Pain in, around, or behind one eye is a very common migraine symptom. Some people may have pain in or around both eyes. Eye pain during migraine is generally caused when something triggers a migraine episode.

During this episode, the trigeminal system is affected. This system includes the trigeminal nerve, which runs around and behind your eyes and carries sensory information about pain, touch, and temperature of your face and head to your brain.

During a migraine attack, specific things may trigger the trigeminal system. When this happens, these nerve endings send pain signals through your trigeminal nerve and may cause pain in, around, or behind your eye. This process is known as central sensitization and may be the cause of your migraine eye pain.

There are other types of headaches that may cause pain in and around your eye or eyes. These include:

  • Retinal migraine: Once called ocular migraine, this type affects your vision and includes an aura. People may feel like these generally painless episodes begin in the eye, but they actually start in the brain. They usually affect one eye and last between 5 and 60 minutes. A headache often follows within 60 minutes. Other symptoms may include:
    • scintillations (seeing twinkling lights)
    • scotoma (areas of decreased or lost vision)
    • temporary blindness
    • blurry vision
    • spots
    • zig-zag lines
  • Cluster headaches: These headaches are characterized by intense pain at and around the eye. Like migraine, cluster headaches may be caused by many things, such as alcohol, medications, light, and foods. There are other symptoms that distinguish these headaches from migraine episodes, such as:
    • restlessness
    • agitation
    • eye redness
    • tearing
    • eyelid swelling
    • droopiness

There are several options for treating migraine pain. Here are the basic options:

  • Pain relief medications: Over-the-counter (OTC) pain relievers, triptans, and gepants may all treat migraine pain.
  • Migraine pain prevention: Examples of treatments that may help prevent migraine episodes include:
    • Traditional medications: antiepileptics, beta-blockers, and antidepressants
    • CGRP monoclonal antibodies: eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), and galcanezumab (Emgality)
    • Onabotulinumtoxin A: Botox
    • Neuromodulation devices: These devices use magnets or electric current to affect nerves involved in migraine pain, including Cefaly (Cefaly Technology), gammaCore (electroCore), Nerivio (Theranica), and SpringTMS (eNeura)
  • Lifestyle changes: These may help you avoid your migraine triggers, such as avoiding certain foods or beverages, consistently getting enough sleep, addressing sleep apnea if necessary, reducing stress, and more.
  • Others: Things like wearing FL-41 lenses that block certain wavelengths of light to help with light sensitivity.

Migraine eye pain can significantly impact your life and health. There are many things you can do to feel better. If you’re having migraine eye pain, speak with your doctor and consult a neurologist. Once they identify the cause of your migraine eye pain, you and your doctor can find the best treatment options for you.