Eye Pain Treatment in Ranchi
Eye pain is your body's warning signal. Dr. Dibya Prabha, MS Ophthalmology (RIMS), FICO, Retina Fellow, provides precise diagnosis and effective treatment for all causes of eye pain at Neurovision Clinic, Ranchi.
When to Worry
- !Severe eye pain with blurred vision, seeing halos around lights, a fixed mid-dilated pupil, and a rock-hard eye — this is the classic presentation of acute angle-closure glaucoma. The intraocular pressure rises rapidly, compressing the optic nerve. This is a true ophthalmological emergency; irreversible optic nerve damage can occur within hours. Immediate medical and laser treatment (laser peripheral iridotomy) is required.
- !Deep, boring eye pain with a red, swollen eye, proptosis (bulging forward), restricted eye movements, and fever — indicative of orbital cellulitis. This is a life-threatening infection posterior to the orbital septum that can extend into the cavernous sinus or brain. It requires emergency IV antibiotics and often surgical drainage.
- !Eye pain following trauma, especially with a history of a high-velocity foreign body (hammering metal, grinding) — an intraocular foreign body must be ruled out. Even a tiny metallic fragment can cause endophthalmitis (devastating intraocular infection) or retinal detachment. A dilated fundus exam and CT scan of the orbits (if a metallic foreign body is suspected) are essential.
- !Severe pain with photophobia (extreme sensitivity to light), ciliary flush (a ring of redness around the cornea), and a constricted pupil — this constellation suggests acute anterior uveitis (iritis). While not as immediately blinding as acute glaucoma, untreated uveitis can lead to posterior synechiae, cataract, glaucoma, and cystoid macular edema. Treatment is with topical steroids and cycloplegics.
- !Post-operative eye pain that is increasing rather than decreasing, especially after cataract or intraocular surgery — worsening pain raises concern for endophthalmitis, a rare but devastating intraocular infection. Endophthalmitis can cause permanent blindness within 24 to 48 hours and requires urgent vitreous tap and intravitreal antibiotics.
- !Eye pain with vesicular rash on the tip of the nose (Hutchinson sign) or around the eye — this indicates herpes zoster ophthalmicus (shingles involving the ophthalmic division of the trigeminal nerve). When the nasociliary branch is involved, there is a high risk of corneal involvement (dendritic keratitis, stromal keratitis, neurotrophic ulcer) and uveitis, both of which threaten vision. Early systemic antiviral therapy reduces ocular complications.
Possible Causes
Corneal Disorders (Abrasions, Ulcers, Keratitis)
The cornea has the highest density of sensory nerve endings of any tissue in the body, making corneal injuries intensely painful. Corneal abrasions occur from trauma (fingernail, paper edge, contact lens overwear). Infectious keratitis — bacterial (Pseudomonas in contact lens wearers), viral (herpes simplex dendritic ulcer), fungal (typically after vegetative trauma), or Acanthamoeba (contact lens wearers using tap water) — is sight-threatening and requires urgent culture-guided treatment. Fluorescein staining under cobalt blue light at the slit lamp reveals the epithelial defect pattern.
Acute Angle-Closure Glaucoma
Occurs when the iris bows forward and blocks the trabecular meshwork, preventing aqueous humor drainage. Intraocular pressure rises rapidly from a normal of 10 to 21 mmHg to 60 mmHg or higher, causing ischemic damage to the optic nerve and corneal endothelial edema. Risk factors include hyperopia (farsightedness), shallow anterior chamber, older age, female sex, and Asian ethnicity. Attacks can be precipitated by pupillary dilation in dim light, certain medications (anticholinergics, adrenergic agents), and emotional stress.
Uveitis (Anterior, Intermediate, Posterior)
Inflammation of the uveal tract (iris, ciliary body, choroid). Anterior uveitis (iritis) presents with deep aching pain, photophobia, redness, and blurred vision. It can be idiopathic or associated with HLA-B27 conditions (ankylosing spondylitis, reactive arthritis), sarcoidosis, infections (herpes, syphilis, tuberculosis), or trauma. Intermediate and posterior uveitis may present with floaters and vision loss rather than pain. Treatment involves topical corticosteroids, cycloplegics, and in severe cases, systemic immunosuppression.
