Each second of the day, your body’s autonomic nervous system is hard at work performing routine tasks such as breathing and blinking. Because these functions are involuntary and reflexive, you typically don’t even notice them – that is until something goes awry. For example, you may take a heightened interest in your blinking if you feel something in your eye or experience eye pain. Recognizing this discomfort is the easy part; diagnosing the cause is more complex. This blog will discuss common causes of eye pain when blinking and how to treat them.
Why Do We Blink?
Blinking occurs about every 3 to 6 seconds, or 10 to 20 times per minute. Over the course of a day, that amounts to anywhere between 9,600 to 19,200 times (assuming you’re awake at least 16 hours).
A single blink takes about 400 milliseconds. This response originates in the brain’s nervous system where it sends a signal to muscles in the upper eyelid, which cause the eyelid to close and then open again.
Blinking serves two purposes. First, it clears debris and particles from the cornea, the transparent part of the eye that covers the iris and the pupil. Second, it lubricates and provides nutrients to the eye using tear film.
Tear film contains enzymes, lipids, metabolites, and electrolytes. The film consists of three layers, all of which are important to keep the cornea healthy.
- Outer oily layer: Keeps the surface of the tear smooth so it can be seen through and prevents the tear from evaporating.
- Inner watery layer: Keeps the eye hydrated, repels bacteria, and helps clear particles away from the cornea.
- Inner mucus layer: Helps the tear spread and stick to the eye.
Why Does It Feel Like Something Is in My Eye?
The cornea has many nerve fibers that make it one of the most sensitive tissues in the human body. As such, it is common for people to sense changes to their eyes – whether it is a piece of sand or a microscopic allergen.
Because the eyelid moves across the cornea each time you blink, any foreign object, dryness, irritation, or inflammation of the cornea can cause eye discomfort.
Here are some of the most common causes of eye pain when blinking:
Allergies: An eye allergy is also known as allergic conjunctivitis. These reactions occur when mast cells in your eye release histamine in response to allergens. The histamine causes red, itchy eyes that become inflamed. The inflammation can be felt when blinking.
Blepharitis: Some people have too much bacteria on their eyelids, which causes them to become red, swollen, irritated, and itchy. Clogged oil glands can also cause blepharitis. In addition to eye irritation, blepharitis also produces crusted scales that flake off similar to hair dandruff.
Conjunctivitis: Viral or bacterial conjunctivitis, also known as “pink eye”, causes the conjunctiva (the clear tissue that covers a portion of the eye and inside of the eyelid) to become red and inflamed, which becomes noticeable when blinking.
Corneal abrasion: A corneal abrasion is a scratch on the outer surface of your eye. Any number of things including tree branches, fingernails, and makeup brushes can cause these scratches. When you blink, you eyelid irritates the scratch causing pain.
Corneal ulcer: A corneal ulcer, also called keratitis, is an open sore on the cornea caused by an eye infection, severe dry eye, or other eye disorders. The inflammation associated with the ulcer causes itchy, watery eyes that may also produce discharge and cause blurred vision. Blinking irritates the ulcer.
Dry eye syndrome: Meibomian and lacrimal glands are responsible for producing tear film. In people with dry eye syndrome, the glands do not produce enough tears or they do not produce the right type of tears (meaning the tear film evaporates too fast or it does not keep the eyes lubricated). Without the tear film to serve as a barrier, you may experience a gritty feeling in your eye when you blink.
Foreign body: Any physical object or substance not naturally part of the environment of your eye can cause irritation and blinking is your body’s natural response to try and remove it. Most foreign bodies, such as an eyelash or a piece or dirt, resolve easily. However, a piece of wood, metal, or chemical irritant may pose a more serious risk that requires immediate attention.
Giant papillary conjunctivitis (GPC): GPC is a condition in which the inside of the eyelid become swollen, red, and rough, sometimes developing bumps, called papillae – all of which makes blinking painful. People who wear contact lenses are most likely to experience GPC.
Styes: Medically known as a hordeolum, styes are red bumps on the eyelids caused by a blocked oil gland. The blockage does not allow oil to drain properly, causing an infection from the bacteria staphylococcus aureus. Styes can cause irritation when blinking.
Why Does the Corner of My Eye Hurt When I Blink?
In some cases, blinking pain is localized in the corner of your eye. This could be due to a foreign body becoming lodged there, or from a scratch or other injury in that area. Other causes could include a tear duct infection or a specific type of eyelid inflammation called angular blepharitis.
How to Treat Eye Pain
As is the case with many eye conditions, the treatment depends on the cause of the discomfort or pain. Here are some examples of how to treat various forms of eye pain. Keep in mind this list is not exhaustive. Certain conditions, such as corneal ulcers, may require special prescription eye drops, while more severe cases of dry eye syndrome can benefit from advanced procedures such as punctal plugs, LipiFlow, or Intense Pulsed Light (IPL).
Antibiotics: While viral eye infections cannot be treated with antibiotics, antibiotics can provide relief from bacterial eye infections and are most commonly prescribed as an eye drop or an ointment.
Antihistamine drops: For eye allergies, your eye doctor may recommend antihistamine drops – both over-the-counter and prescription antihistamine drops are available. However, these drops can decrease tear production, so supplementing antihistamine drops with artificial tears can keep your eyes from drying out.
Artificial tears: Lubricating eye drops can help remove a foreign body from your eye. Artificial tears are also a common treatment for dry eye syndrome. Preservative-free eye drops have fewer additives and are recommended if you have moderate or severe dry eyes. These eye drops can be purchased over the counter.
Cool or warm compresses: Depending on the eye condition, a cold or warm compress can help soothe your eye. For example, a cool, damp washcloth can loosen dried mucus or pus caused by pink eye while warm compresses can help open clogged oil glands associated with styes.
Eyelid scrubs: People with blepharitis have too much bacteria on the eyelids. Eyelid scrubs, which come in pads or a foam, help remove excess bacteria. They are often used in conjunction with a warm compress to help soothe the eyelid.
Eye wash: If a chemical or other irritant enters your eye, it may be necessary to flush it with water. Depending on the chemical or source of irritation, you might wash your eye for five minutes to an hour and immediate medical attention may be necessary.
When Should I be Concerned About Eye Pain?
Any of the conditions outlined above can progress to the point where you need to see an eye doctor in order to find some relief. In particular, if you are experiencing a corneal ulcer, corneal abrasion, GPC, or conjunctivitis you will likely need to be treated by a doctor. In addition, there are certain cases in which you should go to your nearest emergency room to be evaluated by a doctor. These complications include:
- Severe ocular trauma
- Foreign body such as glass or metal
- Sudden, severe pain that does not subside
- Pain that causes new vision problems
- Blood in the eye
- Protruding eyeball
