Eye-related headache

Michael J Marmura MD (

Dr. Marmura of Thomas Jefferson University Hospital received research support from Allergan and Teva; honorariums from Alder, Antres Pharma, Promius, Supernus, Theranica, and Valeant for consulting services; and honorariums from Amgen/Novartis, GammaCore, and Lilly for speaking engagements.

Stephen D Silberstein MD, editor. (

Dr. Silberstein, Director of the Jefferson Headache Center at Thomas Jefferson University, received honorariums from Abbie, Curelator, Ipsen Therapeutics, Lundbeck Biopharmaceuticals, Supernus Pharmaceuticals,  and Theranica for consulting. He is also the  principal investigator for clinical trials conducted by Amgen, ElectroCore Medical, and Teva.

Originally released February 14, 2002; last updated June 7, 2020; expires June 7, 2023


Because headache may be accompanied by pain in the eye or visual symptoms, it is often attributed to ocular disease. However, if the sclerae are white and noninjected, ocular disease is rarely the cause of significant headache. Conjunctival injection, corneal edema, abnormal pupils, and decreased vision are some of the most common signs. Clinicians other than ophthalmologists should be familiar with the symptoms and signs of ocular diseases, such as infection, inflammatory disorders, and glaucoma, that cause headache. This article covers important ocular causes of headache, including updates on the link between glaucoma and headache, and reviews associated inflammatory disorders such as Vogt-Koyanagi-Harada syndrome. The ocular presentations of primary headache, such as photophobia, blurred vision, tearing, ptosis, or ocular pain, are also examined.

Key points


• Eye pain is more likely related to ocular disease, such as glaucoma, when the eye is injected, edematous, or pupils are abnormal.


• Patients with vision loss, ophthalmoparesis, or progressive symptoms usually require urgent neuroimaging or referral.


Pituitary apoplexy is a neurologic emergency presenting with severe headache, vision loss, ophthalmoparesis, or delirium.


• Ocular symptoms such as visual aura, blurry vision, or photophobia are common in patients with primary headache disorders such as migraine.

The content you are trying to view is available only to logged in, current MedLink Neurology subscribers.

If you are a subscriber, please log in.

If you are a former subscriber or have registered before, please log in first and then click select a Service Plan or contact Subscriber Services. Site license users, click the Site License Acces link on the Homepage at an authorized computer.

If you have never registered before, click Learn More about MedLink Neurology  or view available Service Plans.

Find out how you can join MedLink Neurology