Headache behind the eye: Causes and treatments
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Headaches behind the eye can arise from various causes, ranging from ocular issues to serious neurological conditions. Understanding the underlying cause is crucial for effective treatment. While corrective lenses and non-pharmacological therapies can manage some types of headaches, others may require more intensive medical or surgical interventions. If you experience persistent or severe headaches behind the eye, it is essential to seek medical advice for a proper diagnosis and treatment plan.
Headaches behind the eye can be particularly distressing due to their location and intensity. Understanding the underlying causes and effective treatments can help manage this condition more effectively. This article explores the various reasons for headaches behind the eye and the available treatment options.
Causes of Headache Behind the Eye
Ocular Causes
Several ocular conditions can lead to headaches behind the eye. These include refractive errors, convergence insufficiency (CI), and accommodative spasm (AS). Refractive errors cause headaches due to the strain on the eyes, especially in individuals with significant vision problems. CI and AS can result in diplopia (double vision) and strabismus (misalignment of the eyes), often exacerbated by head trauma or systemic disorders. These headaches typically occur towards the end of the day and are associated with prolonged near work1.
Neurological Disorders
Headaches behind the eye can also be a symptom of neurological conditions. Cluster headaches, for instance, are characterized by severe pain around one eye, often accompanied by autonomic symptoms such as lacrimation (tearing) and ptosis (drooping eyelid). These headaches can be debilitating and may require specialized treatments like nerve stimulation5. Additionally, sudden changes in headache patterns can indicate serious conditions like aneurysmal thrombosis, necessitating immediate medical attention7.
Tension-Type Headaches
Tension-type headaches are another common cause of pain behind the eyes. These headaches are often described as a tight band around the forehead and can extend to the neck and shoulders. Muscle tension due to stress and anxiety is a primary cause. Non-pharmacological treatments such as acupuncture and manual therapy have shown promise in alleviating these headaches2.
Serious Ocular Conditions
In rare cases, headaches behind the eye can be a sign of serious conditions like a ruptured cavernous carotid aneurysm (CCA). This condition can present initially as a benign headache but rapidly progress to severe ocular symptoms, including a swollen and bloodshot eye. Prompt diagnosis and treatment are crucial to prevent permanent damage3.
Treatment Options
Corrective Lenses and Orthoptic Exercises
For headaches caused by refractive errors, corrective lenses can provide significant relief. In cases of CI or AS, additional treatments such as prism glasses, eye drops, surgery, or orthoptic exercises may be necessary1.
Acupuncture and Manual Therapy
For tension-type headaches, acupuncture and manual therapy have been found to be effective. These treatments can reduce headache intensity and are comparable to prophylactic medications and tricyclic antidepressants in their efficacy2.
Neurostimulation
In cases of cluster headaches, neurostimulation techniques, such as occipital and supraorbital nerve stimulation, have shown significant benefits. These treatments can alleviate both the headache and associated autonomic symptoms, providing long-term relief5.
Medical and Surgical Interventions
For serious conditions like aneurysmal thrombosis, medical and surgical interventions are required. Medications such as dihydroergotamine can provide temporary relief, but surgical procedures may be necessary to address the underlying cause and prevent recurrence7.