Eye socket pain is most commonly caused by pressure on the ocular nerves, but there are many different reasons that this can happen. Eye disorders, infections, and allergies are likely culprits, but larger problems with the nervous system may also be to blame. The pain could be a symptom of a larger underlying medical condition, too. In most cases it is not an indication of anything serious, but healthcare experts typically recommend that people seek help if they feel persistent pain that doesn’t go away on its own or respond to mild over the counter painkillers.
Glaucoma, a potentially serious eye condition, is one of the most common causes of pressure and pain in the socket. People who suffer from glaucoma have problems with their eye ducts such that fluid builds up and causes the tissues around the ocular nerve to swell. It’s fairly easy to treat if caught early on, but can lead to blindness and considerable pain if nothing is done.
Cataracts are another possibility, but in these cases the pain is usually caused by eye strain. Retinal disorders, which are problems with the nerve connecting the back of the eye, are in this category, too. Both cause blurred or deteriorated vision over time, which can cause people to squint and exert a lot of focus to see things clearly. This straining can cause headaches that make it feel like pain is radiating out of the eye socket, even if this isn’t technically the case.
A lot of what happens in the eyes is driven by the nervous system and the way the body relays signals from the eyes to the vision center in the brain. Optical neuritis is a neurological condition in which the optic nerve spasms and the sensitive coating around it becomes inflamed or irritated. Pain signals around the back of the eye may come from the nerve but feel like they are emerging from the eye socket.
Patients with tumors and buildups of fluid in their skulls can also develop eye socket pain due to pressure. They may notice swelling or bulging eyes along with neurological symptoms like slurred speech, double vision, and tremors; pain is often only one of many more serious signals that something just isn’t right.
Cranial nerve palsy can sometimes also be to blame. When the cranial nerves do not function properly, they sometimes send random signals to the brain and can cause significant pain for the patient. This can be the result of disease, pressure on a nerve, or trauma. Recent trauma should be discussed in an evaluation for eye socket pain, as it can provide a clue to the origins of the symptom. Penetrating trauma is a particular cause for concern, as there may be an injury in the back of the eye that is not readily apparent to a doctor or practitioner performing a more casual physical examination.
The affliction known as “pink eye,” which is known medically as conjunctivitis, might also come with socket pain. The most obvious sign of pink eye is itchy, swollen lids and tissues, but pain isn’t uncommon as a secondary symptom. Pain is also quite common with more routine eye infections, like those that happen when the eyeball or delicate eye tissues are scratched. Scratches open up space for bacteria to enter and multiply, which can cause painful infections that can spread to other parts of the face and body if left untreated. In these cases the pain may or may not be actually radiating from the socket itself, though it can feel like it.
Allergies and Inflammation
People who suffer from seasonal allergies that cause the eyes to water may also discover that their sockets hurt, likely because of how swollen the tear ducts are. The swelling puts pressure on the eyeball itself, which can radiate pain from the back of the socket out. Excessively dry eyes, which is common for people who work or frequently handle harsh chemicals like chlorine or who live in particularly arid climates, behave similarly. When the tear ducts constrict they pull the tissues away from the back of the eyeball, which doesn’t normally happen without discomfort.
Some patients develop orbital cellulitis, an inflammation of the tissues that line the eye socket. This can cause pain, dry eyes, and swelling, as well as blurred vision and other vision changes. It’s also possible to experience chronic inflammation of the eye socket without a clear cause; patients in this category often benefit from anti-inflammatory medications and may respond to therapy with antibiotics or antiviral drugs.
Unrelated Medical Problems
Pressure in the eye socket can also be a symptom of ailments that seemingly have little to do with the eyes or the optic nerve. Migraines, sinusitis, or Addison's disease, a condition of the adrenal glands that results in hormone imbalances, are often at fault. Patients may experience intermittent facial pain with these conditions, which can sometimes affect the eyeball area. People who struggle with temporomandibular joint disorder may also feel pain behind or around their eyes during a flare-up if the cranial nerve is irritated.
Treatments for eye socket pain depend almost entirely on the cause. For minor, temporary aches, over the counter medications, compresses, and rest are usually the best prescriptions. People who feel pain as a result of eye strain can often alleviate the effects by getting their eyes checked, getting corrective lenses if needed, and minimizing time spent in straining activities, such as sitting in front of the computer and doing a lot of driving at night. Longer-term solutions include prescription drugs, usually to treat specific conditions, and in some cases surgery to repair or restore the optical nerve and its surroundings.
When to Get Help
Medical professionals typically encourage people to get any pain that lasts more than a day or two evaluated. In most cases there is no cause for alarm, but the sooner a practitioner can get to the root of the problem, the better. It’s usually a good idea for patients to try and determine the precise location of pain so they can report their symptoms accurately, as this information can be important for ruling various diagnoses out.