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9th November, 202110 min read

Why do I wake up with a headache behind my eyes?

Medical reviewer:Dr Adiele Hoffman
Author:Wendy Davies
Last reviewed: 09/11/2021
Medically reviewed

All of Healthily's articles undergo medical safety checks to verify that the information is medically safe. View more details in our safety page, or read our editorial policy.

What is a headache behind the eyes?

There are several different types of headache, and some can cause you to wake up with pain behind the eyes. There are lots of reasons why headaches can happen, although a cause can’t always be found.

Headache pain behind the eyes can vary, depending on the type of headache. It can be severe or mild, sharp or dull, or a feeling of pressure. Some headaches are one-sided, so you may feel pain behind your left eye or right eye only.

Sometimes, waking up with a headache can be a sign of a more serious problem or condition. So it’s important to see a doctor if it happens often, or if it's very painful.

Read on to learn why you might be waking up with a headache behind your eyes, when you should get medical help, and what treatment options are available.

What causes headaches behind the eyes?

There are many reasons why you might get a headache and pain behind the eyes. In some cases you might wake up with a headache, while in others you’re more likely to get a headache behind the eyes over the course of a day.

Here are some of the common causes of a headache behind the eyes.

Tension headache

Most people will get a tension-type headache at some point – it’s the most common type of headache. It’s what’s known as primary headache, which means it’s not caused by another condition.

Common symptoms include:

  • pressure behind your eyes
  • an ache on both sides of your head
  • tightness in your neck muscles

A tension headache isn’t usually severe. It can go away in as little as 30 minutes, but it may also last for several hours, or even a few days.

Some people get tension headaches regularly. If you have one more than 15 times in a month, for at least 3 months, you have what’s known as chronic tension-type headaches.

Read more about the causes of and treatments for tension-type headaches.

Sinusitis

Sinusitis is a swelling of your sinuses, which are small air spaces behind your nose, eyes and cheeks. It’s usually caused by an infection, and is common after having a cold or the flu.

It commonly causes a headache with pain and tenderness around your eyes, forehead and cheekbones, as well as a blocked nose. You may also have green or yellow mucus from your nose.

Cluster headache

Cluster headaches are extremely severe attacks of pain that happen on one side of your head. Like tension headaches, they’re not caused by another condition. The pain is often sharp and felt around the left eye, right eye or temple, or sometimes face.

Other symptoms can include:

  • a red and watery eye
  • a swollen and drooping eyelid
  • a pupil that is smaller than the other
  • a runny or blocked nostril
  • a sweaty face

Cluster headaches often start suddenly and last between 15 minutes and 3 hours, and happen between 1 and 8 times a day. This pattern can go on for days, weeks or months. The headaches often stop for months or years at a time, before coming back again.

It’s not clear what causes cluster headaches. Some people who get them have other family members with cluster headaches. And an attack can sometimes be triggered by certain things, such as drinking alcohol, or strong smells like paint, petrol or perfume.

Smoking may also increase your risk of getting cluster headaches. Read more about the health risks of smoking and smoking treatments to help you quit.

Migraine

A migraine is a moderate-to-severe headache, usually on one side of your head, which feels like a throbbing pain. It can cause pain behind the eyes and eye pain.

Other common symptoms include feeling or being sick (vomiting), and feeling very sensitive to light and sound.

You can also get what’s known as an aura. This is when you get warning signs that a migraine is about to start, such as seeing flashing lights.

Migraines are primary headaches, and it’s not known exactly what causes them. But it’s thought they can be triggered by various things, including:

  • emotional triggers – such as stress, anxiety or tension
  • physical triggers – such as bad posture, tiredness or bad sleep
  • environmental triggers – such as bright lights and flickering screens
  • certain foods, caffeine or alcohol
  • not drinking enough fluids (dehydration)
  • hormonal changes – migraines can be worse around your period
  • medicines – such as the combined pill and some sleeping tablets

If you get migraines regularly, you might find it useful to keep a diary of your symptoms, to see if you can work out your possible triggers.

Overuse of painkillers

Taking painkillers over a long period, such as 10 days or more, can actually cause a headache. Your body gets used to the medicine, so a headache can develop if you suddenly stop taking them.

It’s important not to stop taking any medicines unless you’re advised to, however. So see a doctor if you think your headaches are caused by medication overuse.

Read more about painkiller headaches.

Eye strain

Straining your eyes or squinting can also cause a headache behind the eyes – although not one you’re likely to wake up with. You may notice eye strain after concentrating on something, such as a computer, for a long time.
If you find you’re straining your eyes, stop what you’re doing before it causes a headache. If a headache is coming on because of a certain activity, stop and rest your eyes.

A condition called astigmatism is a common cause of eye strain and headaches. It’s when your eye is shaped more like a rugby ball than a football, meaning that light is focused at more than 1 place in your eye. It can also cause blurred vision.

