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Headaches: Types, causes, treatment and how they can affect vision

Headaches are a common problem that can cause you to miss work, school or life events. A headache can be caused by uncorrected vision problems, and some types of headaches may affect your eyes.

A headache may feel like generalized pain all over the head, on one side of the head, on top of the head, on the forehead or behind the eyes. Headache pain can feel dull, throbbing or sharp. Headaches are common: Almost half of all adults have had at least one within the past year.

Learn about common types of headaches along with causes, symptoms, diagnosis, treatment and how some types of headaches can affect the eyes.

Headache causes

Some types of headaches don’t have a known cause while others do. Headaches can be brought on by a wide range of factors, from allergies to medications to eye strain. 

It’s not common, but headaches can be caused by a serious underlying issue. A partial list of headache causes includes:

  • Acute sinus infection

  • Aneurysm

  • Brain tumor

  • Head trauma

  • Hormone imbalance

  • Medication overuse 

  • Seasonal allergies

  • Stress or tension

  • Uncorrected vision issues

  • Untreated high blood pressure

Some types of headaches with no definitive cause, such as migraines, may be brought on by a trigger. Common migraine triggers include alcohol, specific foods, sleep problems or stress. 

Primary and secondary headaches

There are two main categories of headache: primary headaches and secondary headaches.

Primary headache

Primary headaches are headaches that aren’t caused by another health problem. The cause of a primary headache isn’t always known, but genetics may play a part, and “triggers” can bring on a headache.

Three of the most common types of primary headaches are cluster headaches, migraine headaches and tension headaches. 

Secondary headache

Secondary headaches are headaches that are caused by an underlying health issue such as an allergy, illness, overuse of headache medication or serious medical problem, such as an aneurysm. There are many types of secondary headaches. (See our headache chart below for more information on types of headaches.)

Types of headaches 

These are some of the most common types of headaches, along with their causes, symptoms, treatment and prevention.

Cluster headache

Cluster headaches usually happen in men ages 20 to 50. They can happen daily for weeks or months and then go away for a year or more. Cluster headaches have been linked to heavy drinking and smoking.

  • Causes – It’s not known exactly what causes cluster headaches.

  • Symptoms – Severe pain around the eyes, watery eyes, nasal congestion and a flushed face. Pain often comes on during sleep.

  • Treatment – Oxygen and various prescription medications can be used to treat cluster headaches.

  • Prevention – Prescription medications such as calcium channel blockers, lithium and steroids may be used to prevent cluster headaches.

Migraine headache

About one in three adults has had a migraine in the past year. You may get a migraine without aura or a migraine with aura

A migraine with aura, also known as a visual migraine, includes vision symptoms, such as seeing colored wavy lines or zigzags of light. These vision symptoms may last about half an hour and often happen before the onset of a headache.

  • Causes – The exact cause of migraine isn’t known, but family history plays a part. Migraine triggers may include certain foods, weather changes and stress.

  • Symptoms – Throbbing head pain, often on one side, and one or more of the following: body aches, dizziness, fatigue, numbness or tingling, pain behind the eyes, sensitivity to light or sound, and nausea or vomiting.

  • Treatment – Over-the-counter pain medications and/or prescription pain medications and anti-nausea medications. Triptans are prescription drugs that shrink the blood vessels in the head. Gepants and ditans are prescription drugs that target sensory receptors on nerves to treat head pain, nausea and sensitivity to light and sound.

  • Prevention – Migraine prevention medications include ACE inhibitors, beta blockers and calcium channel blockers. Keeping a migraine diary to identify food triggers and other triggers so you can avoid them in the future. Wearing sunglasses, getting on a regular sleep schedule, exercising regularly and practicing meditation all may help prevent migraines.

Tension headache

Tension headaches are a very common type of primary headache. They are caused by tense muscles in your head, neck, jaw and shoulders. Tension headaches can be triggered by stress. 

  • Causes – Tension headaches are often caused by anxiety, stress and worry. They can be triggered or made worse by drinking alcohol, missing meals or not getting enough sleep.

  • Symptoms – Dull pain all over the head that stays consistent over time with muscle tension in the head and neck.

