What should you know about cluster eye headache?

Cluster headache attacks often cause piercing or burning pain around or behind one eye. The eye may water or look red, and the nostril on that side may become blocked or run. Some people pace or feel unable to sit still. Attacks can recur in a recognisable pattern, while the pain-free time between them may feel normal.

Eye-area pain is not specific to cluster headache. Sinus symptoms, a cold, dehydration, heat exhaustion, anxiety and other illnesses can also cause head or facial discomfort. Allergic rhinitis may produce nasal blockage and pressure, but a severe new eye pain should not be labelled from symptoms alone.

Write down which eye is affected, when the pain starts, how long it lasts, whether the eye waters or the nose changes, and what you were doing beforehand. Rest in a quiet place and drink fluids if dehydration may be contributing. Arrange a GP assessment for a new, repeated or intense pattern so the eye and neurological symptoms can be reviewed.

Get emergency help for sudden severe eye or head pain with loss of vision, a fixed or unequal pupil, weakness, confusion, fainting, seizure, fever with a stiff neck, or repeated vomiting. Prompt review is also needed for a painful red eye, new visual disturbance or pain that is worsening rather than settling.

Ask whether your symptoms fit a cluster pattern or an eye, sinus or general illness; what examination is needed; which treatments can stop an attack; and which changes should send you to emergency care.