Cluster headache behind the eye: what to know

Cluster headache is a neurological headache disorder that produces intense pain around or behind one eye. Attacks often occur on the same side and may come in a recognisable pattern, with restlessness rather than a wish to lie still. The eye may water or look red, the eyelid can droop, and the nostril on that side may become blocked or run. These features are useful clues, but pain in this location can also have other causes, including eye, sinus, or nerve problems.

Record when the pain starts, how long it lasts, which side is affected, and any eye or nasal changes. Avoid alcohol if it has triggered attacks before, and keep a written list of medicines and health conditions for your clinician. Ordinary painkillers may not act quickly enough for a cluster attack, so arrange a GP Consultation to discuss an individual rescue and prevention plan. Do not use another person’s oxygen or prescription medicine.

Seek emergency help for a sudden, explosive headache, new weakness, confusion, fainting, seizure, fever with a stiff neck, or loss of vision. Get urgent eye assessment for a painful red eye with blurred vision, halos, or marked light sensitivity. New one-sided headache with a drooping eyelid or unequal pupils also needs prompt assessment. For repeated attacks without these warning signs, book a GP Consultation so the pattern can be checked.

Ask whether your symptoms fit cluster headache, what treatment should be used at the first sign of an attack, which medicines can prevent a cluster period, and which eye or neurological symptoms should prompt emergency care.