Differential Diagnosis for Unilateral Severe Eye Pain and Neck Swelling
Single Most Likely Diagnosis
- Acute Angle-Closure Glaucoma: This condition is characterized by sudden, severe eye pain, often accompanied by blurred vision, headache, and sometimes nausea and vomiting. The neck swelling could be secondary to the pain or associated with systemic symptoms. It's a medical emergency requiring prompt treatment.
Other Likely Diagnoses
- Cluster Headache: Known for causing severe, unilateral orbital or periorbital pain, cluster headaches can also lead to swelling and redness of the affected eye and may be accompanied by neck pain or stiffness.
- Optic Neuritis: Inflammation of the optic nerve can cause severe eye pain, especially with eye movement, and vision loss. While neck swelling is less common, it could be associated with conditions that also cause optic neuritis, like multiple sclerosis.
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can cause severe eye pain, swelling, and sometimes neck stiffness due to the spread of infection.
Do Not Miss Diagnoses
- Carotid Artery Dissection: A tear in the carotid artery can cause severe neck pain and eye pain due to the involvement of nerves and potential reduction in blood flow. It's a critical diagnosis to consider due to the risk of stroke.
- Giant Cell Arteritis: This condition can cause severe headaches, jaw claudication, and visual disturbances, including eye pain. It's crucial to diagnose promptly to prevent vision loss.
- Cavernous Sinus Thrombosis: A blood clot in the cavernous sinus can cause severe headache, eye pain, and swelling, along with other neurological symptoms. It's a life-threatening condition requiring immediate treatment.
Rare Diagnoses
- Tolosa-Hunt Syndrome: A rare disorder characterized by severe and unilateral headaches with extraocular palsies, which could be accompanied by eye pain and swelling.
- Raeder's Syndrome: A rare condition causing unilateral facial pain, often accompanied by ptosis and miosis, which could be considered in the differential for severe eye pain and neck swelling.
- Pharyngeal or Retropharyngeal Abscess: Although more commonly presenting with throat pain and difficulty swallowing, in rare cases, these abscesses can cause referred pain to the eye and neck swelling due to the spread of infection.