- Home
- Knowledge centre
- Eye conditions & symptoms A–Z
- Sudden Sharp Stabbing Pain Behind the Eye: Causes by Type of Eye Pain
Sudden Sharp Stabbing Pain Behind the Eye: Causes by Type of Eye Pain
A sudden sharp, stabbing pain behind one eye that lasts only a few seconds is often a harmless "primary stabbing headache" (also called an ice-pick pain). Pain that stays, with a red eye, blurred vision, light sensitivity, nausea or halos around lights, is different and can be an eye emergency such as acute angle-closure glaucoma. The type of pain, how long it lasts and what comes with it point to the cause.
When is eye pain an emergency?
Treat eye pain as an emergency if it starts suddenly or is severe. The NHS says to call 999 or go to A&E for eye pain with any of the following (in other countries, use your local emergency number or go to the nearest eye emergency department):
- pain that began suddenly or stops you sleeping
- a red eye with a severe headache and nausea
- pain with loss of vision, whether partial or complete
- pain and vision loss in a contact lens wearer
- severe pain or vision loss after recent eye surgery
- an eye injury, or an object stuck in or through the eye
Contact a doctor or the NHS 111 service the same day for eye pain with sensitivity to light, blurred vision, colours that look faded, or a very red eye. The NHS also advises not to try to diagnose the cause of eye pain yourself, and not to drive yourself to hospital if the pain is severe.
A free online consultation is not a substitute for emergency care. If you are in doubt, seek in-person care first.
What causes a sudden sharp stabbing pain behind the eye?
The most common harmless cause is a primary stabbing headache; the dangerous causes come with other symptoms. In the International Classification of Headache Disorders, a primary stabbing headache is a single stab or a series of stabs of pain in the head that last up to a few seconds, with no other cause found. Older names include "ice-pick pains" and "needle-in-the-eye syndrome". The classification notes that about 80% of stabs last 3 seconds or less, that attacks usually happen once to a few times a day, and that the stabs often move around rather than staying in one spot. They are more common in people who have migraine.
A stab that stays, repeats in the same place or comes with other symptoms needs a different explanation. The classification says that when stabs are strictly confined to one area, structural causes at that site must be excluded. Use the table to see which type of pain fits yours.
| What the pain is like | Where | Other signs | Possible causes |
|---|---|---|---|
| Brief, sharp, stabbing, a few seconds | Behind or around the eye, may move around | No redness or watering; vision normal | Primary stabbing headache (more common in people with migraine) |
| Gritty, scratchy, "something in my eye" | Surface of the eye | Watering, redness, light sensitivity | Dry eye, corneal scratch (abrasion), foreign body, conjunctivitis |
| Severe, sore, getting worse | Eye surface, often one eye | Redness, light sensitivity, discharge, blurred vision, white spot | Corneal ulcer (keratitis), especially in contact lens wearers |
| Dull ache, worse when you move the eye | Behind the eye or in the eye socket | Dim or blurred vision, faded colours | Optic neuritis (inflamed optic nerve) |
| Severe, deep, tender | Eye and forehead | Red eye, blurred vision, halos around lights, nausea, vomiting | Acute angle-closure glaucoma (emergency) |
| Piercing or burning, repeated attacks | One side, around the eye | Watering, red eye, drooping eyelid, attacks of 15 minutes to 3 hours | Cluster headache |
| Pressure or ache | Around the eyes, cheeks and forehead | Blocked nose, thick nasal mucus, fever | Sinusitis |
| Throbbing, often one-sided | Head, sometimes behind the eye | Nausea, sensitivity to light and sound, zigzag lines | Migraine |
What causes gritty, burning or scratchy eye pain?
Pain on the surface of the eye usually comes from the cornea or conjunctiva. The cornea, the clear window at the front of the eye, has hundreds of times more pain receptors than skin, according to the AAO, so even a tiny scratch hurts.
- Dry eye. The National Eye Institute (NEI) lists a scratchy feeling "like there's something in your eye", stinging or burning, red eyes, light sensitivity and blurry vision. Related reading: burning eyes: causes and relief.
