Differential Diagnosis for Sharp Pain Behind Eye, Photophobia, and Transient Blurry Vision
Single Most Likely Diagnosis
- Migraine: This condition is characterized by sharp pain, often localized around or behind one eye, accompanied by photophobia and sometimes transient visual disturbances like blurry vision. The symptoms provided align closely with migraine characteristics, making it a prime candidate for the single most likely diagnosis.
Other Likely Diagnoses
- Cluster Headache: Known for severe, unilateral orbital or periorbital pain, cluster headaches can also present with photophobia and transient visual changes, although the pain is typically more severe and has a distinct periodic pattern.
- Optic Neuritis: Inflammation of the optic nerve can cause sharp pain behind the eye, especially with eye movement, photophobia, and transient vision loss or blurriness. It's a common presentation in demyelinating diseases like multiple sclerosis.
- Dry Eye Syndrome: While typically not as severe, dry eye can cause sharp pain, photophobia, and blurry vision, especially if the condition is severe or if there's an associated corneal abrasion.
Do Not Miss Diagnoses
- Acute Angle-Closure Glaucoma: A medical emergency characterized by severe eye pain, photophobia, and vision loss. It's crucial to diagnose promptly to prevent permanent vision loss.
- Giant Cell Arteritis: Can cause severe headache, jaw claudication, and visual disturbances, including transient blurry vision and photophobia. Missing this diagnosis can lead to permanent vision loss.
- Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can cause severe headache, photophobia, and visual disturbances due to the involvement of cranial nerves.
Rare Diagnoses
- Ocular Migraine (Retinal Migraine): A condition causing transient, reversible vision loss in one eye, often accompanied by a headache. It's less common than migraines without aura but can present with similar photophobia.
- Pituitary Apoplexy: A rare condition where a pituitary tumor suddenly hemorrhages or infarcts, leading to severe headache, visual disturbances (including blurry vision), and sometimes photophobia.
- Idiopathic Intracranial Hypertension (IIH): Can cause headache, transient visual obscurations, and photophobia, especially in obese women of childbearing age. The diagnosis is often made after other causes of headache and visual disturbances have been ruled out.