While mild to moderate eye pain can be caused by many different diseases or conditions, truly severe eye pain is usually related to only a handful of conditions. Conditions that cause severe eye pain are angle closure glaucoma, corneal abrasions or defects, scleritis, and anterior uveitis. Each of these conditions may cause intense pain and require treatment from an eye doctor.
Types of Eye Pain
Pain in the eye can be either a sharp pain or a deep, boring pain.
Deep, boring eye pain causes tension in the culinary body muscle and iris. These structures control the size of the pupil and can create sensations of pain within the eye.
Pain from Angle Closure Glaucoma
Acute angle closure glaucoma is a very painful condition that occurs quickly compared to the more common open-angle glaucoma which is slowly progressive.
Angle-closure glaucoma occurs when the junction between the cornea and the sclera becomes closed and fluid cannot drain from the eye.
The fluid buildup in the front of the eye leads to an increase in eye pressure and can cause damage by pressing on the structures of the eye.
The pain associated with acute angle closure glaucoma is a very severe, deep pain that comes from the increased pressure on the ciliary body muscle.
In addition to eye pain, acute angle closure glaucoma may cause a red eye, nausea, vomiting, or a hazy cornea.
Angle-closure glaucoma is treated using medications to lower eye pressure — both eye drops and oral medications.
Once the eye pressure is lowered, a laser procedure is done to create an opening in the iris to allow fluid to flow even if the angle becomes narrow or closed again.
Severe Eye Pain from Corneal Abrasions
A corneal abrasion is similar to a scratch on the front of the eye.
Unlike the skin, the cornea has free nerve endings that are susceptible to damage and pain sensations.
This pain is usually a sharp pain and may be described as a terrible paper cut in the eye.
To treat a corneal abrasion, an antibiotic eye drop is used to prevent infection while the cornea heals itself.
Pain from Scleritis
Scleritis is inflammation of the white of the eye. When scleritis occurs, the white of the eye becomes very red and bloodshot from the inflammation of the blood vessels.
Since the inflammation is so severe, it can cause pain in the ciliary body muscle due to the swelling.
Pain from scleritis is usually described as a boring or throbbing pain that worsens on eye movement.
The treatment for scleritis is oral or IV steroids to reduce the inflammation in the sclera.
Pain from Anterior Uveitis
Anterior uveitis is inflammation of the structures in the front of the eye including the iris and cilantro body.
When these structures get inflamed, there can be redness, light sensitivity, and blurry vision along with the pain.
The severe eye pain from anterior uveitis comes from the swollen ciliary muscle being pulled when the pupil changes shape.
Steroid eye drops are used to reduce inflammation and treat anterior uveitis.