Understanding Migraine‑Related Eye Pain

Pain in, around, or behind one eye is a common migraine symptom. It can affect one or both eyes and usually appears when a migraine attack is triggered.

During a migraine, the trigeminal system—particularly the trigeminal nerve that surrounds the eyes—becomes activated. The nerve transmits pain, touch, and temperature signals from the face and head to the brain. When the system is overstimulated, the nerve endings send pain signals that are perceived as eye pain. This process, known as central sensitization, is a primary cause of migraine‑related eye discomfort.

Other Headaches That Can Cause Eye Pain

• Retinal (ocular) migraine: An aura‑type migraine that primarily affects vision. Episodes usually start in the brain, affect one eye, and last 5–60 minutes, often followed by a headache within an hour. Visual symptoms may include scintillations (twinkling lights), scotoma (partial loss of vision), temporary blindness, blurry vision, spots, or zig‑zag lines.
• Cluster headache: Intense pain centered around one eye, often accompanied by restlessness, agitation, eye redness, tearing, eyelid swelling, or drooping. Triggers can include alcohol, certain medications, bright light, and specific foods.

Treatment Options

• Pain‑relief medications: Over‑the‑counter analgesics, triptans, and newer gepants can alleviate acute migraine pain, including eye discomfort.
• Preventive therapies:
  • Traditional drugs: antiepileptics, beta‑blockers, antidepressants.
  • CGRP monoclonal antibodies: eptinezumab (Vyepti), erenumab (Aimovig), fremanezumab (Ajovy), galcanezumab (Emgality).
  • Onabotulinumtoxin A (Botox) injections.
  • Neuromodulation devices: Cefaly (Cefaly Technology), gammaCore (electroCore), Nerivio (Theranica), SpringTMS (eNeura).
• Lifestyle modifications: Identify and avoid personal triggers, maintain regular sleep patterns, treat sleep apnea if present, manage stress, and limit trigger foods or beverages.
• Additional aids: FL‑41 tinted lenses that block specific light wavelengths can reduce photophobia during attacks.

Migraine‑related eye pain can significantly affect daily life. If you experience persistent eye discomfort, consult a neurologist or your primary care physician. Together you can pinpoint the cause and choose the most appropriate treatment plan.