Differential Diagnosis for Ocular Pain and Visual Disturbance
Single Most Likely Diagnosis
- Migraine with Ocular Symptoms: The patient's symptoms of acute onset eye pain, blurry vision, and headaches that are sharp initially then dull, primarily located behind the eyes, and sometimes in the temples, are consistent with migraine headaches. The relief of headaches with Tylenol and triggers such as turning the head or looking up also support this diagnosis.
Other Likely Diagnoses
- Dry Eye Syndrome: This condition can cause eye pain, blurry vision, and headaches. The absence of floaters, which were previously present, could be related to changes in the vitreous humor, but dry eye syndrome is a more common condition that could explain some of the patient's symptoms.
- Vitreous Detachment: The decline in vision and absence of floaters could indicate a vitreous detachment, which can cause eye pain and visual disturbances.
- Tension Headache: The patient's headaches, which are described as sharp initially then dull, could be consistent with tension headaches, which can be triggered by stress, poor posture, or other factors.
Do Not Miss Diagnoses
- Giant Cell Arteritis: This condition can cause sudden vision loss, eye pain, and headaches, and is a medical emergency that requires prompt treatment. Although it is less common, it is critical to rule out this diagnosis due to its potential for severe and irreversible vision loss.
- Acute Angle-Closure Glaucoma: This condition can cause severe eye pain, blurry vision, and headaches, and is a medical emergency that requires immediate treatment to prevent permanent vision loss.
- Optic Neuritis: This condition can cause eye pain, vision loss, and headaches, and can be a sign of an underlying condition such as multiple sclerosis.
Rare Diagnoses
- Ocular Migraine: This condition can cause visual disturbances, including blindness or blurred vision in one eye, and can be accompanied by headaches.
- Sjögren's Syndrome: This autoimmune disorder can cause dry eye syndrome, eye pain, and headaches, and can be associated with other systemic symptoms.
- Cranial Arteritis: This condition can cause headaches, eye pain, and vision loss, and can be a sign of an underlying inflammatory condition.