Why does my eyelid hurt?
Eyelid pain can affect your comfort and daily life. It can be caused by various factors, ranging from styes and eyelid inflammation to eye injury and other conditions. Understanding the potential causes of a sore eyelid can help you determine when to seek medical care.
Common causes of eyelid pain and soreness
Many conditions can affect the skin around your eyes and cause your eyelid to hurt. This discomfort may also be accompanied by redness, inflammation and other symptoms. Some of the most common causes of pain in the eyelid include:
Stye
A stye (hordeolum) is a small, red, painful bump that develops on the edge of the upper or lower eyelid. As a type of eyelid abscess, it is typically caused by a bacterial infection in the eyelid’s sebaceous glands. Styes are categorized based on where they appear on the eyelid margin:
- External styes – Form at the base of an eyelash
- Internal styes – Develop within the oil glands in the eyelids
Styes are diagnosed through an eye exam. While they can make your lower or upper eyelid sore and tender to the touch, styes are usually harmless. They often resolve on their own within seven to 10 days. However, they may require treatment in some cases.
When treatment for a stye is needed, it typically involves:
- Warm compresses on the eyelid – To help drain the stye and relieve eyelid pain
- Antibiotic eye ointment – To treat infection
- Good eyelid hygiene – To reduce bacterial growth
Oral antibiotics or surgery may be recommended for persistent or severe cases.
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Chalazion
A chalazion is a type of eyelid cyst (or lesion) that develops due to a blocked oil gland. While the condition most commonly occurs in the upper eyelid, it can also affect the lower eyelid. Chalazia (plural for chalazion) often look like styes and can even develop because of them.
Chalazia may cause your eyelid to hurt at first, but this usually subsides rather quickly. Then as a chalazion gets larger, it can make your eyelid sore or tender.
Chalazia are diagnosed through an eye exam. They are usually benign and clear up within about a month. Most chalazia can be managed at home through:
- Warm compresses on the eyelid – To soften the plugged material in the gland and promote drainage of the lesion
- Eyelid massage – To help increase oil flow in the glands
- Good eyelid hygiene – To reduce the risk of bacterial buildup
Chalazia may take a while to get better. If, after a month, the remedies listed above haven’t helped, additional treatment may be required. This may include oral antibiotics, steroid injections or surgical removal.
As a rule, hordeola (styes) tend to hurt more than chalazia. Styes should also be treated more aggressively to prevent the onset of preseptal cellulitis (covered later in the article).
Meibomian gland dysfunction (MGD)
Meibomian gland dysfunction is a condition that affects oil glands in the eyelid called meibomian glands. These glands can become clogged and lead to swollen and sore eyelids, eye dryness, and other symptoms. In some cases, MGD can contribute to the development of styes and chalazia.
MGD treatment may involve one or more of the following options:
- Warm compresses on the eyelid – To help loosen clogged oil and promote drainage
- Eyelid massage – To encourage better oil flow from the glands
- Good eyelid hygiene – To reduce the risk of bacterial buildup
- Antibiotic eye drops, ointments or oral medication – To treat inflammation and reduce the risk of infection
- Topical steroid drops or ointments – To reduce inflammation
- Omega-3 fatty acid supplements – To support oil production
More advanced cases of MGD may require clinical procedures, such as:
- Intraductal probing – This procedure involves techniques to physically open blocked glands.
- Electronic heating devices – These use heat to help melt clogged oil in the glands.
- Laser therapies – Laser energy is used to reduce redness and destroy bacteria on the eyelids.
Blepharitis
Blepharitis is a condition characterized by eyelid inflammation. It causes the tissue to become red and swollen, often leading to eyelid soreness and other discomfort. Dandruff-like flakes may form on the eyelids and eyelashes.
Blepharitis can be caused by a variety of factors. However, it commonly results from the overgrowth of microorganisms in the eyelid's oil glands. The condition can also contribute to the development of styes, chalazia and other eye-related problems.
