When “Just a Sinus Infection” Was Something More

She thought it was another sinus infection — until antibiotics for Lyme disease made her eye pain disappear.

Pain that occurs behind the eyes is one of the most overlooked clues of Lyme disease — and one of its most misunderstood. Patients often describe a deep, aching pressure that sits behind or around the eyes. It may worsen with fatigue, bright lights, or certain head movements. Yet, in clinic after clinic, it’s dismissed as sinus pressure, eye strain, or migraines.

For some, an inaccurate diagnosis may explain why the pain doesn’t improve with standard treatments.

What Patients Describe: Pain Behind Eyes

Many Lyme disease patients with pain behind their eyes report eye-related discomfort that doesn’t fit the usual patterns. They may feel pressure rather than sharp pain, often accompanied by headaches, blurred vision, or sensitivity to light. The pain can shift sides or radiate toward the temples.

One patient said, “It felt like someone was pressing from inside my skull, right behind my eyes.” 

But, she improved and her eye pain disappeared after she was treated for Lyme disease.

In my experience, many patients also describe a pressure-like pain that extends across the forehead or into the temples. It can fluctuate from a dull ache to a heavy, band-like sensation, often intensifying with fatigue, computer work, or exposure to bright light.

When standard imaging or eye exams come back normal, patients are told it’s stress or dehydration. But the reality is more complex — and far more physiologic than psychological.

Of course, it’s essential to rule out other causes first — such as sinus infection, migraine, vision changes, or eye strain. But once those possibilities are excluded and the pain persists, Lyme disease should be considered in the differential diagnosis for patients with ongoing pain that occurs behind the eyes.

Why Eye Pain in Lyme Disease Often Gets Missed

Pain behind the eyes is rarely linked to Lyme disease. Most doctors first think of sinus infections, migraines, or eye strain, because they aren’t taught that Lyme can cause this symptom. As a result, they often don’t check for other Lyme-related signs, like fatigue or joint pain.

Yet when antibiotics are prescribed for Lyme disease and the pain is relieved, the connection becomes clear.

Because this symptom is “hidden,” many patients spend months or even years searching for answers that don’t fit.

Have you felt deep eye pain or pressure during your Lyme journey? Share your experience below.

⚠️ Not medical advice. Eye pain warrants prompt professional evaluation.

References

CDC. Signs and Symptoms of Untreated Lyme Disease

International Journal of Medical Sciences. (2009) Ocular manifestations of Lyme borreliosis in Europe

Dr. Daniel Cameron: Lyme Science Blog. Chronic Lyme Disease Education Gap

Dr. Daniel Cameron: Lyme Science Blog. Growing list of eye problems in Lyme disease