Eye pain can is a common reason for patients to seek medical care, and it represents a number of potential problems that can affect one or both eyes. While eye pain is not commonly thought to be life-threatening, anything that puts our vision at risk can be life-altering, so a complaint of sharp eye pain should be taken seriously.
Eye pain can result from events like trauma, infection, inflammation, cancer, or a disruption in the blood supply to the eye. Understanding the potential causes of sharp eye pain, the associated signs and symptoms with those causes, and how to properly manage them are critical tools for healthcare professionals in any setting where they might encounter it.
Causes of Sharp Eye Pain
“Sharp eye pain” is an extremely general patient complaint that is associated with a wide variety of conditions ranging from relatively harmless to critical emergencies. Taking into account a description of the pain, such as the circumstances surrounding its onset, duration, and location, offers insight into which potential issues to focus on.
A common cause of sharp eye pain is the presence of a foreign body in the eye. This can include dirt or dust from the environment, or wood and metal debris that enters the eye when working with these types of materials. The onset of the pain from a foreign body is often sudden, and may have compounding issues relating to how the object became lodged in the eye in the first place. If the patient has facial injuries, for instance, there may be swelling and trauma that overshadows or obscures other problems during diagnosis, so a thorough examination is necessary.
Patients often complain of the sensation that something is stuck in their eye with increased pain when blinking, watering, and redness. Pain that persists after the foreign body has been removed may indicate the presence of a corneal abrasion which can effectively be diagnosed using fluorescein eye stain and a black light.
Many people experience mild eye dryness, but when it becomes severe it can be both extremely painful and possibly symptomatic of a serious issue. Dry eyes may be caused by a variety of conditions, which include:
- Wearing contact lenses
- Taking medications like antihistamines, beta blockers, and chemotherapy
- Hormonal changes
- Environmental conditions like allergies, pollution, particulates, and air conditioning
- Illnesses, such as diabetes, lupus, or Graves’ disease
Dry eyes are often experienced in both eyes and can be managed with simple interventions like eye drops, a humidifier, or a change in medication. However, even though it’s typically a very mild issue, it’s important to conduct a thorough examination to rule out rare but serious problems.
Angle-closure glaucoma, which is also sometimes referred to as narrow-angle glaucoma, results from a buildup of fluid in the front portion of the eye. This increase in fluid volume also causes an increase in pressure within the eye, and it is considered an emergency condition. If it’s not treated within a few hours of onset it can cause irreversible damage to the eye, so healthcare workers need to be familiar with the symptoms and have a clear course of action for treatment referral.
Angle-closure glaucoma is extremely painful, and symptoms appear rapidly and acutely. They often develop in conjunction with other issues like headache, nausea, blurred vision, and a halo around bright lights. This condition requires immediate intervention by a trained medical professional who can alleviate the pressure within the eye by draining the fluid and prescribing medications to reduce the pressure.
Eye infections—often generalized as red eyes or conjunctivitis—can actually be caused by a variety of microbes, such as viruses, bacteria, amoebas, fungi, and parasites. They may produce sharp eye pain as they become more severe, and cause redness, swelling, and discharge. Infections can also spread to or from another location like the sinuses, and may appear in conjunction with other patient complaints. Pain from eye infections is often slower in onset, gradually becoming more bothersome, and can be seen in either one or both eyes.
While it is possible for some infectious processes to improve on their own, they usually require pharmaceutical interventions to resolve. Antibiotic drops or ointments can be used to relieve symptoms and treat the underlying condition, but some issues may require more extensive measures.
Eye infections can be easily dismissed as “pink eye” by healthcare professionals who are not familiar with the range of possible causes, and misdiagnosis can lead to worsening outcomes and irreversible damage down the road. Education and training about the diversity of eye infection causes and treatments is necessary for catching less common—and potentially more severe—conditions.
Trauma to the eye can be the result of any number of blunt, penetrating, thermal, or chemical injuries that can occur from events like a motor vehicle accident, assault, sports injury, or exposure to dangerous chemicals. Through these mechanisms, the integrity of the ocular globe or the soft tissues surrounding it are at high risk for permanent damage.
Patients experiencing eye trauma will complain of the sudden onset of sharp eye pain that coincides with the traumatic event. With loss of vision being the most concerning outcome, intervention and management of the injury by an eye specialist is paramount, and consideration should be given to pain management and early infection prophylaxis.
High-Risk Eye Symptoms and Conditions
The eye is one of the most complicated and delicate structures in the human body, and healthcare professionals who are in non-optometry settings often suffer from a lack of training about possible indicators of serious conditions. Unfortunately, the difference between a minor, easily-fixable issue and a major emergency that requires immediate specialist support can be nuanced, so it’s critical for key staff to have a solid foundational knowledge of potential indicators of dangerous conditions. Strong interdisciplinary relationships and consistent interprofessional collaboration is essential for facilitating fast patient referrals and identifying emergency situations.
Emergency eye conditions that are often effectively managed using an interdisciplinary approach can include:
- Sudden visual changes or loss of vision
- Halo seen around lights
- Chemical or thermal burns to the eyes
- Inability to move the eyes through their normal range of motion
- Evidence of a ruptured globe
- Significantly elevated intraocular pressures within the eye
Improve Your Focus on Sharp Eye Pain Diagnostics
Sharp eye pain is both extremely common and can result from a number of potential causes ranging from minor and some potentially severe. Professionals in any number of disciplines and settings are likely to encounter patients with eye issues, and they need to be informed and prepared to ask the right questions and take appropriate steps.
Premiere is committed to delivering continuing education that empowers healthcare workers in all clinical settings with the knowledge and skills they need to identify and manage serious eye issues. Courses like Navigating the World of Eye Pain - Making Foreign Bodies Familiar by Erika Anderson OD, FAAO and Megan Arbour Ph.D., RN, CNM, CNE covers everything from common causes of eye pain to CDC guided pain management, as well as a description of the value of interprofessional collaboration. All of Premiere’s content and courses are created by leading industry experts, and make staying informed and compliant with licensing standards easy, engaging, and accessible from any screen on a schedule that matches your own.