Migraine Behind Eye: Causes, Symptoms, and Treatment Guide

What Is a Migraine Behind the Eye?

A migraine behind eye is a migraine attack in which the pain is felt in or around one eye. The discomfort may affect one eye (unilateral) or, less commonly, both eyes (bilateral). Some people describe the pain as a throbbing sensation that seems to pulse with their heartbeat, while others experience a constant, deep ache.

Although it may feel like the pain is coming from your eye, the eye itself is usually not the source of the problem. Instead, the pain is caused by changes in the brain and the nerves involved in migraine. These changes can make the pain radiate to the area behind the eye, making it seem like an eye condition when it is actually a neurological headache.

Does Pain Behind the Eye Always Mean a Migraine?

It’s also important to know that migraine isn’t the only cause of pain behind the eye. Cluster headaches, sinus headaches, eye strain, and certain eye conditions can all cause similar discomfort. Because the location of the pain alone doesn’t reveal its exact cause, it’s important to consider other symptoms as well.

Note: Read our blog to learn the difference between a migraine and a headache.

Can a Migraine Affect One or Both Eyes?

Migraine pain usually affects one side of the head and may be felt around or behind one eye. In some cases, the pain can affect both sides of the head. Along with eye pain, many people experience symptoms such as nausea, sensitivity to light and sound, and, in some cases, visual disturbances known as an aura.

Recognizing these accompanying symptoms can help distinguish a migraine from other causes of pain behind the eye.

What Causes a Migraine Behind Eye?

A migraine behind the eye doesn’t actually start in the eye. Instead, it begins in the brain due to changes in nerve activity and the way pain signals are processed. While experts don’t know the exact cause of migraines, research suggests that genetics, hormonal changes, brain activity, and certain triggers can all contribute to migraine attacks. These factors can activate migraine pain, making it feel like it’s coming from behind one or both eyes.

Changes in Brain Activity

Migraines occur because of changes in how the brain functions during an attack. These changes affect the nerves that transmit pain and can cause discomfort around the eye, forehead, or temple.

Changes in Nerve Signaling:

During a migraine, nerve cells begin sending abnormal signals. This activates the trigeminal nerve, which is responsible for sensation in the face and head. As a result, pain may spread to the area behind the eye, even though the eye itself isn’t causing the problem.

Activation of Pain Pathways:

As the migraine progresses, the brain releases chemicals that activate pain pathways and increase inflammation around nearby nerves and blood vessels. This is what causes the throbbing or pulsating pain many people associate with migraines.

Genetic Factors:

If migraines run in your family, you’re more likely to experience them yourself. Having a parent or sibling with migraines doesn’t guarantee you’ll develop them, but it does increase your risk. This suggests that genetics plays an important role in how the brain responds to migraine triggers.

Hormonal Changes:

Hormone fluctuations, especially changes in estrogen levels, can trigger migraines in some people.

• During the menstrual cycle: Many women notice migraines just before or during their period when estrogen levels drop.
• During pregnancy: Some women experience fewer migraines, while others may develop new or more frequent attacks, particularly in early pregnancy.
• During menopause: Hormonal changes during the transition to menopause can temporarily make migraines more frequent before they improve.

Environmental Triggers:

Certain things in your surroundings can trigger a migraine if you’re already prone to them.

Common environmental triggers include:

• Bright or flashing lights
• Loud noises
• Strong smells, such as perfume, smoke, or cleaning products
• Changes in the weather, including temperature or air pressure

Not everyone is affected by the same triggers, so it’s helpful to pay attention to what seems to bring on your migraines.

Lifestyle Triggers:

Your daily habits can also influence how often migraines occur.

Some of the most common lifestyle triggers include:

• Stress or emotional tension
• Not getting enough sleep or changes in your sleep schedule
• Skipping meals
• Dehydration
• Drinking too much caffeine or suddenly cutting it out
• Alcohol, especially if you’re sensitive to it

Following a regular routine with enough sleep, water, and balanced meals may help reduce migraine attacks.

Certain Foods:

Some foods can trigger migraines in certain people, although the triggers vary from person to person.

Common dietary triggers include:

• Aged cheeses
• Processed meats
• Artificial sweeteners
• Foods containing monosodium glutamate (MSG)

If you suspect food is triggering your migraines, keeping a migraine diary can help you identify patterns and avoid foods that may contribute to your symptoms.

Symptoms of a Migraine Behind Eye

A migraine behind eye can cause a range of symptoms beyond just head pain. While symptoms vary from person to person, common signs include:

Throbbing or Pulsating Pain Behind the Eye:

• Intense pain felt behind one eye or around the eye socket.
• Pain may spread to the temple, forehead, or one side of the head.
• Discomfort may feel like pressure, pulling, or a deep ache.
• Pain often worsens with physical activity or movement.

