In short
Pain behind the eyes is most often caused by migraine, tension-type headache or eye strain. Severe pain behind one eye with a watery eye and runny nose suggests cluster headache. A painful red eye with blurred vision, vision loss, or pain when moving the eye needs urgent medical care.
On this page
Common causes
Migraine
Migraine pain often centres around or behind one eye. It’s typically throbbing, moderate to severe, and comes with nausea and sensitivity to light and sound. See migraine symptoms.
Tension-type headache
Pressure across the forehead and behind both eyes, like a band. Often linked to stress, screens and poor sleep. See tension headache.
Cluster headache
Excruciating pain behind or around one eye, lasting 15 minutes to three hours, with a red, watering eye and blocked or runny nose on the same side. See cluster headache.
Eye strain
Long periods of screen or close work, or glasses that need updating, can cause aching around the eyes and forehead. An eye test with an optometrist is worthwhile.
Sinusitis
Pressure between and behind the eyes with a blocked nose and thick mucus after a cold. See sinus headache.
Less common but important causes
- Acute angle-closure glaucoma: sudden severe eye pain, a red eye, blurred vision, haloes around lights, headache and vomiting. This is an emergency.
- Optic neuritis: pain behind one eye that’s worse with eye movement, with blurred or dim vision or faded colours.
- Giant cell arteritis: in people over 50, a new headache, tender scalp or temples, jaw pain when chewing and vision changes. This needs same-day care to protect sight.
- Other eye inflammation or infection.
Headaches taking whole days away?
Talk it through with an Australian doctor online. No referral needed.
Get urgent help (call 000 or go to an emergency department) for
- a painful red eye with blurred vision, haloes or vomiting
- sudden loss of vision, or double vision
- a sudden severe headache, or one with weakness, confusion or trouble speaking
- headache with fever and a stiff neck
- headache with jaw pain and vision changes over the age of 50
When to see a GP
See a GP for headaches behind the eyes that keep coming back, are getting worse, or affect your work and sleep. A GP can work out the type and refer you to an optometrist, ophthalmologist or neurologist if needed.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- . Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1-211.
- Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 2018;17(1):75-83.
- Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021;7(1):24.
- Robbins MS. Diagnosis and Management of Headache: A Review. JAMA. 2021;325(18):1874-1885.
- healthdirect. Headaches.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.