What is the differential diagnosis for unilateral ocular pain behind one eye?

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Differential Diagnosis for Pain Behind 1 Eye

Single Most Likely Diagnosis

  • Tension headache: This is often the most common cause of pain behind one eye, typically presenting with a dull, aching sensation and can be related to stress, poor posture, or eye strain.
  • Migraine: A migraine can cause severe, unilateral pain behind an eye, often accompanied by sensitivity to light, sound, or nausea.

Other Likely Diagnoses

  • Cluster headache: Characterized by severe, unilateral orbital or periorbital pain, often accompanied by autonomic symptoms like lacrimation or nasal congestion.
  • Sinusitis: Inflammation of the sinuses can cause pain behind the eyes, especially if the ethmoid or frontal sinuses are involved.
  • Optic neuritis: Inflammation of the optic nerve can cause pain behind the eye, especially with eye movement, and is often associated with vision loss.
  • Glaucoma: Acute angle-closure glaucoma can cause severe, unilateral eye pain, often accompanied by blurred vision, nausea, and vomiting.

Do Not Miss Diagnoses

  • Giant cell arteritis: This condition can cause severe, unilateral headache and is a medical emergency due to the risk of vision loss if not promptly treated.
  • Cavernous sinus thrombosis: A rare but potentially life-threatening condition that can cause pain behind the eyes, often accompanied by fever, ptosis, and cranial nerve palsies.
  • Pituitary apoplexy: Sudden hemorrhage or infarction of a pituitary tumor can cause severe headache, often accompanied by visual disturbances and altered mental status.

Rare Diagnoses

  • Trigeminal neuralgia: A condition characterized by sudden, severe, unilateral facial pain, including pain behind the eye, often triggered by specific facial movements.
  • Idiopathic orbital inflammatory disease: A rare condition that can cause pain behind the eye, often accompanied by proptosis, eyelid swelling, and limited eye movement.
  • Ocular myositis: Inflammation of the extraocular muscles can cause pain behind the eye, especially with eye movement, and is often associated with diplopia.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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