Eye pain in older adults

Overview

Eye pain in older adults means any discomfort or ache in or around the eye. It can range from a mild scratchiness to a sharp, severe pain. The pain may be a sign of a minor irritation or a more serious condition that needs quick treatment.

Yes, eye pain becomes more common as people age because the eyes undergo changes and are more prone to certain conditions like dry eyes, glaucoma, or infections.

It affects adults aged 65 and older, especially those with chronic health conditions like diabetes, high blood pressure, or a history of eye problems.

Symptoms

Common symptoms

• Aching or sharp pain in one or both eyes
• Redness or swelling around the eye
• Sensitivity to light
• Watery eyes or discharge
• Blurred or decreased vision

Symptoms in children

• Not applicable – this article focuses on older adults. For eye pain in children, consult a pediatrician.

Symptoms in older adults

• Dry, gritty feeling – often from dry eyes, which is common with age
• Pain with eye movement – may suggest inflammation inside the eye
• Deep, dull ache – could be a sign of increased pressure in the eye (glaucoma)
• Sudden, severe pain with nausea or vomiting – may indicate acute angle-closure glaucoma, an emergency

Causes

Main causes

• Dry eye syndrome – tears are not enough or evaporate too quickly, causing irritation and pain
• Blepharitis – inflammation of the eyelid edges, often with redness and crusting
• Conjunctivitis (pink eye) – infection or allergy causing redness and discharge
• Corneal abrasion – a scratch on the clear front part of the eye
• Glaucoma – increased pressure in the eye that can damage the optic nerve
• Uveitis – inflammation inside the eye, often with pain and light sensitivity
• Shingles (herpes zoster) near the eye – a reactivation of the chickenpox virus that causes a painful rash and eye inflammation

Risk factors

• Age over 65
• Diabetes
• High blood pressure
• Previous eye surgery or injury
• Use of certain medications that dry the eyes (like antihistamines or diuretics)
• Smoking
• Family history of glaucoma or other eye diseases

When to see a doctor

See a doctor urgently if:

• Sudden, severe eye pain – go to the emergency room or call your local emergency number
• Eye pain with vision loss, double vision, or seeing halos around lights
• Pain after an eye injury or chemical splash
• Eye pain with symptoms of shingles (rash, blisters on one side of face)
• Eye pain that is constant and getting worse

Book a routine appointment if:

• Mild eye pain that comes and goes, especially with reading or computer use
• Pain with dry eyes that gets better with artificial tears
• Redness without severe pain that lasts a few days

Diagnosis

Your doctor will ask about your symptoms, medical history, and do a thorough eye exam. They will check your vision, the pressure in your eyes, and look at the front and back parts of your eyes using special instruments.

Tests that may be done

• Visual acuity test – reading letters on a chart to check how sharp your vision is
• Slit-lamp exam – a microscope with a bright light to examine the eye structures
• Tonometry – a puff of air or a gentle probe to measure eye pressure
• Fluorescein stain – a yellow dye to see scratches on the cornea
• Dilated eye exam – special drops to widen the pupil and inspect the retina and optic nerve

What to expect at your appointment

The exam is usually painless. Some tests, like the air puff test for pressure, may be briefly uncomfortable. Drops may cause blurry vision for a few hours, so it helps to have someone drive you home. The doctor will explain the results and discuss next steps.

Treatment

Treatment depends on the cause. Many conditions can be managed with simple measures, while others require medicine or surgery. The goal is to relieve pain, treat the underlying problem, and protect your vision.

Self-care at home

• For dry eyes: use artificial tears (preservative-free drops) as needed, and take breaks during reading or screen time
• Apply a warm compress over closed eyes for a few minutes to soothe irritation and help unclog oil glands
• Avoid rubbing your eyes – this can make irritation worse or cause infection
• Keep the eyelids clean with a gentle wash if you have blepharitis
• Wear sunglasses outdoors to reduce light sensitivity

Medical treatments

Your doctor may prescribe antibiotic or antiviral eye drops for infections, steroid eye drops for inflammation, or medications to lower eye pressure for glaucoma. They may also recommend oral medicines if an infection or shingles is present. Always follow your doctor's instructions about how to use eye drops and for how long.

When is surgery considered?

Surgery may be needed for some types of glaucoma if drops are not enough, for a cataract that causes pain, or to repair a damaged cornea. Your eye specialist will discuss the options if surgery is recommended.

Living with this condition

Living with eye pain can be frustrating, but most causes are treatable. Follow your treatment plan, keep your follow-up appointments, and tell your doctor if symptoms change. Protect your eyes from injury by wearing safety glasses during activities like gardening or home repairs.

Lifestyle tips

• Use good lighting when reading or doing close work to reduce eye strain
• Take frequent breaks from screens (use the 20-20-20 rule: every 20 minutes look at something 20 feet away for 20 seconds)
• Keep the air in your home moist with a humidifier if you have dry eyes
• Avoid smoke and dust, which can irritate the eyes

Diet and exercise

A balanced diet rich in fruits and vegetables, especially leafy greens and foods high in omega-3 fatty acids (like fish), supports eye health. Regular exercise improves blood flow to the eyes, but protect your eyes if you do contact sports. Stay hydrated to help maintain tear production.

Mental health and emotional wellbeing

Chronic eye pain can cause stress, anxiety, or frustration, especially if vision is affected. It is normal to feel worried. Talk to your doctor or a counselor if you feel overwhelmed. You are not alone.

Prevention

Not all causes of eye pain can be prevented, but you can reduce your risk by: having regular eye exams (every 1-2 years if over 65), managing chronic conditions like diabetes and high blood pressure, wearing protective eyewear, and avoiding smoking.

Vaccines

The shingles vaccine is recommended for adults aged 50 and older to prevent shingles, which can cause severe eye pain and vision loss. Ask your doctor or pharmacist if this vaccine is right for you.

Screening programmes

Regular eye exams can detect conditions like glaucoma and dry eye disease early, when they are easier to treat. Screening is especially important if you have diabetes or a family history of eye disease.

Complications

If left untreated

• Untreated glaucoma can lead to permanent vision loss
• Corneal infections (ulcers) can scar the cornea and reduce vision
• Uveitis can cause cataracts, glaucoma, or retinal damage
• Shingles affecting the eye can cause chronic pain, vision loss, or scarring

Long-term outlook

The outlook for eye pain in older adults is generally good when you get prompt care. Many causes are treatable, and vision can often be saved or pain controlled. Even if some vision loss occurs, low vision aids and support services can help you live well. Do not delay seeking help – treatment works best when started early.

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