Headache Behind Eyes: Symptoms & Causes


When headaches occur behind the eyes, it can be a symptom of an eye problem, headache or something deeper. Such headaches can give the sensation of pressure behind the eyes, or dull, throbbing, intense, burning or explosive.

Often times people have for that continues for more months without any external cause or stimuli. The connection between eye and headache is called symptomatic headaches.

Basically, you can distinguish between ocular disorders that also make headaches and headaches that also cause eye symptoms.
For the sake of simplicity, let’s begin with the eyes:

Possible Causes & Symptoms

Acute glaucoma

This disease, which can occur in patients with narrow chamber angles, is actually rare, but should not be ignored because of its possible blindness. The eye is red (congestion of the conjunctival vessels), the cornea is dulled because of the high pressure, and the pupil for the same reason usually get rigid.

Logically, the view on this eye is not clear. Other symptoms include a one-sided headache, often pulling from front to back, malaise, nausea, vomiting (sometimes in the swelling). A bilateral acute glaucoma is extremely rare.

An increased eye pressure does not hurt at first and the visual disturbance comes only when more than 50% of nerve fibers are incurably destroyed.

Refractive Error

How often uncorrected refractive errors of the eyes are causing headaches is somewhat controversial. This is mainly dependent on short or long-sightedness, astigmatism, and how strong this change is. The hyperopes must be accommodated all day in order to see sharp, which leads towards tired eyes towards the evening, to headaches mostly over the forehead, or over the nosebones, during exertion or concentration. Depending on the strength of the refraction error, this is already noticeable in children (headaches in the school!), In the adult age then rather eg with longer screen work.

The computer also makes headaches for the astigmatist (corneal curvature), even these patients then indicate to be better in the morning than in the evening (because they “cramp” on the screen). The oblique axis position of the astigmatism is especially problematic. Likewise, anisometropia (very different refractive errors) often lead to corresponding headaches, which can sometimes be one-sided.


The “axis position” can, of course, also affect the entire eye or its rest position. Physiologically, our eyes stand very slightly outwards in the resting state, in order then to assume a certain basic tone during normal wakefulness. The bi-foveolar reflex (fixation absorption of an object by both eyes) is a strongly dominant reflex, which usually fixes the eyes uniformly and centrally at the same time.

In such cases using proper glasses eliminates the symptoms unless it is a vegetative dystonia or similar dysfunction (which is not so rare).

Inflammatory Eye Diseases

In contrast to the preceding, inflammatory problems are usually immediately apparent to everyone. Average conjunctivitis, however, also makes no headaches. A keratitis (corneal inflammation) or erosion (superficial injury) of the cornea, which is very well supplied with nerve fibers, can sometimes cause unpleasant sensations to the back of the head. In rare cases, the pain radiates into the gums (which, in turn, can sometimes cause “teeth to radiate into the eyes”).

The diseases from the rheumatic circle are more frequently associated with headaches. An iritis (rainbow-skin inflammation) practically always causes pain in the back of the eye.

From Head to Eye

The reverse is actually more common: problems in the head make symptoms or visible changes in the eye. This begins with a migraine, which precedes a “visible” aura, and ends with generalized diseases such as systemic lupus erythematosus or Wegener’s granulomatosis.

These also lead to disturbances of vision over the course of time, but these usually occur relatively late: the vomiting in the surge, for example, is a much earlier sign. It can be ruled out with CT or MRI, Scan because you can often see where the pressure increases.

Pseudotumor Cerebri

An exception to this is the pseudotumor cerebri. This disease, which is not exactly known, is also not common in overweight young women with migraine headaches of the stress type, possibly pulse-synchronous hearing impairments and episodic visual disturbances (up to short blindness attacks) or intermittent However, double images should be considered. You can almost always see a papillary vein, but CT and MRI are normal, although the CSF pressure is increased.

The Migraine

All forms of migraine are among the primary headaches. Everything associated with kaleidoscopic lightning and lightning phenomena and flicker-like scotomas is indicative of this disease. There is a clear enlargement of the connective-tissue vessels, often redness and swelling of the region of the lid and of the temples, local pressure-sensitivity, or over-excitation, especially at the nerve-points, A slight constriction of the pupil on the affected side (is almost always one-sided). Bulbus movement pain and pressure dolouris in the orbit are also frequently described.

Vascular Problems

These secondary headaches with associated eye problems are common. Of course, there are also rare things like the carotis dissection or enlargement of an artery caused by weakness in the arterial wall in the brain. In such a case, however, an immediate hospitalization is necessary: ​​head and facial pain on the same side, a narrowed pupil with drooping upper eyelid and possible pain in the eye cavity as well as a vascular nois


It is worth trying to find out whether the problem is primarily localized in the head, in the whole body or around the eye. Since a targeted eye examination (not only iris diagnosis) can provide decisive indications, a referral or visit to the ophthalmologist is often helpful and useful.

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