Ask Fiona: Why am I experiencing eye and jaw pain with my Vestibular Neuritis?

Dear Fiona,

I was diagnosed with vestibular neuritis. My balance is off, and I feel dizzy. However, I also have sharp pains around my eye, and my jaw hurts, especially when I chew. Are those related? What might be causing this, and what can I do about it?

What is Vestibular Neuritis?

Vestibular neuritis or neuronitis is an inflammation of the vestibular nerve, which carries signals about balance and head motion from the inner ear to the brain.

The classic symptoms include sudden, severe vertigo (a spinning sensation), nausea and vomiting, imbalance, difficulty walking, and problems with eye movements (for example, involuntary eye movements called nystagmus). 

Can Vestibular Neuritis Cause Eye Pain? What Might Be Going On

While the standard symptom list doesn’t usually include eye pain per se, there are several ways that vestibular neuritis or its consequences might lead to discomfort around the eyes. Some possible causes:

Eye strain due to involuntary eye movements (nystagmus):

• In vestibular neuritis, the imbalance in signals from one inner ear leads the brain to try to correct the mismatch via eye movement reflexes. The eyes may drift, twitch, or make rapid movements to compensate for the imbalance. Holding your gaze, tracking objects, or simply stabilizing what you see can become more effortful. Over time, this effort may result in fatigue or discomfort in the eye or surrounding areas.
• Medical sources frequently note that “jumping vision” or unstable vision is a common symptom associated with vestibular neuritis. 

Secondary effects, such as headaches or migraines:

Headaches can cause ocular (eye) pain and co-occur or be exacerbated by vestibular disorders.  

Visual issues and reading, focusing, or light sensitivity:

Vestibular dysfunction affects gaze stability, leading to blurred or unstable vision, which can strain the eyes, especially in bright light or while reading. That strain could manifest as pain or discomfort around or behind the eyes.

Possible Explanations for Jaw Pain in the Context of Vestibular Neuritis

Jaw pain is less commonly associated with vestibular neuritis; however, plausible connections and overlapping conditions exist. Some possibilities:

Temporomandibular Joint Disorders (TMD / TMJ disorder)

• TMJ problems involve the jaw joint and muscles. Symptoms can include jaw pain, clicking/popping in the joint, difficulty chewing, and sometimes ear pain or discomfort.¹
• Stress, clenching or grinding of teeth (especially when clenching as a response to stress or imbalance), or poor jaw posture can exacerbate TMJ disorders.

Muscle tension and referred pain from the face/head/neck

When someone has intense vertigo and imbalance, it’s natural to stiffen the neck, tilt or hold the head in unusual positions, grip the jaw, or clench facial muscles—especially if trying to steady oneself. That tension can refer to pain in the jaw.

Trigeminal Nerve Involvement

The trigeminal nerve supplies sensation to much of the face, jaw, and area near the eye. Irritation, compression, or overlap of neural pathways (or possibly secondary inflammation) could produce facial or jaw pain. For example, trigeminal neuralgia is a distinct condition that causes sharp facial or jaw pain. The presence of a vestibular problem could co-exist or exacerbate related nerve stress.²

Ear/Inner Ear Structures Proximity

The temporomandibular joint is located right in front of the ear. Any swelling or pressure in or near the ear (from the inner ear inflammation, or secondary effects) may exacerbate pain in or around the jaw, sometimes mimicking or triggering TMJ symptoms.

What Should You Discuss With Your Healthcare Provider

If you’re experiencing eye pain and jaw pain along with your vestibular neuritis, here are things to check or ask:

• Eye exam or neuro-ophthalmology consultation: To make sure there isn’t optic nerve involvement, or another eye problem (dry eyes, strain, etc.)
• TMJ evaluation: Dentists, oral maxillofacial specialists, or TMJ specialists can look for TMJ dysfunctions such as misalignment, arthritis, or muscle overuse
• Neurologic exam for facial nerves / trigeminal involvement: Especially if the pain is sharp, electric, or triggered by facial movement
• Assessment of muscle tension in neck/face/head: Physical therapy, posture analysis
• Imaging only if indicated: If symptoms are atypical, severe, or not improving, imaging (MRI, CT) may be used to rule out other causes

What You Can Try (Self-Care & Treatment Suggestions)

While working with healthcare providers, these measures may help relieve eye and jaw pain and reduce strain:

• Vestibular rehabilitation therapy (VRT) helps train the brain and eye reflexes to better compensate, potentially reducing the burden on eye movements.¹
• Rest your eyes more often: Especially during vertigo spells; avoid intense visual tasks (reading small print, screens) during acute phases.
• Good lighting, reducing glare: To reduce eye strain
• Jaw relaxation techniques:

• • Eat only soft foods to reduce chewing strain

• • Avoid large jaw movements such as yawning hard

• • Gently stretch and massage the jaw

• • Apply heat or cold packs
• Stress and clenching awareness: If you clench your teeth at night or during the day, a dental guard or relaxation/mindfulness may help reduce jaw pain
• Over-the-counter pain relievers: Non-steroidal anti-inflammatories (NSAIDs), if not contraindicated, may reduce joint or muscle inflammation

When Pain May Suggest Something More

While eye or jaw pain can be related to vestibular neuritis and its secondary effects, there are red flags. You should seek medical attention if:

• You have vision loss, severe light sensitivity, or pain with eye movement.
• Jaw pain comes with swelling, fever, or signs of infection.
• Facial numbness or weakness
• Pain is sharp, electric, or feels like a “shock” effect
• Symptoms persist long after the expected resolution of vestibular neuritis (weeks to months) without improvement.

Bottom Line

• Vestibular neuritis primarily affects balance, causing vertigo and abnormal eye movements, and can also lead to eye strain and discomfort.
• Jaw pain is less directly related to vestibular neuritis, but can arise from TMJ issues, muscle tension, or nerve irritation.
• A multi-disciplinary approach (ENT, neurologist, dentist/TMJ specialist, physical therapist) can help pinpoint whether your jaw and eye pain are secondary effects or caused by another overlapping condition.
• Many of the symptoms improve over time with rehabilitation, rest, and targeted treatments.

Reviewed by Danielle Beatty, DPT

References

1. Cleveland Clinic: Vestibular Neuritis – Symptoms, Causes & Treatment  
2. Johns Hopkins Medicine: Labyrinthitis and Vestibular Neuritis 
3. Cleveland Clinic: Temporomandibular Joint Disorders (TMD) 
4. Johns Hopkins Medicine: Trigeminal Neuralgia
5. Cornerstone Physical Therapy: What is Vestibular Neuritis?