Differential Diagnosis for Throbbing Pain Off and On Behind One Eye
- Single Most Likely Diagnosis
- Migraine: This is the most common cause of throbbing, unilateral headaches. Migraines can be accompanied by sensitivity to light, sound, or smells, and may be preceded by an aura. The pain is often described as pulsating and can be exacerbated by physical activity.
- Other Likely Diagnoses
- Cluster Headache: Known for severe, unilateral orbital, supraorbital, or temporal pain, cluster headaches occur in cyclical patterns or clusters. They are often accompanied by autonomic symptoms like nasal congestion, rhinorrhea, or ptosis on the same side as the headache.
- Tension-Type Headache: Although typically bilateral, tension-type headaches can occasionally present unilaterally and may cause a sensation of pressure or tightness around the eyes.
- Sinusitis: Inflammation of the sinuses can cause pain and pressure in the face, particularly around the eyes, and can be accompanied by nasal congestion and discharge.
- Do Not Miss Diagnoses
- Temporal Arteritis (Giant Cell Arteritis): This condition is an inflammation of the blood vessels and can cause severe, unilateral headaches, often accompanied by jaw claudication and visual disturbances. It is a medical emergency due to the risk of blindness if not promptly treated.
- Acute Angle-Closure Glaucoma: Characterized by severe eye pain, blurred vision, and often accompanied by nausea and vomiting. It is an ophthalmologic emergency requiring immediate treatment to prevent permanent vision loss.
- Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can cause headache, fever, and cranial nerve deficits. It often arises from facial or sinus infections.
- Rare Diagnoses
- Trigeminal Neuralgia: A chronic pain condition that affects the trigeminal nerve, causing intense shock-like or stabbing pain in parts of the face, which can include the area around the eyes.
- Occipital Neuralgia: Involves the occipital nerves and can cause severe, stabbing pain on one side of the head, often starting at the base of the skull and radiating to the eye.
- Idiopathic Intracranial Hypertension (IIH): Also known as pseudotumor cerebri, it can cause headaches that are often worse in the morning and can be accompanied by transient visual obscurations and papilledema.