Differential Diagnosis for Lancinating Retroorbital Pain
- Single Most Likely Diagnosis
- Cluster headache: This is the most likely diagnosis due to the characteristic lancinating, retroorbital pain that is often described as sharp and stabbing. Cluster headaches are known for their severe, unilateral pain, typically centered around the eye.
- Other Likely Diagnoses
- Migraine: Migraines can cause severe, unilateral headaches that may be accompanied by retroorbital pain. While the pain is often described as throbbing, some patients may experience a lancinating quality.
- Trigeminal neuralgia: This condition involves sudden, severe, shock-like pain in the face, which can be triggered by minor stimuli. The pain can be retroorbital and is often described as lancinating.
- Optic neuritis: Inflammation of the optic nerve can cause severe, retroorbital pain that may be described as lancinating. This condition often presents with vision loss or changes.
- Do Not Miss Diagnoses
- Temporal arteritis: This condition involves inflammation of the blood vessels in the head and can cause severe, retroorbital pain. It is a medical emergency due to the risk of vision loss if left untreated.
- Pituitary apoplexy: A sudden hemorrhage or infarction of the pituitary gland can cause severe, retroorbital pain, often accompanied by vision changes, headache, and other symptoms.
- Cavernous sinus thrombosis: A blood clot in the cavernous sinus can cause severe, retroorbital pain, often accompanied by vision changes, headache, and other symptoms.
- Rare Diagnoses
- Tolosa-Hunt syndrome: A rare condition characterized by inflammation of the cavernous sinus or superior orbital fissure, causing severe, retroorbital pain, often accompanied by vision changes and other symptoms.
- Raeder syndrome: A rare condition characterized by a combination of symptoms including retroorbital pain, ptosis, and miosis, often due to a lesion in the middle cranial fossa.
- Orbital pseudotumor: A rare, inflammatory condition of the orbit that can cause severe, retroorbital pain, often accompanied by vision changes and other symptoms.