Eye doctors typically diagnose blepharitis through an eye exam. A variety of treatments may be used to manage the condition and relieve pain in the eyelids, including:
- Regular eyelid hygiene – To remove debris and help control bacterial growth
- Artificial tears – To help keep the eyes lubricated
- Ophthalmic steroid drops – To reduce eyelid inflammation
- Antibiotic eye drops, topical ointments or oral medication – To treat or reduce the risk of infection
Clinical procedures may be needed for some cases of eyelid inflammation. These focus on removing buildup and debris from the oil glands and improving oil flow, and can include:
- Thermal pulsation therapy (such as LipiFlow) – This technique uses gentle heat and pressure to open blocked glands.
- Thermal therapy (such as MiBoFlo) – This option applies heat to the outside of the eyelid to improve oil flow.
- BlephEx – This device contains a special burr to clear debris from the gland openings.
- Meibomian gland probe – This small tool helps open clogged glands with an electrical current.
- Intense pulsed light (IPL) therapy – This treatment uses broad-spectrum light to heat and melt clogged oil and destroy microorganisms to reduce eyelid inflammation and help open plugged glands.
SEE RELATED: What causes eyelid swelling?
Conjunctivitis (pink eye)
Conjunctivitis (commonly known as pink eye) occurs when the conjunctiva — the clear tissue lining the white of your eye and inner eyelids — becomes inflamed. It can be caused by bacteria, viruses, allergens or other factors. Pink eye often leads to swelling in and around the eye and can make the eyelid sore.
Conjunctivitis is diagnosed through an eye exam. Treatment depends on the cause but can include one or more of the following:
- Antibiotic eye drops or ointments (for bacterial conjunctivitis) – To treat bacterial infections
- Allergy eye drops (for allergic conjunctivitis) – To reduce swelling, itching and other symptoms of an allergic reaction
- Topical steroid drops or ointments – To treat inflammation
- Artificial tears – To help lubricate the eye and increase comfort
Most cases of pink eye resolve within seven to 14 days.
READ MORE: Types of pink eye
Eye allergies
Eye allergies, also called allergic conjunctivitis, can cause red, swollen eyelids and other ocular symptoms. While they can be associated with eye pain, eye allergies more commonly lead to itching, burning and watering.
Ocular allergies develop when an allergen (such as pollen or dust) triggers an allergic reaction, causing the conjunctiva and the eyelids to become inflamed.
Diagnosing eye allergies typically involves an exam to rule out other eye conditions. The first line of defense in treating these allergies is to avoid potential allergens. But if that’s not possible, one or more of the following treatments may be recommended:
- Artificial tears – To flush allergens from the eyes and help relieve dryness
- Decongestant or antihistamine drops – To reduce itching, redness and other eye allergy symptoms
- Oral antihistamines – To provide relief from allergy symptoms
- Topical steroid drops – To reduce eye allergy symptoms in persistent or severe cases
- Allergy shots – To help desensitize the immune system to allergens
Eye allergies can occur seasonally or persist throughout the year.
Contact dermatitis
Contact dermatitis develops when something causes irritation or an allergic reaction in the skin. It can develop anywhere on the body, including the skin around the eyes. Eyelid dermatitis often causes the skin on the eyelids to burn, sting or itch. It can result from irritants or other triggers, including:
- Scratching or rubbing at the area
- Cosmetics or other personal care items (like facial cleanser or shampoo)
- Household products (like laundry detergent or soap)
- Dust or pollen
- Chemicals
- Certain metals (like those found in some jewelry and beauty tools)
- Extreme temperatures or other environmental factors
Doctors typically diagnose eyelid dermatitis by examining the eyelids. Treatment may involve two categories of anti-inflammatory, immunosuppressant medications:
- Steroids (topical or oral)
- Calcineurin inhibitors
These medications should reduce eyelid inflammation and irritation and help control the immune system’s response to irritants.
Eyelid dermatitis symptoms usually improve within one to three days after treatment starts. However, flaking of the skin may occur once the condition begins to resolve.
Eye injury
Injuries to the eye and surrounding tissues and structures can result from any physical impact or chemical exposure. They can cause eyelid pain, swelling and other symptoms.
Eye injuries should be evaluated promptly by a medical professional. They will examine the eye and may order imaging tests to assess the extent of the injury.
Treatment for eye and eyelid trauma varies depending on the type and severity of the injury, in addition to other factors. However, it may involve:
- Eye irrigation with water (for chemical exposure) – To flush harmful substances from the eye
- Cold compresses applied to the eyelid – To reduce swelling
- Prescription eye drops – To treat infection or inflammation
- Pain medication – To relieve eye and eyelid pain
- Eye patching – To protect the eye as it heals
More serious eye injuries may require other procedures or surgical care.
