Differential Diagnosis for Ice Pick Right Eye Pain Headache

• Single most likely diagnosis
  • Cluster headache: This condition is characterized by severe, unilateral orbital or periorbital pain, often described as sharp or stabbing, which can be accompanied by headache. The "ice pick" description fits well with the sharp, stabbing quality of pain often reported in cluster headaches.
• Other Likely diagnoses
  • Migraine with aura: Some migraines can present with sharp, stabbing pains, especially if they involve the eye. The headache associated with migraines can be severe and may be preceded by an aura, which could potentially include visual disturbances perceived as affecting one eye.
  • Trigeminal neuralgia: This condition involves sudden, severe, shock-like or stabbing pain around the eyes, lips, or nose mainly because of abnormal blood vessels pressing on the trigeminal nerve in the head. The pain of trigeminal neuralgia can be triggered by minor stimuli and is typically confined to one side of the face.
  • Optic neuritis: This is an inflammation of the optic nerve that can cause pain, especially with eye movement, and is often described as sharp or stabbing. It usually affects one eye and can be associated with vision loss.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Acute angle-closure glaucoma: This is a medical emergency that presents with severe eye pain, often accompanied by headache, nausea, vomiting, and blurred vision. The pain can be described as sharp or stabbing and is usually unilateral.
  • Temporal arteritis (Giant Cell Arteritis): This condition can cause severe, sharp headaches and visual disturbances, including pain in one eye. It's a medical emergency because it can lead to blindness if not promptly treated.
  • Cavernous sinus thrombosis: A rare but potentially life-threatening condition that can cause severe headache, eye pain, and visual disturbances due to a blood clot in the cavernous sinus.
• Rare diagnoses
  • Ocular melanoma: Though rare, a melanoma in the eye can cause pain, especially if it involves the iris or ciliary body, and can be associated with headache.
  • Tolosa-Hunt syndrome: A rare disorder characterized by severe and unilateral headaches with extraocular palsies, which can cause sharp pains around the eye.
  • Raeder syndrome: A rare condition that involves a combination of facial pain (often described as sharp or stabbing), miosis, and ptosis, usually affecting one side of the face.