouth. This can make it feel like the throbbing pain or pressure is in the eye.
Injury to the face
Fracture to the eye socket from injuries sustained in car accidents or playing sports can damage the eye
muscles, nerves, and sinuses. This can lead to pressure and pain behind the eyes.
Treatment for pressure behind the eyes depends on the cause. The best plan if you feel a pressure
sensation behind the eyes is to first visit your optometrist to rule out any sight threatening conditions. If
it is unrelated to the eyes, your primary care physician should be able to help. Obviously, if you sustain
an injury to the face, a visit to the ER should be first on the list. We are always here in Collinsville to help out if you need us!
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