EYE PAIN VS MIGRAINE: HOW TO TELL THE DIFFERENCE

Not all headaches that feel like a migraine start in the brain. Sometimes, the eyes or the structures around them are the real source. This page explores conditions that mimic migraine symptoms but stem from ocular or neurological issues, helping you spot the difference and avoid misdiagnosis.

EYE CONDITIONS THAT CAN MIMIC MIGRAINE

Possible culprits include:

Conjunctivitis
Corneal abrasions or lesions
Anterior uveitis
Angle-closure glaucoma
Optic neuritis
Orbital tumors or pseudotumors
Tolosa-Hunt syndrome

Note: Many of these may present with pain behind the eye, vision changes, or photophobia — all symptoms that overlap with migraine.

WHEN IT’S SOMETHING MORE

Eye pain can also result from less common or more serious causes:

Dissection of the internal carotid artery
Retrobulbar neuritis
Meningitis
Nasopharyngeal carcinoma with ocular symptoms
Paratrigeminal syndrome or small vessel disease

Surreal artistic image of a woman's eye overlaid on blurred newspaper and nature imagery

NOT EVERYTHING EYE-RELATED IS SERIOUS

As Dr. Carlow noted, it’s rare for the eye itself to be the true cause unless the signs are obvious.

Visual strain, muscle imbalance, or uncorrected vision may contribute — but are rarely the sole issue
“Ocular neurosis” or psychogenic eye strain is often diagnosed when structural causes are ruled out
Convergence insufficiency may be the exception

If your migraines always seem to “start in the eye,” it’s worth checking in with both your doctor and an eye specialist. But often, it’s still migraine - just with a strong visual component.

DISCLAIMER

This content is for informational purposes only and does not replace professional medical evaluation. If you experience persistent or severe eye pain, consult a qualified healthcare provider.