Differential Diagnosis for Headache Behind Eyes
- Single Most Likely Diagnosis
- Tension headache: This is the most common type of headache and often presents with a dull, aching pain behind the eyes, typically due to muscle tension in the neck and scalp.
- Other Likely Diagnoses
- Migraine: Migraines can cause severe, throbbing pain, often behind one eye, and may be accompanied by sensitivity to light, sound, and nausea.
- Sinusitis: Inflammation of the sinuses can cause pain and pressure behind the eyes, especially if the ethmoid or frontal sinuses are affected.
- Cluster headache: These are extremely painful headaches that occur in cycles, often waking the patient from sleep, and are characterized by pain behind one eye.
- Do Not Miss Diagnoses
- Subarachnoid hemorrhage: A life-threatening condition caused by bleeding into the space surrounding the brain, which can present with a sudden, severe headache, often described as "the worst headache of my life."
- Temporal arteritis: Inflammation of the blood vessels in the temples, which can cause headaches, jaw pain, and vision problems, and may lead to blindness if left untreated.
- Pituitary apoplexy: A rare but potentially life-threatening condition caused by bleeding into the pituitary gland, which can present with sudden, severe headache, vision changes, and altered mental status.
- Rare Diagnoses
- Trigeminal neuralgia: A chronic pain condition that affects the trigeminal nerve, causing intense, shock-like pain in the face, including behind the eyes.
- Idiopathic intracranial hypertension: A condition characterized by increased pressure within the skull, which can cause headaches, vision changes, and papilledema.
- Orbital pseudotumor: A rare, inflammatory condition that affects the tissues around the eye, causing pain, swelling, and vision changes.