- Corneal abrasion or erosion. A scratch from a fingernail, make-up brush or branch, or from rubbing the eye, feels like something is stuck in the eye, with redness, watering and light sensitivity. The AAO says small abrasions typically heal within 1 to 2 days and larger ones in about a week. A recurrent erosion often hurts suddenly on waking, because the eyelid sticks to a dry cornea.
- Conjunctivitis. The NHS describes red, burning or gritty eyes that usually get better in a couple of weeks. Conjunctivitis on its own is not usually very painful: eye pain or light sensitivity with it needs an urgent check.
- Corneal ulcer (keratitis). The AAO lists severe pain and soreness, redness, tearing, light sensitivity, discharge and sometimes a white spot on the cornea. Causes include bacteria (especially in contact lens wearers), herpes simplex, fungi and, rarely, parasites. It needs immediate medical attention because it can permanently damage vision. The US Centers for Disease Control and Prevention (CDC) notes that failing to wear, clean and store lenses as directed raises the risk of infection.
- Foreign body or chemical splash. The NHS says to rinse a chemically contaminated eye with clean lukewarm water for at least 20 minutes while waiting for help, and never to try to remove an object that has pierced the eye.
What causes pain behind the eye or when you move it?
Pain behind the eye, or pain that gets worse when you move the eye, points to inflammation of the optic nerve or the eye wall.
- Optic neuritis. The AAO lists blurry or dimmed vision, dull or faded colours and pain in the eye socket or when moving the eye. It is linked to autoimmune conditions such as multiple sclerosis and to some viral infections, and symptoms can worsen with heat or fatigue. The AAO says corticosteroids help most people recover vision, and that you should have an urgent eye examination.
- Scleritis. Inflammation of the white of the eye causes pain and tenderness with redness, swelling, blurred vision and light sensitivity, and sometimes jaw, face or head discomfort. The AAO links it to autoimmune diseases such as rheumatoid arthritis and lupus, and says prompt treatment is needed because it can lead to vision loss.
- Uveitis. The AAO describes a red eye with or without pain, light sensitivity, blurry vision and sudden floaters. It can follow infections such as shingles or herpes simplex and is linked to inflammatory diseases; it needs prompt treatment, usually with steroid drops, to prevent lasting damage.
- Sinusitis. The NHS lists facial pain around the cheeks, eyes or forehead, a blocked nose, green or yellow mucus and fever. It usually clears within 4 weeks, and a GP should review it if it lasts longer than that or painkillers do not help.
What causes severe eye pain with a red eye, headache or nausea?
This combination can be acute angle-closure glaucoma, and it is a medical emergency. The AAO describes sudden blurred vision, severe eye or forehead pain, a red eye, rainbow-coloured rings or halos around lights, headache, nausea and vomiting, and warns that it can cause blindness if not treated right away. The NHS advises calling 999 or going to A&E, and not driving yourself. Treatment includes a laser iridotomy, in which a tiny hole is made in the iris so fluid can drain.
Two more causes need quick action:
- Shingles near the eye. If a shingles rash affects the eye or nose, the NHS says to ask for an urgent GP appointment or call NHS 111, because it can affect eyesight. Antiviral medicine works best when started within 3 days of the rash appearing.
- Giant cell arteritis. The NHS lists frequent severe headaches, scalp or temple tenderness, jaw pain when eating or talking, and vision loss or double vision. It needs urgent treatment, usually with steroids, to prevent stroke and blindness. Related reading: double vision: causes and urgent signs.
What causes eye pain and headache together?
Eye pain with a headache is most often migraine, cluster headache, sinusitis or eye strain, but glaucoma and giant cell arteritis must be ruled out. The right treatment depends on the cause.
