Making Sense of the Eye Pain-Headache Connection | AAO 2025

Have a headache and there is pain from around your eyes? Is it an eye problem?

"In some cases, the brain or your mind can be not very good at differentiating what pain is coming from the eyeball itself, what is coming from the structures round about the eyeball — what we call the orbit, the eye socket — or what is actually truly coming from other parts of the head, and it feels to the patient as if it's coming from the eyes," explains Michael Gilhooley, M.D., Ph.D., a neuro-ophthalmologist at Doheny Eye Institute in Pasadena, California.

Gilhooley gave a talk today about headaches at the American Academy of Ophthalmology annual meeting in Orlando, Florida. The title, "What You Need to Know About Headache: A Pain for the Patient and a Pain for the Doctor," hints at the difficulties in diagnosis and treatment that headaches can present for ophthalmologists, Gilhooley explained in an interview with Managed Healthcare Executive before his talk.

Gilhooley noted that the large trigeminal nerve that innervates the face and the scalp also branches out to the eye.

Ophthalmologists can play a role in ferreting out the cause of a headache because a buildup of pressure in the brain that causes a headache may put pressure on the optic nerves, Gilhooley said.

We, as eye doctors, can look into the back of the eye and see changes in the nerve at the back of the eye. Just by looking, that can help us localize that perhaps these headaches are being caused by something that's causing the pressure to rise inside the brain, like a tumor, without doing any scans," he said.