Scleritis and Episcleritis
Episcleritis is a benign, self-limited inflammation of the episclera presenting with sectoral redness and mild discomfort, often in young adults. Scleritis, by contrast, is a severe, destructive inflammation of the sclera with intense boring pain that radiates to the face and jaw and worsens at night. It is associated with systemic autoimmune diseases (rheumatoid arthritis, granulomatosis with polyangiitis, lupus) in 50 percent of cases. Scleritis threatens vision through corneal thinning, uveitis, glaucoma, and scleral perforation. It requires systemic treatment with NSAIDs, corticosteroids, or immunosuppressants.
Which Specialist Should You See?
An ophthalmologist is the appropriate first specialist for eye pain. Dr. Dibya Prabha, MS Ophthalmology (RIMS), FICO, and Retina Fellow at LV Prasad Eye Institute Hyderabad, has the slit-lamp examination skills and diagnostic equipment at Neurovision Clinic, Ranchi, to differentiate between the numerous causes of eye pain — from common corneal abrasions to vision-threatening conditions like acute glaucoma and scleritis. If the pain is referred from a neurological source (trigeminal neuralgia, cluster headache), a neurologist consultation with Dr. Yuvraj Lahre can be arranged at the same clinic.
Diagnostic Approach
Dr. Dibya Prabha's evaluation begins with a targeted history: onset and duration of pain, character (sharp, dull, throbbing, foreign-body sensation), location (surface vs deep vs periocular), aggravating and relieving factors (blinking, eye movement, light), and associated symptoms (redness, discharge, vision change, systemic symptoms). The examination includes: best-corrected visual acuity, pupillary examination (anisocoria or relative afferent pupillary defect), slit-lamp biomicroscopy with fluorescein staining to detect corneal defects, tonometry for intraocular pressure (essential to rule out glaucoma), and dilated fundus examination to evaluate the posterior segment. Seidel test is performed if globe perforation is suspected. At Neurovision Clinic, we coordinate corneal cultures, B-scan ultrasound, or CT orbits when indicated.
Experiencing Eye Pain?
Don't ignore your symptoms. Get expert evaluation from Dr. Dibya Prabha at Neurovision Clinic, Ranchi.
Frequently Asked Questions
What are the most common causes of eye pain?
Eye pain can originate from the surface of the eye (corneal abrasions, dry eye syndrome, corneal ulcers, foreign bodies), from inside the eye (acute glaucoma, uveitis, scleritis), or from structures around the eye (orbital cellulitis, optic neuritis, sinusitis with referred pain). The character of the pain provides important clues: sharp, scratching pain suggests a corneal problem; deep, aching pain suggests intraocular inflammation or elevated pressure; and pain with eye movement suggests optic neuritis. Dr. Dibya Prabha uses a systematic slit-lamp examination to pinpoint the exact source of your eye pain and provide targeted treatment.
When is eye pain a medical emergency?
Eye pain is an emergency when accompanied by: sudden vision loss or blurring, seeing halos around lights (a sign of acute glaucoma), severe headache with nausea or vomiting (also acute glaucoma), a red, swollen eye that appears to bulge forward (orbital cellulitis), pain after eye trauma or a chemical splash, pain with a history of recent eye surgery, or pain in an immunocompromised patient (risk of aggressive infections). If you experience eye pain with any of these features, seek immediate evaluation at Neurovision Clinic or your nearest emergency department.
Can dry eyes cause severe eye pain?
Yes. Severe dry eye syndrome can cause significant discomfort that patients often describe as burning, stinging, or a gritty foreign-body sensation. In advanced cases, the corneal surface can develop filamentary keratitis or even sterile corneal ulcers, which are intensely painful. However, dry eye pain is typically bilateral, worse at the end of the day or with prolonged screen use, and improves (at least temporarily) with lubricating drops. Dr. Prabha evaluates the tear film and ocular surface to diagnose the specific type of dry eye (aqueous-deficient vs evaporative) and offers treatments ranging from artificial tears and anti-inflammatory drops (cyclosporine) to punctal plugs and meibomian gland expression.
What is the difference between corneal pain and intraocular pain?
Corneal pain (from the ocular surface) is typically sharp, stabbing, or gritty, aggravated by blinking, and associated with tearing and light sensitivity. It comes from the cornea's dense network of sensory nerve endings derived from the trigeminal nerve — the cornea has the highest density of nerve endings of any tissue in the human body, making it exquisitely sensitive. Intraocular pain (from inside the eye) is deeper, dull, and aching, often radiating to the brow or temple, and may be associated with a red eye, blurred vision, or halos. The two types of pain are distinguished through slit-lamp examination and tonometry. Conflating the two can lead to missed diagnoses like uveitis or angle-closure glaucoma.