Differential Diagnosis for Floaters in Vision with Headache
- Single most likely diagnosis
- Migraine: This condition is characterized by headaches and visual disturbances, including floaters. The floaters can be part of the aura phase of a migraine, which often precedes the headache.
- Other Likely diagnoses
- Posterior Vitreous Detachment (PVD): This is a common condition where the vitreous gel in the eye separates from the retina, causing floaters. It can be accompanied by flashes of light and, occasionally, headache.
- Tension Headache with Visual Disturbances: Tension headaches are common and can cause visual disturbances, including floaters, due to muscle tension around the eyes and head.
- Dry Eye Syndrome: Although less directly linked to headache, severe dry eye can cause visual disturbances, including the perception of floaters, and may be accompanied by headache due to eye strain.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Retinal Detachment: This is a medical emergency where the retina separates from the back of the eye. Symptoms include sudden onset of floaters, flashes of light, and vision loss. It requires immediate treatment to preserve vision.
- Giant Cell Arteritis: This condition involves inflammation of the arteries and can cause headaches, visual disturbances (including floaters), and even blindness if not promptly treated.
- Pituitary Apoplexy: A rare but life-threatening condition where a pituitary tumor suddenly hemorrhages or infarcts, leading to severe headache, visual disturbances (which can include floaters), and other neurological symptoms.
- Rare diagnoses
- Ocular Malignancies (e.g., Choroidal Melanoma): Rarely, floaters and headache can be symptoms of eye cancers, which are critical to diagnose early for effective treatment.
- Intraocular Inflammation (Uveitis): This can cause floaters and headache among other symptoms and, while not typically deadly, requires prompt treatment to prevent vision loss.
- Acute Angle-Closure Glaucoma: A medical emergency characterized by sudden, severe eye pain, headache, blurred vision, and seeing halos around lights, which can also include floaters due to the acute increase in intraocular pressure.