Astigmatism is usually diagnosed in a routine eye test, so it’s important to have regular checks with an optician. You may need glasses or contact lenses, or choose to have laser eye surgery or lens surgery.

Read more about looking after your eyes.

Eye strain headache

Less common causes of a headache behind the eyes

  • dehydration – when you don't have enough fluids in your body. This is a common cause of headaches when you have a hangover
  • sex – this can sometimes cause a headache that builds with sexual excitement and becomes intense at orgasm. However, if it’s very sudden and severe, see a doctor urgently, as headaches triggered by physical exertion can be a sign of a more serious condition such as a brain bleed or aneurysm (see below)
  • a head injury – most head injuries aren’t serious, but it’s important to get urgent medical help if they are. Learn how to tell if you have a serious head injury
  • more serious brain problems, such as a stroke, bleeding or an aneurysm, giant cell arteritis or a tumour

When to see a doctor for a headache behind the eyes

Most people get headaches from time to time – they usually aren't anything serious, and often go away on their own. However, there are times when you should seek help.

Call an ambulance or go to the emergency department if:

  • you have a head injury from a fall or accident
  • your headache comes on very suddenly and is extremely painful
  • you have a fit or blackout (lose consciousness)

You should also call an ambulance or go to the emergency department if you have a very painful headache and:

  • feel confused or drowsy
  • suddenly have problems speaking or remembering things
  • a very high temperature (fever)
  • a stiff neck
  • a rash
  • you feel hot and shivery
  • the white part of your eye is red
  • you can't see properly or lose vision in part or all of your eye
  • feel dizzy (vertigo)
  • keep being sick (vomiting)
  • have trouble moving your arms or legs or part of your face (weakness)
  • you’re pregnant or have recently given birth

See a doctor as soon as possible if you have a bad headache and:

  • blurred or double vision
  • vomiting
  • a sore scalp
  • a red or swollen face
  • your jaw hurts when you eat
  • it gets worse when you lie down or stand up
  • it’s triggered by coughing, sneezing, bending or exercise
  • you’re over 50 years old
  • your personality has changed
  • people you live with have similar symptoms (possible carbon monoxide poisoning)

Book an appointment with a doctor if you have a headache and:

  • it keeps coming back or gets worse
  • it doesn’t get better with painkillers
  • it’s a painful throbbing feeling at the front or side of your head
  • you feel sick or vomit and find noise or light painful
  • you have a weakened immune system
  • you’ve had cancer in the past

Your doctor will ask questions about what your headaches are like, your diet and lifestyle, and whether anyone else in your family gets headaches. This will help them to work out what type of headache you have.

Treatments for a headache behind the eyes

Treatment options vary, depending on the type of headache you have.

Tension headaches can usually be treated with simple painkillers such as paracetamol or ibuprofen, which should ease the pain fairly quickly. Speak to a pharmacist about how to take these medicines safely.

It’s important not to take painkillers for more than a few days at a time, as this can cause headaches from overuse, as mentioned above.

Tension headaches can also be managed by drinking plenty of water (if dehydration or a hangover caused your headache) and rest (if tiredness caused your headache).

Sinusitis can often be treated with painkillers and the methods mentioned above, too. The infection usually clears up on its own, but sometimes you may need medication from a doctor. Learn more about treating sinusitis.

Cluster headaches can’t be treated with simple painkillers, because they don’t work fast enough to deal with the pain. A specialist clinic can prescribe treatments both to relieve the pain and help stop them from happening again. This may include injections, nasal sprays and tablets. Read more about cluster headaches treatment.

If you get migraines, simple painkillers can often help, especially if taken at the first signs of a migraine. If you’re struggling to manage your symptoms, a doctor may prescribe a stronger painkiller or other medication. Read more about treatment for migraines.

Stress and anxiety can be triggers for both tension headaches and migraines, so relaxation techniques may also help. Having a massage can help you feel more relaxed, as can yoga and other relaxing forms of exercise. You could also try applying a warm flannel to the back of your neck, or a cool flannel on your forehead.

If you think eye strain is causing your headaches, it’s a good idea to see an optician for an eye check.

If you think your headache could be due to an underlying condition, see your doctor as soon as possible, so your symptoms can be investigated.

Your health questions answered

  • What if I have a constant headache behind my eyes?

    If you have a headache behind your eyes that doesn’t go away, see your doctor. You should also see your doctor if your headache keeps coming back, painkillers aren’t helping, or if you get other symptoms with your headache.

Key takeaways

  • there are several reasons why you might wake up with a headache behind the eyes, and most headaches aren’t serious
  • common causes of headaches behind the eyes include tension headaches, sinusitis, migraines, cluster headaches and eye strain
  • depending on the cause, treatment options include simple painkillers, lifestyle changes and prescription medicines
  • taking painkillers for a long period of time can actually cause headaches
  • see a doctor if your headache doesn’t get better with painkillers, gets worse or keeps coming back
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