Differential Diagnosis for Retroorbital Pain
Single Most Likely Diagnosis
- Tension headache: This is a common condition that can cause retroorbital pain due to muscle tension in the face and head. The pain is often described as a dull ache or pressure and can be exacerbated by stress or poor posture.
Other Likely Diagnoses
- Sinusitis: Inflammation of the sinuses can cause pain behind the eyes, especially if the ethmoid or frontal sinuses are affected. Other symptoms may include nasal congestion, facial pressure, and fever.
- Migraine: A migraine headache can cause severe, throbbing pain that may be localized to one eye or spread to the entire head. Sensitivity to light and sound, nausea, and vomiting may also occur.
- Dry eye syndrome: Insufficient tear production or poor tear quality can cause irritation and pain in the eyes, including retroorbital pain. Other symptoms may include blurred vision, redness, and a gritty sensation in the eyes.
Do Not Miss Diagnoses
- Giant cell arteritis: This is an inflammatory condition that affects the blood vessels, including those in the head. It can cause severe, sudden-onset pain in one or both eyes, as well as vision loss, jaw claudication, and scalp tenderness. Prompt diagnosis and treatment are essential to prevent permanent vision loss.
- Cavernous sinus thrombosis: A blood clot in the cavernous sinus can cause severe, retroorbital pain, as well as vision changes, proptosis, and cranial nerve palsies. This is a medical emergency that requires immediate attention.
- Orbital cellulitis: An infection of the tissues surrounding the eye can cause severe pain, redness, swelling, and vision changes. Prompt antibiotic treatment is essential to prevent serious complications.
Rare Diagnoses
- Trigeminal neuralgia: A condition that affects the trigeminal nerve, causing sudden, severe pain in the face, including the eyes. The pain is often described as sharp, stabbing, or electric shock-like.
- Sphenoid sinus mucocele: A rare condition where a mucous-filled cyst forms in the sphenoid sinus, causing retroorbital pain, vision changes, and other symptoms.
- Orbital tumors: Benign or malignant tumors in the orbit can cause retroorbital pain, proptosis, and vision changes. These are rare and often require imaging studies and biopsy for diagnosis.