Pain in and around the eye
introduction
With a weight of only 7.5 g and a diameter of 2.3 cm, the eye is one of the smallest organs in our body. Nevertheless, a wide variety of diseases can occur, which sometimes lead to uncomfortable to severe pain. Fortunately, not all parts of the eye can be painful and the cornea, sclera, and uvea are usually affected. But there are also appendages or in the periphery of the eye Adnexa like glands, eyelids, and eye muscles that can cause pain.
Pain in the eye
The Conjunctiva forms the front boundary of the eye, it pulls down on the inside edge of the eyelid and, after a fold, ends directly on the cornea of the eyeball. You can see the conjunctiva when you pull one eyelid down with your hand, as it lines this from the inside.In this position the conjunctiva is always exposed to a multitude of external stimuli and ignited accordingly quickly. One then speaks of one Conjunctivitis or Conjunctivitis. In addition to pain also occur itching, Redness, Burn, Foreign body sensation and increased tearing. Occasionally it also occurs with conjunctivitis Pain in the corner of the eye.
Conjunctivitis can have a variety of causes: In addition to mechanical influences such as dusty or smoky surroundings, dry air in particular is considered to be the trigger for conjunctivitis. So-called dry conjunctivitis can also arise from reduced production or increased drainage of the tear film. On the one hand, this can be the case if the glands are blocked, or on the other Ectropion, an outwardly curved eyelid. As a result, the tear film cannot be kept on the eye, the eye dries out. Conventional conjunctivitis is relatively common, but it can also have more serious causes, such as bacterial or viral Infestation. A bacterial colonization is critical insofar as pus is produced in addition to pain. If the treatment is not carried out, it may be necessary to remove the eye in the end-stage.
While an ectropion the "tilting outwards“Of the eyelid is called an inwardly curled eyelid Entropion. Entropion can cause pain because the edge of the eyelid drags along the foreground of the eye. At a Fluorescent marking of the cornea you can see very clearly the damaged areas, which pain, but also a Decreased vision can evoke. Furthermore, pain occurs in one Inflammation of the dermis (Sclera) of the eye. The sclera lies at the back of the eyeball to the eye sockets, its inflammation is called Scleritis designated. Scleritis is usually associated with severe pain and in half of the cases has a systemic cause - that is, the cause that affects the entire body. If there is inflammation, there will be Swelling of the sclera. Since the sclera rests against the bony eye socket and therefore cannot move in any direction, this pressure has a direct effect on the eyeball. Then there is pressure pain or general eye pain.
Pain can also be from one Uveitis originate. Uveitis is an inflammation of the uvea, i.e. the Eye skin. This consists of several parts, which can all be affected to the same extent, namely from iris, Corpus cilliare and from Choroid. A uveitis is anatomically divided into one Anterior uveitis, intermedia and posterior. In anterior uveitis, the front part of the eye including the anterior chamber affected. Anterior uveitis can be both chronic as well as acute occur. Very severe pain, reddening of the eye as well as reduced visual acuity and are typical Photophobia. 60-70% of all uvetides affect the anterior chamber. Middle and posterior uveitis is usually symptom-free and also painless, but this does not make it less dangerous: possible complications are cataract or. cataract and in the worst case Blindness.
Pain adnexa
Both Adnexa it is about the Appendage of the eye, i.e. muscles, Glands, Eyelids and eyelashes. Pain in the eye can also always have its cause in the periphery, for example the eye muscles. Humans have 4 straight and 2 oblique eye muscles that are required for rolling in, rolling out and moving to the right / left and up / down. Normally, both eyes are synchronized by the respective one Cranial nerves controlled and moved absolutely evenly. However, if there are deviations in the axis of movement, for example due to a muscle failure in one eye or a one-sided nerve lesion, the eye movement is asynchronous.
