What causes a buildup of pressure behind the eyes? By Dan Wessels Reviewed by Ann Marie Griff, OD

There are many types of eye pain, but a feeling of pressure behind the eyes is something else altogether. This unpleasant sensation may be caused by an issue affecting the eyes, but the cause is more likely a condition affecting the surrounding tissue of the face.

Here we look at the following conditions that can cause a feeling of pressure behind the eyes:

1.  migraines and other headaches
2. sinus infection
3. Graves' disease
4. optic neuritis
5. toothache
6. injury to the face

We also look at when someone should see a doctor, and what the treatment options are.

Causes of pressure behind the eyes

1. Migraines and other headaches

The American Migraine Foundation note that headaches and pain around the eyes often go together. However, they also point out that most headaches are classified as migraine- or tension-type, and have nothing to do with eye strain or related conditions.

Migraines are frequently associated with a feeling of pressure or pain behind the eyes.

Other symptoms of a migraine include:

• pulsing pain in the head
• nausea
• vomiting
• sensitivity to sound
• sensitivity to light
• strange lights or sounds before the onset of a headache

Other types of headache include:

• Tension headaches. There will be a sensation of tightening and pressing, rather than pulsing.
• Cluster headaches. These will last for 15–180 minutes and frequently occur up to eight times a day. Infection, swelling, or pain in areas of the face, including the eyes, is common with cluster headaches.

2. Sinus infection

The sinuses are hollow spaces in the skull, positioned above, below, behind, and between the eyes.

Problems with the sinuses often include feelings of pain in and around the face.

One of the main symptoms of a sinus infection is throbbing pain and pressure around the eyeballs. At least one type of sinus infection — sphenoid sinusitis — is linked to an ache behind the eyes.

According to the Centers for Disease Control and Prevention (CDC), other symptoms of a sinus infection include:

• runny or stuffy nose
• loss of sense of smell
• headache
• pain or pressure in the face
• mucus dripping from the nose down the throat
• sore throat
• fever
• cough
• tiredness
• bad breath

• 3. Graves' disease

  A result of an overactive thyroid gland, Graves' disease can cause the tissues, muscles, and fat behind the eye to swell. This causes the eyeball to bulge from the socket and can lead to other issues, such as being unable to move the eyeball.
  The swelling of the tissues behind the eye may result in a feeling of pressure.
  Common eye-related symptoms of Graves' disease include:
  • a feeling of irritation in the eyes
  • dry eyes
  • the eyes tearing up more than usual
  • the eye bulging from the socket
  • sensitivity to light
  • double vision
  • ulcers on the eye
  • loss of vision
  • swelling of the eyeball
  • being unable to move the eye

  4. Optic neuritis

• Optic neuritis is a condition in which the nerve that connects the eyes and brain becomes inflamed and swollen. Side effects can include pain and temporary loss of vision, which usually peaks within a few days and can take 4–12 weeks to improve.

  Infections can trigger optic neuritis, and it is also commonly associated with multiple sclerosis (MS). Around 50 percent of all people with MS experience optic neuritis, which is often the first indication of MS.

  Symptoms of optic neuritis include:

  • reduced vision
  • color blindness, or colors appearing less vibrant
  • blurry sight, especially after the body temperature has risen
  • loss of vision in one eye
  • pain in the eye, especially when moving it
  • the pupil reacting unusually to bright light

  • 5. Toothache

    A toothache, especially as a result of infection, may cause throbbing pain and feelings of pressure to spread to nearby parts of the face, as the surrounding nerves become affected.
    For example, a 2007 case study published in the Malaysian Journal of Medical Sciences concerned a person whose toothache led to a swelling of the left eye socket after 2 days. The vision in the swollen eye grew worse, and the pain increased along with the swelling.

    6. Injury to the face

    Injuries to the face, such as those sustained in car accidents or while playing sports, may lead to a feeling of pressure and pain behind and around the eyes.
    Different types of fracture to the eye socket can cause damage to the eye muscles, nerves, and sinuses.
    Some symptoms of eye socket fractures include:
    • the eye appearing to either bulge or sink into the socket
    • a black eye
    • double vision, blurry vision, or reduced eyesight
    • numbness in parts of the face around the injured eye
    • swelling near and around the eye
    • a flat-looking cheek, possibly with severe pain while opening the mouth

    When to see a doctor

  • Pressure behind the eyes is not a serious medical concern on its own, but it may indicate the presence of a more acute condition.

    Anyone who notices symptoms such as loss of vision, bulging eyes, fever, frequent headaches, or facial swelling should see their doctor.

    If the doctor is unable to make a diagnosis, they will refer the person to an appropriate expert who can investigate more thoroughly
  • Some of these experts include:
    • ear, nose, and throat specialists
    • dental surgeons
    • neurologists, specializing in brain and nerve issues
    • ophthalmologists, specializing in eye issues
    Some techniques that may help with a diagnosis include:
    • Blood tests to determine hormone levels. Hormones produced by the thyroid are key in diagnosing Graves' disease.
    • CT scans to develop an accurate picture of the brain and organs.
    • MRI scans — another method of mapping the brain and body.
    • Endoscopy, which involves inserting a camera into the nose to investigate the health of the sinuses.

    Treatment options

    Successfully treating pressure behind the eyes involves addressing the underlying causes.
    Over-the-counter anti-inflammatory drugs and painkillers are safe to use. They may ease the feeling of pressure if it is not severe and does not seem to be a side effect of a more serious condition.
    If the pressure is severe or comes with other symptoms, see a doctor. Following diagnosis, the doctor will prescribe any treatments needed.
    These could include:
    • ibuprofen, aspirin, or acetaminophen to treat headaches
    • antibiotics, steroid nasal sprays, or antihistamines to treat sinus infections

    Outlook

    The outlook for pressure behind the eyes will depend on the underlying cause.
    This pressure will often be due to simple headaches or sinus conditions, which are easy to deal with and unlikely to cause complications.
    However, pressure behind the eyes may be a symptom of a more serious condition, such as optic neuritis or Graves' disease. In these cases, seek further treatment.