| Cause | What it feels like | Typical treatment |
|---|---|---|
| Migraine | Throbbing, often one-sided; nausea; sensitivity to light and sound; episodes last 4 hours to 3 days (NHS) | Painkillers and migraine-specific medicines; cannot be cured, but can be managed (NHS) |
| Cluster headache | Sharp, burning or piercing pain on one side around the eye; red, watering eye, drooping eyelid; attacks of 15 minutes to 3 hours; more common in men in their 30s and 40s (NHS) | Triptan injection or nasal spray, oxygen, preventive medicines; paracetamol and ibuprofen do not work (NHS) |
| Sinusitis | Pressure around eyes, cheeks, forehead; blocked nose (NHS) | Rest, fluids, painkillers, salt-water nasal rinse; antibiotics rarely needed (NHS) |
| Digital eye strain | Tired, dry, watery eyes, blurry vision, headache (AAO) | Regular breaks, blinking, artificial tears, correct screen distance (AAO) |
| Acute angle-closure glaucoma | Severe eye and forehead pain, halos, nausea (AAO) | Emergency treatment by an eye surgeon |
The NHS says to call 999 for a headache that started suddenly and is extremely painful, or that comes with vision loss, a stiff neck, light sensitivity or confusion, and to call 111 for a headache with vision problems.
Does it matter whether the pain is in the left or right eye?
No. The same conditions can affect either eye, so left eye pain causes and right eye pain causes are the same list. What helps your doctor is the type of pain, how long it lasts and what comes with it. One-sided pain with a red eye, vision changes or a rash is more concerning than the side it is on. Pain in only one eye that appeared suddenly should always be checked the same day.
How do you treat eye pain at home, and can you stop it immediately?
There is no safe instant fix when the cause is unknown, but a few steps are safe while you arrange a check. For mild surface irritation, the NHS, AAO and NEI suggest:
- Do not rub the eye. The AAO says rubbing can slow healing or make a scratch worse.
- Take contact lenses out and do not wear them until an eye doctor says you can (AAO).
- Avoid make-up until the eye has healed (NHS).
- Use preservative-free artificial tears if the eye is dry or gritty (NEI), and rinse the eyelids with cooled boiled water for mild conjunctivitis (NHS).
- Rest your eyes from screens and use a humidifier, and avoid smoke, wind and air conditioning (NEI, AAO).
- For a chemical splash, rinse with clean lukewarm water for at least 20 minutes and go to A&E (NHS).
For a headache with eye pain, home remedies such as rest, fluids and a dark, quiet room can ease a migraine, but they do not treat the cause. Keep a note of when the pain started and what came with it, and see a doctor if it keeps returning.
Do eye pain relief tablets work?
Paracetamol or ibuprofen can ease discomfort after a minor injury or an ordinary headache, but they do not treat the cause of eye pain. The NHS lists them for minor eye injuries and headaches, and says they do not work for cluster headaches. Do not use tablets to cope with sudden, severe eye pain, or pain with vision changes: that would delay the check you need. Ask a pharmacist about any medicine, and follow the pack instructions.
What will an eye doctor do?
An eye doctor finds the cause with a close examination and treats it directly. For corneal and inflammation problems, this includes a slit-lamp examination (a microscope with a light); the AAO describes it for scleritis. Treatment depends on the diagnosis, for example:
- lubricating drops, ointment or a healing contact lens for a corneal scratch or erosion
- antibiotic, antifungal or antiviral drops for a corneal ulcer
- steroid drops for uveitis, and steroids for optic neuritis
- a laser iridotomy for angle-closure glaucoma
The three surgeons at Laser Istanbul Clinic cover these areas: Prof. Dr. Ahmet Satıcı treats glaucoma, Doç. Dr. Muhammet Derda Özer (Doç. means Associate Professor) treats corneal disease and uveitis, and Op. Dr. Aysan Bayram treats retinal disease. Doç. Dr. Özer speaks English and Turkish, and Op. Dr. Bayram speaks English.
If you have had eye surgery and pain returns, the NHS advises emergency care for severe pain or vision loss shortly after surgery. Once you are home, contact your surgeon and, if you cannot reach them quickly, go to your nearest eye emergency service.
Frequently asked questions
The most common cause is a primary stabbing headache: a jab of pain lasting up to a few seconds, with no redness or vision change. Sudden pain that stays, or comes with a red eye, blurred vision, halos or nausea, can be a serious eye problem such as acute angle-closure glaucoma and needs urgent care.
Sudden pain in one eye can come from a scratch, a foreign body, infection, optic neuritis, acute glaucoma or a cluster headache. Because some of these threaten sight, get a same-day examination, and call an emergency service if you have a red eye with severe headache, nausea or vision loss.
