7 Causes and Treatments of Pressure Behind the Eyes

Pressure Behind Your Eye

Pressure behind the eyes is an uncomfortable feeling of fullness inside the eye. Someone with pressure behind the eyes may require immediate medical attention depending on the underlying cause. 

The pressure doesn’t always stem from within the eye. Injury or disease in other parts of the head can also lead to pressure build-up behind the eye.

You may mistake pressure behind the eyes for glaucoma, pink eyes, or allergies. However, these conditions only cause eye pain and not a sensation of pressure behind the eyes.

When to Worry About Pain Behind Your Eye

Pain behind your eyes may not signal any serious problem. However, you need to consult your doctor right away if you experience any of these symptoms:

• Severe headache or fever
• Extreme light sensitivity (photophobia)
• Sudden vision changes
• Swelling in or around the eyes
• Difficulty moving or keeping eyes open
• Bleeding eyes
• Pus filled eyes

Diagnosing Pain Behind Eye 

If you experience pressure behind your eyes, your doctor will perform tests to determine the underlying cause. The tests may include:

• Endoscopy. Use of an endoscope to examine the hollow cavities of the body (esophagus, stomach, and the small intestine)
• Magnetic resonance imaging (MRI)
• Computed tomography (CT) scan
• Blood tests and radioactive iodine uptake (for thyroid diseases)

If your eye pressure stems from your eye, an eye exam will be necessary. Your doctor will use a device called a slit lamp to examine the health of your optic nerve and surrounding structures.

If you have a jaw or tooth misalignment, you’ll be referred to a dentist to determine whether your situation is causing muscle strain and pressure behind your eyes.

Determining Treatment

To effectively relieve pressure behind the eyes, you must address the underlying cause. Over-the-counter medications are effective and safe for treating mild symptoms. However, seek professional medical advice if you experience severe eye pressure accompanied by other symptoms such as swollen eyes, severe inflammation, eye pain, or vision loss. 

Your eye doctor will recommend appropriate treatment based on the diagnostic findings.

7 Causes of Pressure Behind The Eye

The following conditions cause pressure behind the eye:

1. Migraines and Headaches

There are over 150 types of headaches.¹ A simple headache can cause a sensation of pressure behind the eyes.

For example, tension headaches are consistent and will feel like you’re wearing a tight band around your head. On the other hand, cluster headaches are accompanied by pulsing pain. 

Migraines are much worse than headaches and occur periodically. They’re characterized by a pulsing pain on one side of the head that worsens with physical activity or bright light. Someone with a migraine may feel pressure behind the eyes.

Other Symptoms

• Flashing lights
• Headache that lasts about 4 to 42 hours
• Sensitivity to noise or smell
• Loss of appetite
• Red, teary eyes
• Nausea and vomiting
• Feeling tired
• Tenderness on the scalp
• Temporary vision issues

Treatment

Treatment for headaches and migraines depends on consistency and severity. Most people feel better without treatment. However, in severe or persistent cases, your doctor may prescribe over-the-counter pain medication, such as:

• Acetaminophen (Tylenol, Panadol)
• Aspirin 
• Ibuprofen (Advil, Motrin IB) 
• Naproxen sodium (Aleve) 

Triptans such as almotriptan, eletriptan, and frovatriptan are also effective in relieving migraines and cluster headaches.²

2. Sinusitis

Sinusitis is the inflammation of the sinuses. Sinuses are hollow cavities in the skull. The largest is the maxillary cavity, a common place for a sinus infection.

Sinusitis is usually caused by allergies, nasal polyps, and respiratory tract infections. Sinusitis results in fluid build-up and blockage of the sinus cavities, causing bacterial growth and infection (bacterial sinusitis). Someone with sinusitis will experience pressure behind the eyes.

According to a National Health Interview Survey, chronic sinusitis affects about 14% to 16% of the US population.³

Other Symptoms

• Coughing
• Stuffy or runny nose
• Headaches
• Eye pain
• Fever or chills
• Fatigue
• Reduced sense of smell
• Bad breath

Treatment

Sinusitis can clear up without treatment. However, home remedies such as getting enough rest, taking plenty of fluids, and cleaning your nose with salt water can help relieve symptoms. 

If the symptoms persist, your doctor will recommend over-the-counter pain relievers (acetaminophen, ibuprofen, or aspirin), decongestants and allergy medications. 

Nasal corticosteroids such as fluticasone, budesonide, mometasone (Nasonex), and beclomethasone are also useful in treating inflammation.

3. Facial Injury

Facial injuries are common and can affect the eyes significantly. Such injuries mostly occur during car accidents, fights, or contact sports and may damage nerves, eye muscles, and sinuses.

For example, a severe nose injury can cause a septal hematoma,  a condition characterized by an accumulation of blood in the septum (area between your nostrils), causing blockage and potential infection.⁴ This may result in a feeling of pressure behind and around the eyes.

Other Symptoms

• Swollen eyes
• Double vision
• Blurry vision
• Numbness around the injury
• Bulging or sunken eyes
• Severe pain when opening the mouth

Treatment

You can treat facial injuries using over-the-counter anti-inflammatory medicines (NSAIDs) and pain relievers.⁵ Antibiotics can also help in case the site of injury gets infected.