The appearance of an eye injury — including those that seem minor — may not always indicate the extent of damage that has occurred. It’s important to seek immediate medical care for any injury to the eye.
LEARN MORE: How to prevent eye injuries
Dry eyes
Dry eye disease occurs when your eyes fail to make enough tears or when the quality of your tears is insufficient. Eyelid conditions such as blepharitis and meibomian gland dysfunction, along with other factors, can cause dry eyes. As a result, dry eye syndrome can contribute to eyelid pain, redness and inflammation.
Eye doctors diagnose dry eye disease through an eye exam. They may perform various tests to evaluate tear production, tear quality and how quickly tears dry up. Dry eye treatment options typically include:
- Warm compresses on the eyelids – To promote oil flow in the glands
- Eyelid massage – To improve oil gland function and tear production
- Eyelid cleansers – To remove debris and promote good eyelid hygiene
- Artificial tears – To help keep the eyes lubricated
- Prescription eye drops or ointments – To treat inflammation, infection or other related issues
In some cases, special plugs (called punctal plugs) may be placed temporarily in the tear ducts to preserve tears. Surgery to block the tear ducts permanently may also be recommended.
Foreign body in the eye
A foreign object — such as an eyelash, sand or other debris — can become trapped beneath your eyelid or on the cornea (the clear front layer of the eye). As you blink, the object can scratch the cornea or cause irritation, leading to eye and eyelid pain and other symptoms.
Foreign bodies in the eye are evaluated through an eye exam. A yellow dye called fluorescein may be used to identify areas of corneal damage. Depending on the situation, your doctor may use one of the following techniques to remove a foreign body:
- Eye irrigation with saline solution – To flush small particles from the eye
- Manual removal – Using special tools to safely remove debris lodged in the eye
Other procedures may be necessary if a particle is hard to reach, embedded in the eye’s surface or penetrating into the eye.
Cellulitis
Cellulitis is a serious infection involving the skin and underlying tissue. Often caused by bacteria, it can affect the tissue around the eye (preseptal or periorbital cellulitis) or the eye socket (orbital cellulitis). Preseptal cellulitis can also result if the infection from an internal hordeolum (stye) spreads.
Cellulitis typically causes redness and swelling, which can lead to discomfort and pain in the eyelid (upper or lower).
An eye exam is the first step in diagnosing cellulitis involving the eye. Your eye doctor may also perform blood tests, imaging scans and other procedures to confirm a diagnosis.
Cellulitis treatment may include:
- Oral or intravenous (IV) antibiotics – To treat infection
- Surgery – To treat more severe cases, such as those involving extensive tissue damage or abscesses
Treatment options vary according to the type of cellulitis, its severity and other factors. Orbital cellulitis is the more serious form and may require more aggressive treatment. It carries the risk of dire complications, including vision loss.
Tear duct blockage or infection (dacryocystitis)
A blocked tear duct (also called a nasolacrimal duct obstruction) can lead to dacryocystitis, which is inflammation or infection of the lacrimal (tear) sac. This blockage can be caused by other types of infections, injury, narrow tear ducts or additional factors that prevent proper tear drainage. A blocked tear duct can lead to symptoms such as lower eyelid pain, redness and swelling toward the eye’s inner corner.
Diagnosing a blocked tear duct begins with an eye exam. Eye doctors may also use fluorescein dye or other testing methods to determine if a blockage exists. Treatments may vary depending on the severity of the condition, but they may involve:
- Warm compresses and tear duct massage – To help clear a blocked tear duct
- Prescription eye drops or ointments – To treat inflammation, infection or other issues
- Oral antibiotics – To treat infection
For more severe cases, surgery or other procedures may be needed to open the duct and remove the blockage.
Eye herpes
Eye infections due to the herpes simplex virus (also called eye herpes) can affect various eye structures. When the condition impacts the eyelids, it can cause painful blisters, eyelid soreness and other symptoms.