It can be. Pain behind the eye that worsens when you move it, with dim vision or faded colours, can be optic neuritis. The AAO advises an urgent eye examination, because steroid treatment helps most people recover vision.
The side does not change the list of causes. Migraine, cluster headache, sinusitis, eye strain and glaucoma can all cause eye pain with a headache in either eye. Look at what comes with it: nausea, halos or vision loss mean an emergency.
There is no safe instant fix when the cause is unknown. Do not rub the eye, take contact lenses out, and use preservative-free artificial tears for a dry or gritty eye. If the pain is severe, sudden or comes with vision changes, get emergency help instead of waiting for it to settle.
For mild surface irritation, rest your eyes from screens, use artificial tears, avoid make-up and lenses, and avoid smoke and wind. If the pain is not clearly better within 24 hours, or you have light sensitivity, discharge or blurred vision, see a doctor.
Paracetamol or ibuprofen are the painkillers the NHS lists for minor eye injuries and headaches, taken as the pack directs. They do not work for cluster headache and they do not treat the cause. Ask a pharmacist, and never use them to delay seeking help for severe pain.
Yes. The AAO lists tired, dry or watery eyes, blurry vision and headache after long screen use. Looking away from the screen regularly, blinking fully and using artificial tears usually help. If the pain does not ease with rest, have your eyes and glasses prescription checked.
Eye pain that keeps coming back, or a question about treatment?
Once any emergency has been ruled out, a specialist can look at your history, scans and prescription. Our surgeons at Laser Istanbul Clinic cover corneal disease, uveitis, glaucoma, cataract, laser and retina: Prof. Dr. Ahmet Satıcı, Doç. Dr. Muhammet Derda Özer and Op. Dr. Aysan Bayram.
Sources for the facts on this page
- NHS. Eye pain. https://www.nhs.uk/symptoms/eye-pain/
- NHS. Glaucoma (acute angle closure symptoms). https://www.nhs.uk/conditions/glaucoma/
- NHS. Cluster headaches. https://www.nhs.uk/conditions/cluster-headaches/
- NHS. Migraine. https://www.nhs.uk/conditions/migraine/
- NHS. Headaches. https://www.nhs.uk/conditions/headaches/
- NHS. Sinusitis. https://www.nhs.uk/conditions/sinusitis/
- NHS. Conjunctivitis. https://www.nhs.uk/conditions/conjunctivitis/
- NHS. Eye injuries. https://www.nhs.uk/conditions/eye-injuries/
- NHS. Shingles. https://www.nhs.uk/conditions/shingles/
- NHS. Temporal arteritis (giant cell arteritis). https://www.nhs.uk/conditions/giant-cell-arteritis/
- American Academy of Ophthalmology (AAO). Eye pain. https://www.aao.org/eye-health/symptoms/eye-pain
- AAO. What is optic neuritis? https://www.aao.org/eye-health/diseases/what-is-optic-neuritis
- AAO. What is glaucoma? (angle-closure glaucoma section) https://www.aao.org/eye-health/diseases/what-is-glaucoma
- AAO. What is scleritis? https://www.aao.org/eye-health/diseases/what-is-scleritis
- AAO. What is uveitis? https://www.aao.org/eye-health/diseases/what-is-uveitis
- AAO. What is a corneal ulcer (keratitis)? https://www.aao.org/eye-health/diseases/what-is-keratitis
- AAO. What are corneal abrasion and erosion? https://www.aao.org/eye-health/diseases/what-is-corneal-abrasion
- AAO. Digital devices and your eyes. https://www.aao.org/eye-health/tips-prevention/digital-devices-your-eyes
- National Eye Institute (NIH). Dry eye. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/dry-eye
- Headache Classification Committee of the International Headache Society. ICHD-3, 4.7 Primary stabbing headache. https://ichd-3.org/4-other-primary-headache-disorders/4-7-primary-stabbing-headache/
- US Centers for Disease Control and Prevention. Contact lens health. https://www.cdc.gov/contact-lenses/about/index.html