Headache Behind Eyes? Meaning, Causes, & Treatments

Headache pain can occur in any part of the head due to multiple causes. However, there are certain headache types that typically cause pain behind the eyes. A headache behind the eyes can also be due to other health conditions. Please continue reading to find out possible causes and treatments for headaches behind the eyes.

What kind of headache pain feels like pressure behind the eyes?

Headache pain that feels like pressure behind the eyes can be due to migraines and other types of headaches, eye strain, undiagnosed nearsightedness, sinus infections, allergies, optic neuritis (swelling and inflammation of the optic nerve in the eye), scleritis (inflammation of the outer covering of the eye), glaucoma (increased pressure in the eye), Graves disease (thyroid eye disease), toothache, and facial trauma.

What causes headaches behind the eyes?

Migraine headaches

Migraines are recurrent headaches that occur on one side of the head. They are characterized by moderate to severe pain that is pulsating or throbbing in nature. Migraine pain can be present behind one eye. Additional symptoms of migraines frequently include nausea, vomiting, and sensitivity to lights, noises, and odors.

Triggers for migraine headaches include changes in weather, lack of sleep, too much sleep, skipping meals, bright or flashing lights, strong odors or fumes, stress, overexertion, hormonal changes, depression, and anxiety. Certain foods can trigger migraines, such as monosodium glutamate (MSG), aspartame, aged cheeses, fermented foods, alcohol, and processed foods, especially meats.

Home remedies for migraines include napping in a quiet, dark room, placing cold compresses or ice packs on the forehead, and staying well-hydrated. A small amount of caffeine at the start of a migraine headache may help.

Drug therapy for migraines includes medications such as:

Over-the-counter pain medicines, for example, nonsteroidal anti-inflammatory drugs (ibuprofen, naproxen)
Combination analgesics, such as acetaminophen and caffeine
Triptans such as zolmitriptan (Zomig), sumatriptan (Imitrex), eletriptan (Relpax), naratriptan (Amerge), frovatriptan (Frova), almotriptan (Axert)
Ergot derivatives such as ergotamine (Cafergot) and dihydroergotamine (Migranal)
Anti-nausea drugs such as prochlorperazine (Compazine) and metoclopramide (Reglan)
Narcotic analgesics for severe migraine (these are not for chronic headaches)

Important Note: Overusing pain medicines to treat migraines and other types of headaches can lead to an increase in the frequency and intensity of headache pain. This is called medication overuse headache or analgesic rebound headache. To prevent headaches due to medication overuse, don’t take pain medications for a headache unless necessary. Make an appointment to see your healthcare provider if you are taking non-prescription painkillers on more than 15 days a month or prescription anti-migraine drugs such as triptans on more than 10 days a month.

Tension headaches

Tension-type headaches are very common and occur due to stress and tension in the muscles of the neck, jaw, face, and scalp. Pain behind the eyes can be a symptom of tension headaches. Tension headaches can also occur due to sleep disorders such as sleep apnea, temporomandibular joint dysfunction (TMJ), and arthritis in the neck.

Headache triggers for a tension headache include jaw clenching, lack of sleep, missed meals, intense concentration, depression, and anxiety.

Alternative therapies for tension headaches include managing stress with meditation, relaxation, cognitive behavioral therapy, and biofeedback.

Drug therapy for tension headaches includes pain relievers such as nonsteroidal anti-inflammatory drugs. Antidepressants are sometimes prescribed to manage stress, depression, and anxiety. Triptans and ergot derivatives may be used if you have both tension headache and migraine.

Cluster headaches

Cluster headaches are characterized by sudden, severe pain that usually occurs at the same time of the day and continues for several weeks. The headache pain can be severe enough to wake you up from sleep. It is usually on one side of the head and is often located behind or around one eye. Other symptoms of cluster headache may include nausea, a migraine-like aura, facial redness and swelling on the affected side, eye tearing, restlessness, changes in heart rate and blood pressure, and light sensitivity.

Medications such as triptan drugs, antipsychotic medications, anticonvulsants, and calcium channel blockers are used to reduce the severity and frequency of cluster headaches. Other treatment options for cluster headache include oxygen therapy, galcanezumab-gnlm injections, and vagus nerve stimulation with a hand-held device. In very severe cases, occipital nerve stimulation or surgery on the facial nerves may be necessary.

Sinus headaches

Headache behind the eye can occur with a flu-like illness, for example, an upper respiratory infection that spreads to the sinuses, causing a bacterial sinus infection and sinusitis (inflammation). Symptoms accompanying a sinus headache may include a constant, dull facial pain that worsens with head movements and straining, fever, pressure or pain behind the eyes, nasal stuffiness or congestion, sore throat, cough, and postnasal drip. Treatment options for sinus headaches include pain medicines, decongestants, and antibiotics.

Rare headache types

Certain rare types of headache can also cause pain behind the eye, including:

Trigeminal autonomic cephalgias in which you may have severe pain in or around one eye along with redness, tearing, drooping of the eyelid, and a runny nose.
Paroxysmal hemicrania in which the symptoms are similar to cluster headache but shorter in duration and include severe throbbing or piercing pain on one side of the face or in, around, or behind one eye.
SUNCT (short-lasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing) in which there is moderate to severe throbbing, piercing, or burning pain behind the eye, in the forehead, or in one temple, bloodshot eyes, tearing, puffy eyelids, and increased pressure in the affected eye.

What does a dehydration headache feel like?

Dehydration is one of the known risk factors for headaches. A dehydration headache may cause pain all over the head or in one spot, including behind the eye. The pain can be dull, sharp, constant, throbbing, or pounding. There can be worsening pain with movement. Other common headache triggers besides dehydration include hunger, lack of sleep, smoking, alcohol use, bright lights, strong smells, stress, hormonal changes, and infections and illnesses.

What is a one-sided headache with eye pain?

Cluster headaches are a common cause of one-sided headache with eye pain. Your healthcare provider can make a proper diagnosis.

How do doctors diagnose the type of headache?

Your doctor will obtain a medical history, perform a physical exam, and they also may order certain tests for diagnosing headache type. You should keep a headache journal so that you can answer questions about your headache at your appointment, such as:

Intensity, duration, and frequency of headache pain
Time of day it occurs
Triggers
Foods eaten in the last 24 hours
Activities immediately before the headache
Use of prescription and OTC medicines
Sleep habits
Stress levels
Other known health conditions

When to see a doctor for headache symptoms?

Call your healthcare provider without delay if you have:

Two or more headaches per week
A persistent headache that does not go away with lifestyle changes or over-the-counter painkillers
Sudden or severe headache accompanied by other symptoms such as neck stiffness; fever, nausea, or vomiting without a known cause; double vision, confusion, weakness, or loss of consciousness; numbness, weakness in any part of the body; shortness of breath; seizures
Change in headache intensity, frequency, or pattern
Headache following head trauma
Recurrent headache in a child