Eye herpes is typically diagnosed through an eye exam. Treatment may include:
- Oral antiviral medications – To help suppress the virus
- Antiviral eye drops or ointments – To help manage eye-related symptoms
- Antibiotic drops or ointments – To reduce the risk of bacterial infection
- Steroid drops – To reduce inflammation
Eye shingles
Shingles, or herpes zoster, is a skin rash caused by the varicella virus (which also causes chicken pox). It can affect various parts of the body, including the eyes and eyelids. When it affects the eye, it is referred to as herpes zoster ophthalmicus or ocular (eye) shingles.
Eyelid-related symptoms often include painful blisters, a burning sensation and skin sensitivity.
Diagnosing eye shingles usually involves an eye exam. Tests involving tonometry (eye pressure measurement) and fluorescein dye may be used to assess possible secondary effects of the condition.
Pain medication and cold compresses can help manage pain in the eyelid and other symptoms. Medical treatments may involve:
- Oral antiviral medications – To help suppress the virus
- Antibiotic eye drops or ointments – To reduce the risk of bacterial infection
- Oral steroids and steroid drops – To reduce inflammation
Other types of eye drops may be used alongside steroid drops to reduce high eye pressure caused by ocular shingles. Additional procedures may also be performed to evaluate and treat any secondary effects caused by the condition.
Ectropion
Ectropion is a condition in which the eyelid turns outward, away from the eyeball. It can have various causes but most commonly results from the weakening of the eyelid tissues, often due to aging. Ectropion typically affects the lower eyelid.
The condition can cause symptoms such as eye and eyelid pain, irritation, and redness. It can also cause conjunctival dryness, increasing the risk of eye dryness, conjunctivitis and other complications.
Doctors diagnose ectropion through an eye exam. Treatment is based on the underlying cause and may include:
- Artificial tears, ointments or gels – To lubricate the eye and relieve dryness
- Surgery – To reposition the eyelid or reconstruct the eyelid tissue and improve its function
Entropion
Entropion occurs when the eyelid turns inward, toward the eyeball. It commonly results from the loosening of the eyelid tissues, often due to age, but can be caused by other factors. While entropion can affect both the upper and lower eyelids, it is more common in the lower eyelid.
Entropion can cause the eyelashes to grow toward the eye (trichiasis) and rub against the eye’s surface. This can lead to eye pain, redness and irritation. Left untreated, entropion can increase the risk of corneal damage and other complications.
Doctors diagnose entropion through an eye exam. Treatment depends on the cause and severity of the condition but may include:
- Artificial tears – To lubricate the eye and help prevent irritation
- Contact lenses – To help protect the eye’s surface from irritation and damage
- Botox injections – To temporarily relax the eyelid muscles and reduce the inward turning
- Surgery – To correct the position of the eyelid and improve its function
Floppy eyelid syndrome
Floppy eyelid syndrome is characterized by loose, sagging eyelids. It results from the loss of elasticity in the eyelids, causing them to be stretchy, droopy and easily everted (turned inside out). While the exact cause is unknown, research indicates that the following factors may play a role:
- Age
- Obesity
- Eye rubbing
- Connective tissue disorders
- Obstructive sleep apnea (OSA)
The condition can affect the upper and lower eyelid but is more common in the upper eyelid. Symptoms can include eyelid soreness, eye pain and other uncomfortable issues. It can also increase the risk of dry eye disease and corneal conditions.
Diagnosing floppy eyelid syndrome begins with an eye exam. Measurements may be taken to determine the degree of eyelid laxity, the range of movement and the severity. A sleep study may also be recommended to see if OSA is a contributing factor.
Treatment may involve:
- Eyelid tape or shields – To keep the eyelids closed during sleep
- Artificial tears or ointments – To help keep the eyes lubricated during sleep
- Continuous positive airway pressure (CPAP) therapy – To treat OSA and reduce eyelid elasticity
- Surgery – To tighten the eyelid and improve its function
When should you call an eye doctor about a sore eyelid?
Many causes of eyelid pain or soreness are minor and easily treated. However, if you have a sore eyelid or your eyelid hurts when you blink, it’s important to visit your eye doctor as soon as possible to determine the cause.
Some symptoms and underlying causes of eyelid pain can indicate a more serious or urgent issue. If you experience an eye injury, facial weakness or paralysis, or any vision changes, seek medical care immediately.
READ NEXT: Why does my eye hurt when I blink?