Severe facial injury cases such as septal hematoma may require a more invasive treatment like surgery to drain the fluid.

4. Tooth Pain

Toothaches affect about 40% of adults.⁶ While it may seem unlikely, a toothache can affect your eyes. Misalignment of the jaw or a sore tooth can cause tension in the face muscles. This can result in pressure behind the eye.

On the other hand, a tooth infection can spread to other parts of the body, including the sinuses and eyes. Severe infection can cause swelling, inflammation, and a feeling of pressure behind the eyes.

Other Symptoms

• Sharp, constant, or throbbing pain
• Fever (in case of infection)
• Headache
• Bad mouth odor
• Pus formation around the affected tooth

Treatment

A toothache can resolve by itself or with home remedies, such as a cold compress or over-the-counter pain and inflammation medication. Rinsing with salt water or hydrogen peroxide can also help clear the infection.

There are also natural remedies for tooth pain. These include clove oil, garlic, vanilla extract, and peppermint tea.

In severe cases, medical intervention is recommended. In case of cavity pain, your dentist will put a filling in it or take out the affected tooth.

5. Optic neuritis (ON)

Optic neuritis is the inflammation of the optic nerve. This is a bundle of nerve fibers responsible for relaying visual information to the brain for interpretation.⁷ An inflamed optic nerve is accompanied by swelling, pain, eye pressure, and vision loss.

According to research, optic neuritis affects people of all ages but is common among adults 20 to 40 years old. It’s also common among Caucasians.⁸ Although the cause is unclear, scientists regard optic neuritis as an autoimmune disease where an infection (or other triggers) causes the immune system to attack the optic nerve.

Other conditions associated with optic nerve damage include multiple sclerosis (MS), Schilder’s disease, and neuromyelitis optica (NMO).

Other Symptoms

• Mild to severe vision loss
• Eye pain that worsens with eye movement
• Abnormal pupil reaction to light
• Dyschromatopsia (inability to identify colors)
• Photophasia (flashing lights or floaters)
• Uhthoff’s phenomenon (worsening vision loss due to increased body temperature)

Treatment

Optic neuritis may resolve on its own within a few weeks if there are no underlying health conditions. Otherwise, illnesses such as Lyme disease, cat-scratch fever, measles, mumps, and herpes may act as triggers.

In some cases, doctors recommend steroid medications to ease optic nerve inflammation. The steroids are delivered intravenously (by vein injection).

Plasma exchange therapy can also help in vision recovery in the case of severe vision loss. However, studies haven’t confirmed the effectiveness of this therapy in repairing damaged optic nerves.

6. Graves’ Disease

Graves’ disease is an immune disorder resulting from overproduction of the thyroid hormone (hyperthyroidism).⁹ Although anyone can be affected, Graves’ disease is common among women and people below 40 years old, accounting for 60% to 80% of all hyperthyroid cases.

Symptoms of Graves’ disease may manifest all over the body, and pressure behind the eyes is common.

Other Symptoms

• Irritability
• Tremor of the hands or fingers
• Enlarged thyroid gland (goiter)
• Abnormal menstrual cycle
• Erectile dysfunction
• Muscle weakness
• Double vision
• Heat sensitivity
• Unexplained weight loss
• Irregular/fast heartbeat
• Bulging eyes
• Frequent bowel movements
• Sleep disturbance

The symptoms above may be associated with other diseases. See your doctor for a more accurate diagnosis if you suspect Graves’ disease.

Treatment

Graves’ disease is a lifelong condition. The following treatments aim to reduce thyroid hormone production and may result in temporary recovery:

• Beta-blockers (e.g., propranolol and metoprolol). The first line of treatment regulates the heart rate and protects the heart to allow the medications to take effect.
• Antithyroid medications (e.g., methimazole and propylthiouracil). These block the production of the thyroid hormone.
• TEPEZZA (teprotumumab-trbw). Used to treat thyroid eye disease, a condition closely related to Graves’ and characterized by bulging eyes, eye pain, and double vision.
• Radioiodine therapy. It involves taking radioactive iodine for several months to destroy thyroid gland cells.
• Thyroidectomy. This surgery removes part of, or the entire, thyroid gland.

7. Eye Strain

Although eye strain is not a medical condition, it can cause a feeling of pressure behind the eyes.¹⁰ Eye strain may result from reading small prints, staring at a screen for extended periods, or driving for hours.

Other Symptoms

• Blurry vision
• Heavy eyelids
• Dry eyes
• Headache
• Muscle spasms
• Inability to keep eyes open

Treatment

The best solution for eye strain is rest. Take a break from strenuous activity until the pressure behind your eyes resolves.

Wearing proper prescription eyeglasses and adjusting fonts can protect your eyes against strain or drying. In case your eye strain is accompanied by a severe headache, over-the-counter pain medications can help.

Summary

Pressure behind the eye is an uncomfortable feeling of fullness inside the eye. Someone with pressure behind the eyes may require immediate medical attention depending on the underlying cause. The pressure may stem from within the eye or from other parts of the head.

Several causes of pressure behind the eyes include facial trauma, migraines, headaches, eye strain, sinusitis, optic neuritis, toothaches, and Graves’ disease. 

Most of these causes have similar symptoms. Professional diagnosis is important in determining the exact cause and guiding treatment.