  • Treatment – A doctor may recommend over-the-counter pain relievers, prescription pain relievers or muscle relaxants, and therapy.

  • Prevention – Minimizing stress and using relaxation techniques.

Allergy headache

An allergy headache is typically caused by seasonal allergies rather than by food allergies.

  • Causes – Seasonal allergies, such as a pollen allergy or “hay fever.”

  • Symptoms – Dull headache, nasal congestion, watery eyes.

  • Treatment – Antihistamines or nasal cortisone spray.

  • Prevention – Allergy shots.

Caffeine withdrawal headache

A caffeine withdrawal headache typically is caused by dilation of blood vessels from consuming a large amount of caffeine, commonly coffee, then stopping “cold turkey.”

  • Causes – Consuming a large amount of caffeine and then stopping abruptly.

  • Symptoms – A throbbing headache.

  • Treatment – Rest and avoiding large amounts of caffeine.

  • Prevention – Cut down or quit coffee and other caffeinated food and drinks.

Eye strain headache

An eye strain headache is a less common type of headache that can be caused by uncorrected vision issues, such as uncorrected astigmatism, uncorrected nearsightedness (myopia) or uncorrected farsightedness (hyperopia). They can also be caused by outdated prescription lenses for these conditions.

  • Causes – Uncorrected vision issues that cause eye strain.

  • Symptoms – Pain in the forehead on both sides of the head.

  • Treatment – See an eye doctor for an eye exam and vision correction.

  • Prevention – Regular comprehensive eye exams and vision correction as prescribed by your eye doctor.

SEE RELATED: A Guide to Digital Eye Strain

Hormone headache

Also known as a “menstrual migraine,” a hormone headache happens right around the time you ovulate or have a period.

  • Causes – Changes in levels of estrogen and progesterone with monthly cycles.

  • Symptoms – A throbbing headache, typically on one side, possibly with other symptoms such as nausea and sensitivity to light or sound.

  • Treatment – Over-the-counter and prescription medications.

  • Prevention – Prescription medications, including hormone therapy.

Hypertension headache

A hypertension headache is linked to untreated high blood pressure and is very treatable.

  • Causes – Untreated high blood pressure.

  • Symptoms – An all-over pain or pain on top of the head that is worse in the morning and lessens throughout the day.

  • Treatment – Prescription blood pressure medication.

  • Prevention – Keep blood pressure under control with medication and lifestyle measures.

Rebound headache

A rebound headache is caused by overuse of headache medication, usually for migraine headaches.

  • Causes – Overuse of certain headache medications, especially narcotic or over-the-counter pain medications.

  • Symptoms – Headaches more than 15 days of the month for three or more months while taking migraine medications.

  • Treatment – Tapering off of pain relief or anti-migraine medications.

  • Prevention – Avoid taking headache medications more than two to three days a week.

Sinus headache

A sinus headache is caused by an acute sinus infection. Patients with undiagnosed migraine may mistakenly self-diagnose with “sinus headache.”

  • Causes – A sinus infection that is blocking the sinuses and preventing normal drainage.

  • Symptoms – Pain on the face around the nose that typically gets worse throughout the day, along with fever and stuffy nose.

  • Treatment – Antibiotics, decongestants and possibly surgery.

  • Prevention – There’s really no way to prevent sinus headaches.

Trauma headache

A trauma headache is typically easy to diagnose because it is brought on by trauma, such as getting hit in the head.

  • Causes – Blunt force trauma to the head.

  • Symptoms – Head pain that may feel similar to a migraine or sinus headache and happens daily.

  • Treatment – Biofeedback and over-the counter or prescription medication.

  • Prevention – Taking safety precautions to avoid future head trauma.

Headache diagnosis

Talk to your doctor if you’re experiencing headaches. Your doctor will ask questions about your family history, symptoms and lifestyle. Your doctor may ask about:

  • Frequency of headaches and how long they last

  • Location of pain and how it feels (for example, dull, throbbing, sharp)

  • Severity of headaches 

  • Other symptoms (such as nausea or sensitivity to light)

  • Family history of migraine or other headaches

Based on your answers to these questions and a physical exam, your doctor may be able to diagnose you with a certain type of headache. If your doctor suspects an underlying cause, or sees “red flags,” they may order imaging, such as a CT or MRI scan, to make a headache diagnosis.

