Sore eyes

What are sore eyes?

Sore eyes can feel gritty, itchy, burning, or achy, and the white of the eye may look red or bloodshot. It's a very common symptom with many possible causes, ranging from mild and short-lived to something that needs urgent treatment.

What are the common causes of sore eyes?

Sore eyes usually come from something affecting the surface of the eye or the eyelids. Common causes include:

• dry eyes, from not making enough tears, or from long periods looking at screens
• allergies, such as hay fever, dust, or pet dander
• conjunctivitis (pink eye), caused by a virus, bacteria, or an allergy
• inflamed eyelids (blepharitis)
• a stye, an infected or blocked gland at the edge of the eyelid
• a foreign body, scratch, or other minor injury to the eye
• problems with contact lenses, such as wearing them for too long or not cleaning them properly.

Less often, sore eyes are linked to a more serious problem inside the eye, such as:

• inflammation inside the eye (uveitis) or of the white of the eye (scleritis), often linked to autoimmune conditions or infections
• a sudden rise in eye pressure (acute angle-closure glaucoma), which is a medical emergency
• an infected or ulcerated cornea (keratitis or a corneal ulcer)
• inflammation of the optic nerve (optic neuritis)
• sinusitis, an infection in your sinuses, which can cause pressure or pain behind or below your eyes.

Are there different types of sore eyes?

Sore eyes aren't classified into set types, but it helps to know two things. First, soreness on the surface of the eye, such as from dryness, allergies, or a minor infection, is usually less serious and often settles with simple care. Pain that feels like it's coming from inside the eye is more likely to signal something that needs prompt assessment.

Conjunctivitis, the most common cause of sore, red eyes, itself comes in three main types: viral, bacterial, and allergic. Viral conjunctivitis tends to produce a watery, see-through discharge and often comes alongside a cold or respiratory infection, while bacterial conjunctivitis causes a thicker, pus-like discharge that can stick your eyelids together, especially in the morning. Allergic conjunctivitis usually affects both eyes from the start, with more intense itching and watering but no sticky discharge.

How is the cause of sore eyes diagnosed?

If your sore eyes don't settle with simple self-care, a doctor or optometrist will ask about your symptoms, any recent illnesses, and whether you wear contact lenses. They'll examine your eyes closely, and may take a swab if they suspect an infection that needs specific treatment.

If things aren't improving, or the cause isn't clear, you may be referred to an eye specialist for further tests.

How are sore eyes treated?

Many causes of sore eyes settle with simple self-care at home. This might include:

• a warm, clean compress held over your closed eyes a few times a day can help with styes / blepharitis
• artificial tears (lubricating eye drops) to soothe dryness and irritation
• over-the-counter antihistamine eye drops or tablets if allergies are the cause
• paracetamol or ibuprofen to ease discomfort
• resting your eyes and taking regular breaks from screens
• avoiding contact lenses and eye makeup until your eyes have settled.

If a cause needs specific treatment, this depends on what's behind it. Bacterial conjunctivitis is treated with antibiotic eye drops or ointment, used several times a day for about a week, while viral conjunctivitis usually clears up on its own over a similar time.

Blepharitis often responds to warm compresses and eyelid cleaning. Acute angle-closure glaucoma is a medical emergency, treated urgently with medication or surgery to relieve the pressure inside the eye.

When should I see a doctor?

See a doctor, optometrist, or call NHS 111 today if you have eye pain along with severe pain, sensitivity to light, changes to your vision, or a very red eye. It's also worth getting checked if soreness lasts longer than a week, keeps coming back, or you're taking blood-thinning medicines such as warfarin.

Call 999 or go straight to A&E if:

• your eye symptoms started suddenly and severely
• the pain keeps you awake at night
• you wear contact lenses and have eye pain with loss of vision
• you have a red eye, severe headache, and feel sick
• you have severe pain or vision loss and had eye surgery in the last 4 weeks
• you cannot see, or something is stuck in or has pierced your eye.