Headache Behind Eyes: Common Causes and When to Worry

At-a-Glance

• Most headaches behind the eyes are caused by eye strain, sinus issues, or tension headaches
• Screen time and poor lighting are increasingly common triggers
• Migraines often cause pain behind one or both eyes with light sensitivity
• Seek immediate care if accompanied by vision changes, severe pain, or fever
• Simple lifestyle changes can prevent many cases

What It Feels Like

A headache behind the eyes can feel like pressure, throbbing, or a dull ache located deep in the eye sockets or just behind them. The sensation may affect one or both eyes and can range from mild discomfort to severe, debilitating pain.

People often describe it as:

• A feeling of pressure pushing outward from behind the eyes
• A throbbing or pulsing sensation synchronized with your heartbeat
• A dull, constant ache that worsens with eye movement
• Sharp, stabbing pains that come and go
• A sensation of fullness or heaviness in the eye area

The pain may worsen when you move your eyes, bend over, or are exposed to bright lights.

Common Causes

Eye Strain (Digital Eye Strain)

In our screen-dominated world, eye strain has become one of the most common causes of headaches behind the eyes. When you focus on screens for extended periods, your eye muscles work overtime, leading to fatigue and pain.

Signs it might be eye strain:

• Pain develops after prolonged screen time or reading
• Eyes feel tired, dry, or irritated
• Symptoms improve with rest or closing your eyes
• You notice you're squinting or having trouble focusing
• Pain is usually bilateral (both eyes)

What helps:

• Follow the 20-20-20 rule: Every 20 minutes, look at something 20 feet away for 20 seconds
• Adjust screen brightness and position
• Use artificial tears if eyes feel dry
• Ensure proper lighting in your workspace
• Consider computer glasses if you wear prescription lenses

Sinus Infection or Sinusitis

Your sinuses are air-filled spaces around your eyes and nose. When they become inflamed or infected, pressure builds up, causing pain that radiates behind the eyes.

Signs it might be sinusitis:

• Pain worsens when bending forward or lying down
• Accompanied by nasal congestion, runny nose, or post-nasal drip
• Facial pressure or tenderness, especially around the nose and forehead
• Thick, discolored nasal discharge
• Reduced sense of smell
• Low-grade fever may be present

What helps:

• Steam inhalation or warm compresses
• Saline nasal rinses
• Stay hydrated
• Over-the-counter decongestants (short-term use)
• See a doctor if symptoms persist beyond 10 days or worsen

Migraine Headaches

Migraines commonly cause intense pain behind one or both eyes. They're neurological events that involve changes in brain chemistry and blood flow.

Signs it might be a migraine:

• Moderate to severe throbbing pain, often on one side
• Sensitivity to light (photophobia) and sound
• Nausea or vomiting
• Visual disturbances (aura) before or during the headache
• Pain lasts 4-72 hours if untreated
• Family history of migraines

What helps:

• Rest in a dark, quiet room
• Cold compress on forehead or eyes
• Over-the-counter pain relievers (taken early)
• Prescription migraine medications if recommended by your doctor
• Identify and avoid triggers (certain foods, stress, lack of sleep)

Tension Headaches

Tension headaches are the most common type of headache and can cause pain that radiates to the area behind the eyes. They're often related to stress, poor posture, or muscle tension.

Signs it might be a tension headache:

• Dull, aching pain on both sides of the head
• Feeling of tightness or pressure, like a band around your head
• Tenderness in scalp, neck, and shoulder muscles
• Not worsened by physical activity
• No nausea or vomiting (unlike migraines)

What helps:

• Stress management techniques
• Regular breaks from desk work
• Neck and shoulder stretches
• Proper ergonomic setup
• Adequate sleep
• Over-the-counter pain relievers

Cluster Headaches

Though less common, cluster headaches cause severe pain around or behind one eye. They occur in cyclical patterns or "clusters."

Signs it might be a cluster headache:

• Severe, burning, or piercing pain around one eye
• Attacks occur at the same time each day, often at night
• Eye redness, tearing, or drooping eyelid on affected side
• Nasal congestion on the affected side
• Restlessness during attacks
• Each attack lasts 15 minutes to 3 hours

What helps:

• Oxygen therapy (prescribed by doctor)
• Prescription medications (triptans, preventive medications)
• Avoiding alcohol during cluster periods
• Medical evaluation is essential for proper diagnosis and treatment

Less Common but Serious Causes

Acute Angle-Closure Glaucoma

This is a medical emergency where pressure builds rapidly in the eye.

Warning signs:

• Sudden, severe eye pain
• Blurred vision or seeing halos around lights
• Red eye
• Nausea and vomiting
• Rapid onset of symptoms

Action: Seek emergency care immediately to prevent permanent vision loss.

Optic Neuritis

Inflammation of the optic nerve can cause pain behind the eye, especially with eye movement.

Warning signs:

• Pain that worsens with eye movement
• Vision loss in one eye
• Loss of color vision
• Flashing lights

Action: See an eye doctor or neurologist promptly.

When to See a Doctor

Schedule a doctor's appointment if:

• Headaches are becoming more frequent or severe
• Over-the-counter medications aren't helping
• Headaches interfere with daily activities
• You're using pain relievers more than 2-3 times per week
• You have new headache patterns after age 50

Self-Care and Prevention

Immediate Relief Strategies

• Rest your eyes: Close them for 10-15 minutes in a dark room
• Cold or warm compress: Apply to eyes and forehead (cold for migraines, warm for sinus issues)
• Hydrate: Dehydration can trigger headaches
• Gentle massage: Temple and neck massage may help tension headaches
• Over-the-counter pain relief: Ibuprofen, acetaminophen, or aspirin (follow package directions)

Long-Term Prevention

• Optimize your workspace: Proper lighting, screen position at eye level, ergonomic chair
• Regular eye exams: Ensure your prescription is current; uncorrected vision problems cause strain
• Manage stress: Meditation, yoga, regular exercise
• Maintain sleep schedule: Aim for 7-9 hours of consistent sleep
• Stay hydrated: Drink adequate water throughout the day
• Limit screen time: Take regular breaks, especially from phones and computers
• Identify triggers: Keep a headache diary to spot patterns

Frequently Asked Questions

The Bottom Line

Headaches behind the eyes are common and usually caused by benign conditions like eye strain, sinus issues, or tension headaches. In our digital age, screen-related eye strain has become an increasingly frequent culprit.

Most cases respond well to simple measures: taking screen breaks, staying hydrated, managing stress, and using over-the-counter pain relievers when needed. However, certain warning signs—such as sudden severe pain, vision changes, or accompanying neurological symptoms—require immediate medical attention.

If you're experiencing frequent or severe headaches behind your eyes, don't hesitate to consult a healthcare provider. Proper diagnosis ensures you receive appropriate treatment and can rule out more serious conditions.

Remember: This information is for educational purposes only and doesn't replace professional medical advice. Always consult a healthcare provider for persistent or concerning symptoms.