Visual Disturbances (Aura):

• Temporary changes in vision before or during a migraine attack, experienced by only about 1 in 4 people with migraine.
• Flashing lights, zigzag lines, or unusual visual patterns.
• Blurred vision or blind spots.
• In rare cases, temporary vision changes may affect one eye. This should be evaluated by a doctor.

Sensitivity to Light, Sound, and Smells:

• Increased sensitivity to bright lights (photophobia).
• Discomfort from loud sounds (phonophobia).
• Strong odors, such as perfumes or smoke, may trigger or worsen symptoms.

Nausea and Vomiting:

• Feeling sick to your stomach during a migraine attack.
• Some people may experience vomiting along with severe headache pain.
• Nausea can make it difficult to continue daily activities.

Eye Watering or Redness:

• Watery eyes or mild redness during a migraine episode.
• These symptoms may occur due to nerve activity around the eye and face.
• They are less common but can happen in some people.
• If watering or redness is prominent, one-sided, and paired with nasal congestion on the same side, this pattern is more typical of cluster headache and should be discussed with a healthcare provider.

Dizziness and Fatigue:

• Feeling lightheaded or dizzy during or after a migraine.
• Tiredness and difficulty concentrating.
• A feeling of exhaustion after the migraine improves.

How Is a Migraine Behind Eye Diagnosed?

There isn’t a single test that can confirm a migraine behind the eye. Instead, a healthcare provider will review your symptoms and medical history and perform an examination to rule out other conditions that can also cause pain behind the eye, such as cluster headaches, sinus problems, or eye disorders.

Medical History:

Your healthcare provider will ask about:

• When your headaches started and how often they occur
• Where the pain is located and how severe it is
• How long each migraine lasts
• Any family history of migraines
• Possible triggers, such as stress, certain foods, or hormonal changes

Symptom Assessment:

You’ll be asked to describe your symptoms in detail, including:

• Whether the pain is throbbing, sharp, or constant
• If the pain affects one eye or both sides of the head
• Whether you experience nausea, vomiting, or dizziness
• Any sensitivity to light, sound, or smells
• Vision changes, such as flashing lights, blurred vision, or an aura

Physical and Neurological Examination:

Your provider may perform a physical and neurological exam to check for signs of other conditions. This may include evaluating your:

• Reflexes
• Muscle strength
• Balance and coordination
• Vision and eye movements
• Speech and memory

Eye Examination:

If your symptoms suggest an eye condition, your provider may recommend an eye examination. This helps rule out problems such as glaucoma or other eye diseases that can also cause pain behind the eye.

Imaging Tests:

Most people with typical migraine symptoms do not need imaging tests. However, your healthcare provider may order an MRI or CT scan if they suspect another underlying condition or if you have unusual symptoms, such as:

• A sudden, severe headache
• Changes in vision that don’t improve
• Weakness or numbness
• Confusion or difficulty speaking
• A new or different type of headache

These tests help identify or rule out other possible causes of pain behind the eye.

Treatment for Migraine Behind Eye

Treatment depends on the severity of your symptoms, how often migraines occur, and your overall health. Your healthcare provider may recommend one or more of the following approaches.

Home Remedies:

For mild migraine attacks, self-care measures may help relieve symptoms:

• Rest in a quiet, dark room.
• Apply a cold compress to your forehead or neck.
• Drink plenty of water to stay hydrated.
• Get enough sleep and avoid strenuous activity.
• Limit exposure to bright lights and loud noises.

Over-the-Counter Pain Relievers:

For some people, non-prescription pain relievers may help reduce migraine symptoms, especially when taken early in the attack. However, frequent use can lead to medication-overuse headaches, so it’s important to follow your healthcare provider’s advice.

Prescription Treatments:

If your migraines are severe, frequent, or don’t improve with over-the-counter medications, your healthcare provider may prescribe treatments to relieve symptoms or help stop a migraine attack.

Preventive Treatment:

If you experience frequent or disabling migraines, your healthcare provider may recommend preventive treatment to reduce the number and severity of attacks. This may include prescription medications or other therapies, depending on your individual needs.

Lifestyle Changes:

Healthy habits can also help reduce migraine frequency:

• Get enough sleep each night.
• Eat regular, balanced meals.
• Stay hydrated.
• Manage stress through relaxation techniques or regular exercise.
• Identify and avoid your personal migraine triggers.
• Keep a migraine diary to track symptoms and possible triggers.

Furthermore, if you’re looking for ways to ease symptoms during an attack, these 10 tips for instant migraine relief may help.

Clinical Research for a Better Tomorrow in Neurology

Pantheon Clinical Research is conducting neurology clinical trials to study potential new treatment options for people affected by brain and nervous system conditions. Our pediatric migraine clinical trials provide children and families an opportunity to take part in research that may help improve future migraine care. Join us in advancing neurological research for future generations.