Why Do My Eyes Feel Pressure? Common Causes and When to Worry

Most of the time, a feeling of pressure in or behind your eyes comes from something outside the eye itself, like sinus congestion, eye strain, dry eye or a headache. It is usually not glaucoma, because the most common type of glaucoma causes no pain or pressure feeling at all.

"My eyes feel like they're being pushed on" is something I hear a lot in the exam chair. The good news is that it's usually very fixable once we figure out where it's coming from.

Is the pressure I feel the same as "eye pressure"?

Not really, and this mix-up worries a lot of people.

When an eye doctor talks about eye pressure, we mean intraocular pressure. That's the fluid pressure inside your eyeball. It's measured in millimeters of mercury, and it's a number we check at your exam. High intraocular pressure is a major risk factor for glaucoma.

Here's the surprising part. You almost never feel high intraocular pressure. So a pushing or aching feeling is a clue that something else is going on. And a normal-feeling eye does not mean your number is normal. Only a test can tell.

What are the most common causes of a pressure feeling around the eyes?

Sinus congestion

Your sinuses sit right above, below and between your eyes. When they swell from allergies, a cold or a sinus infection, that pressure spreads into the area around your eyes. It often gets worse when you bend over. In Georgia and East Tennessee, spring and fall pollen seasons bring a wave of these visits.

Eye strain from screens and close work

Your focusing muscles work hard when you read, scroll or work on a computer for hours. When they get tired, you may feel a dull ache, heaviness or tightness around the eyes and brow. Blurry vision at the end of the day and trouble refocusing at distance are common too.

Dry eye

Dry eye doesn't always feel "dry." Many people describe it as burning, grittiness, tired eyes, or a heavy, pressured feeling. It's often worse later in the day or after screen time. You can read more in our post on why your eye drops stopped working.

Tension headaches and migraines

Tension headaches often feel like a tight band around the forehead and behind the eyes. Migraines can cause pain behind one eye, light sensitivity, and sometimes zigzag lines in your vision before the headache starts.

An outdated or uncorrected prescription

If your glasses are old, or you need glasses and don't know it, your eyes work overtime all day. This is one of the easiest causes to fix.

Less common causes

A few eye conditions can cause pain or a pressure feeling. These include swelling inside the eye (uveitis or iritis) and swelling of the optic nerve (optic neuritis), which often hurts when you move your eye. Thyroid eye disease can also make the eyes feel full or bulging. These need an eye exam to sort out.

Can glaucoma cause eye pressure or pain?

The common type, open-angle glaucoma, almost never does. It slowly damages the optic nerve with no warning. That's why we call it a silent disease, and why regular eye exams matter so much. Learn more in our article on glaucoma causes, symptoms and treatment.

There is one important exception: acute angle-closure glaucoma. In this condition, the eye's drainage area suddenly gets blocked and the pressure inside the eye rises fast. It's painful and it's an emergency. Signs can include:

• Sudden, severe eye pain, often in one eye
• A red eye
• Blurred vision
• Seeing rainbow-colored halos around lights
• Headache, nausea or vomiting

If that sounds like you, don't wait. Call us right away or go to the emergency room.

How do we measure the pressure inside your eye?

Checking intraocular pressure is a normal part of a comprehensive eye exam. It's quick and doesn't hurt. It may be done with a gentle puff of air, or with numbing drops and a small instrument that lightly touches the front of the eye for a moment.

But one number alone doesn't tell the whole story. That's why we also look directly at the optic nerve and take retinal photos. With an in-office telehealth visit, we also do two OCT scans, one of the optic nerve and one of the macula. OCT uses light, not sound waves, to measure the layers of the optic nerve and retina in fine detail. If anything looks suspicious, we may check your side vision with a visual field test.

What can I do at home for that pressure feeling?

These steps help with the most common causes. They are not a substitute for an exam if the feeling keeps coming back.

• Rest your focusing muscles. Every 20 minutes, look at something about 20 feet away for 20 seconds.
• Blink on purpose. We blink less when we stare at screens, which dries the eyes.
• Try a warm compress. A warm washcloth over closed eyes for several minutes can soothe tired, dry eyes.
• Treat your sinuses. Saline rinses and allergy care often help. Ask your doctor or pharmacist what's right for you.
• Check your setup. Keep your screen a little below eye level and about an arm's length away.

When should you see an eye doctor?

Make a regular appointment if the pressure feeling keeps coming back, if your glasses seem off, or if it's been more than a year since your last eye exam.

Call us right away or go to the emergency room if you have:

• Sudden vision loss or blurry vision in one or both eyes
• A curtain or shadow moving across your vision
• New flashes of light or a sudden shower of floaters
• Severe eye pain with nausea, vomiting or halos around lights
• A chemical splash or injury to the eye
• Pain when you move your eye along with vision changes

How we do it at Bolt Eye Group

When you come in with a pressure complaint, we start by listening. When does it happen? One eye or both? Then we do a full eye-health check.

Our comprehensive eye exams include a careful look at the optic nerve. Every patient also gets retinal photos and a corneal map for $39. With an in-office telehealth visit, that same $39 also covers two OCT scans, one of the optic nerve and one of the macula. If dry eye is part of the picture, we offer dry eye care right in the office. And if your eye is red, painful or injured, we offer same-day visits.

We accept VSP, EyeMed, Davis Vision, Spectera, Medicare and major medical plans, including Blue Cross Blue Shield, Aetna, UnitedHealthcare, Cigna and Humana. HSA/FSA and CareCredit are welcome too.

Frequently asked questions

Can high eye pressure cause a headache?

Usually not. The common form of high eye pressure and glaucoma causes no pain. The exception is acute angle-closure glaucoma, which can cause a severe headache with eye pain, redness, halos and nausea, and needs care right away.

How do I know if eye pressure is from my sinuses?

Sinus pressure often comes with congestion, facial tenderness, and pain that worsens when you bend forward. It usually affects the area around both eyes rather than one eye. If it doesn't improve as your sinuses clear, have your eyes checked.

Can dry eyes feel like pressure?

Yes. Many people with dry eye describe tired, heavy, or pressured eyes rather than dryness. An eye exam can tell whether dry eye is the cause and what kind you have.

Can I tell if my eye pressure is high without a test?

No. High intraocular pressure usually has no symptoms. The only way to know your number is to have it measured during an eye exam.

Should I worry about pressure behind one eye?

Pressure behind one eye is often from a migraine, cluster headache or sinus problem. But if it comes with vision changes, severe pain, redness or pain when you move the eye, call us or go to the emergency room.

Book an exam at your nearest Bolt Eye Group office

If your eyes feel pressured, achy or tired, let's find out why. Book an exam at your nearest Bolt Eye Group office in Canton, East Cobb/Marietta, Lawrenceville, Riverdale or Johnson City, TN. See all locations and directions.