What does this mean?
The area around the eye is one of the busiest nerve junctions in the face. The roots of the upper back teeth, the sinus in the upper jaw and the floor of the eye socket are all neighbours. Because of this closeness, pain arising in one area can be felt in another; where the pain is felt is not always where the problem is.
How the pain behaves tells you something about its source. Pressure on one side that increases when you bend forward, with a blocked nose and foul-smelling discharge, suggests a sinus; and that sinusitis may itself start from an upper back tooth. Pain that begins at the same hours every night, lasts a short time but is very severe, and brings redness and watering of the eye and a drooping eyelid on the same side describes a different type of headache.
There are also causes that arise from the eye itself, and things do not move on until these have been ruled out. Redness of the eye together with reduced vision, seeing haloes around lights, an eyeball that feels hard, or pain that increases when you move the eye all call for assessment by an eye specialist. A dentist examines the teeth and the floor of the sinus within their own field; if there is a finding in the eye, they refer you on.
The source of pain around the eye may be a tooth, a sinus, a nerve or the eye itself. How long the pain lasts, whether it is one-sided and what comes with it decide the distinction. The headings below are the possibilities most often taken up for pain in this area.
Likely causes
What helps at home?
- Write down what time the pain starts, how long it lasts, and whether there is redness of the eye, watering or a blocked nose; those three do most of the work of telling the causes apart.
- Bend forward and wait a few seconds; if the pressure increases markedly, pass this on to whoever examines you, as it is a simple observation that suggests a sinus origin.
- Do not press or rub your eye, and do not use eye drops bought without a prescription; in a red, painful eye some drops can make matters worse.
- If biting on one of your upper teeth brings on the pain, stop chewing on that side and do not keep testing the tooth by forcing it.
- Your vision has reduced or blurred, or you are seeing double
- The eye is red and feels hard, or you are seeing haloes around lights
- The eyelid and the area around it are swollen and red, moving the eye hurts, or you have a fever
- The eyeball looks as though it has been pushed forward
- The pain comes with numbness in the face, slurred speech or confusion
Frequently asked questions
- Can pain around the eye come from a tooth?
- It can. The roots of the upper molars and premolars sit very close to the floor of the sinus; an infection starting from these teeth can involve the sinus and turn into pressure in the cheek and under the eye. In that situation the pain is mostly on one side, with a blocked nostril on that side and foul-smelling discharge. Unless the tooth that is the source is dealt with, a lasting result is not expected from antibiotics alone.
- How do I tell sinus pain from toothache?
- With sinus pain, several upper teeth on the same side are usually tender together, the pressure increases when you bend forward and there are findings in the nose. With pain that comes from a tooth, one single tooth stands out, it is set off markedly by cold or heat, and tapping that tooth shows you where the pain sits. The definite distinction is made with an examination and X-rays.
- What does it mean if my eye waters and my nose blocks during the pain?
- If watering and redness of the eye, a drooping eyelid and a blocked nose are seen together on the same side as the pain, these are called autonomic signs and they suggest certain types of headache. They are not expected with pain that comes from a tooth, which is why they count as distinguishing signs and may mean the assessment has to be taken over to neurology.
This content is for general information and does not replace an in-person examination. Symptoms overlap between conditions, and a diagnosis can only be made clinically.