Headache treatment

Headache treatment will vary depending on the type of headache. However, there are general categories of treatment used for many types of headaches.

Headache medications

Over-the-counter and prescription medications can be used to treat many types of headaches, but the specific medications may vary by headache.

The most common OTC treatments for headache include:

  • Acetaminophen

  • Aspirin

  • Ibuprofen

A doctor may also prescribe medication to be taken daily to prevent headaches, or they may prescribe medication that can be used to provide relief when you get a headache. 

Prescription treatments may include:

  • Pain medications

  • Nasal sprays

  • Tricyclic antidepressants.

In the case of headaches caused by overuse of medication, treatment may involve slowly reducing the amount of headache medication used.

Lifestyle changes for headaches 

Lifestyle changes such as eating nutritious meals, getting on a regular sleep schedule and using stress reduction tools may help prevent headaches. For example, your doctor may suggest meditation or yoga to help reduce stress in your life.

Addressing headache causes

If you have a type of secondary headache, it will be necessary to address the root cause of your headaches. Treatment will vary based on the type of headache. For example, you may need to cut back on caffeine for caffeine-withdrawal headaches, or you may need to get vision correction for eye strain headaches.

Headaches and the eyes

There is a two-way relationship between headaches and the eyes. An eye issue may cause a headache, or a headache may cause eye issues.

For example, eye strain caused by uncorrected vision issues may lead to an eye strain headache. And some types of headaches, such as migraines, can cause eye symptoms. Here are some common headache-related eye symptoms:

  • Eye pain – If you get migraines, you may feel like you have a headache behind the eyes. And some other types of headaches, such as a cluster headache, may cause pain around the eyes.

  • Visual disturbances – If you have migraine with aura (visual migraine) you may see wavy lights, zigzags or a flickering blind spot in your field of vision in both eyes. With a more serious ocular migraine, you may experience temporary vision loss in one eye.

  • Watery eyes – If you have an allergy headache, you also may experience watery eyes or eye buildup.

It’s important to see your eye doctor if you have any vision problems, with or without a headache. Vision problems may be a symptom of a visual migraine, an ocular migraine, or a condition such as retinal detachment or eye stroke that require emergency treatment.

When to go to the ER for a headache

There are times when a headache can be a sign of a health emergency, such as an aneurysm or stroke. You may need to seek emergency care for a severe headache that starts suddenly and is not similar to other headaches you’ve had in the past.

It may also be a good idea to go to the ER for a headache if you also experience any of  these symptoms at the same time:

ER doctors may order testing such as a CT scan to make sure your symptoms are not caused by a life-threatening condition. If you’re experiencing a migraine that won’t go away, ER doctors may offer you a “migraine cocktail” made up of several different medications to treat your migraine.

Tell your eye doctor about headaches or vision issues

When you visit your eye doctor for an eye exam, it’s important to tell them if you’re having headaches or vision issues. Your eye doctor is an important partner not only in taking care of your eyes but in helping you get to the bottom of any issues with your overall health that may involve eye symptoms.

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Headache disorders. World Health Organization. April 2016.

Headache categories. National Headache Foundation. Accessed June 2021.

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Types of headaches. Stanford Health Care. Accessed June 2021.

What is migraine? American Migraine Foundation. January 2021.

Acute medicines. The Migraine Trust. Accessed June 2021.

Preventive medicines. The Migraine Trust. Accessed June 2021.

Keeping a migraine diary. The Migraine Trust. Accessed June 2021.

Menstrual migraine. National Headache Foundation. Accessed June 2021.

Stopping the vicious cycle of rebound headaches. Harvard Health Publishing. November 2019.

Approach to acute headache in adults. American Family Physician. May 2013.

When to go to the emergency room for a migraine or headache. American Migraine Foundation. February 2017.

Headache treatment and headache relief. Stanford Health Care. Accessed June 2021.

Migraine in the emergency department. American Migraine Foundation. April 2016.

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