The three-dimensional See is created by the two perspectives that our two eyes pass on to the head. The brain calculates a spatial image from this. To do this, however, both eyes must be precisely coordinated to the nearest millimeter, otherwise the brain cannot do anything with the two images - we see twice. Double visionsuch as, for example, after Eye muscle paralysis occur, cause a headache and with it pain too. Eye muscle paralysis can be its cause Nerve lesions, but also traumatic brain injury or stroke to have. Incidentally, 3D films like the ones we see in the cinema are also recorded with two cameras, which are slightly offset from one another - in exactly the same way as our two eyes do.
Another source of eye pain is the numerous glands that are around the eye. According to their discoverers and first descriptors, they have names like Meibomian gland, Minor gland, or Zeis gland. Your job is the production of components for the Tear fluid. For example, the meibomian glands produce an additive that they release into the tear fluid. It prevents the tear fluid from evaporating too quickly. However, if the meibomian glands become inflamed, what is known as an inflammation forms in the acute case Stye (or Hordeolum), in chronic cases Hailstone (Chalazion). Both are accompanied by redness, swelling, and pain.
In the event of pain at the edge of the eyelid or the periphery of the eye, an inflammation of one of the glands must always be considered. The lacrimal gland is of particular importance: it produces the Tear fluidthat keeps the eye moist as well as cleanses and rinses. An obstruction of the lacrimal gland or the draining tear ducts leads to an insufficient supply of the eye with tear fluid and thus to dry eyes. This can for example be with a tumor or a stone obstructing the tear ducts. On the one hand the eye hurts because it is dry and sticky, on the other hand it causes Inflammation of the lacrimal gland (also Dacryoadenitis called) an uncomfortable feeling of pressure, which is often associated with pain.
However, dry eyes do not only have to be based on an obstruction of the tear ducts: dry air, computer work or excessive computer games as well Tobacco smoke can dry out the eyes and cause uncomfortable burning sensation and pain. Another Adnexa or Eye tags are the Eyelids. Pain in the eyelid usually has its cause in the underlying structures, such as an inflamed conjunctiva or blocked glands. Often, however, the pain appears on the lid and not at the actual point of origin. In the event of pain in the eyelid, damage to the other adnexa must always be taken into account.
Eye socket pain
Pain in the eye socket affects the eye and can have a number of causes. A suppuration of the eye socket (also known as orbital phlegmon) is a bacterial inflammation, usually based on a sinus infection. It is usually caused by staphylococci or streptococci. Symptomatic of orbital phlegmon are very severe pain, swelling of the eyelids and a general feeling of illness with fever. Since this is a serious and dangerous clinical picture, immediate treatment with antibiotics and, if it is unsuccessful, invasive cleansing of the pus focus is necessary. In the eye socket there is also the optic nerve or nervus opticus, which - like almost all parts of the body - can become inflamed. One speaks of an optic nerve inflammation.
Read more on the topic: Optic nerve inflammation symptoms
With such optic neuritis, eye movements cause great pain, and one-sided deterioration within a few hours is typical. The causes of optic neuritis are still unclear. However, an accumulation of first manifestations is observed between the ages of 18 and 45. Women are more often affected than men. Both the pain and the reduced visual acuity respond well to therapy with cortisone - the symptoms usually disappear within two weeks. However, pain in the eye socket can also have its cause in the hormonal balance:
With an overactive thyroid gland it comes to a so-called hyperthyroid metabolism. Antibodies occupy the thyroid tissue and provoke inflammation and increased production of the thyroid hormones T3 and T4. The TRAK antibodies, which should actually only dock on the thyroid tissue, find tissue in the eye socket to which they can dock just as well as that of the thyroid. Inflammation now takes place in this tissue too, although there is actually no room for it in the bony eye socket. Therefore, the inflamed tissue presses on the eyeball from behind and pushes it forward, out of the eye socket. For an endocrinologist, this is again a clear indication of an overactive thyroid. Unfortunately, this process is also associated with pain, especially pressure pain. However, these decrease as soon as the underlying disease, i.e. the hyperthyroid metabolic condition, has been treated. This is achieved with cortisone therapy to curb the inflammation behind the eye and on the thyroid. The eyes then move back to their original position, long-term damage is not to be expected.
Read more about the topics here: Pain over the eye and pain behind the eye
