Differential Diagnosis for 65 yo with Right Eye Floaters and Headache

• Single most likely diagnosis
  • Posterior Vitreous Detachment (PVD): This condition is common in older adults and can cause sudden onset of floaters due to the vitreous gel shrinking and pulling away from the retina. The headache could be unrelated or due to the patient's increased awareness of their vision.
• Other Likely diagnoses
  • Retinal Detachment: Although less common than PVD, retinal detachment can also cause floaters and is a serious condition that requires prompt treatment. The headache might be due to the physical stress of the detachment.
  • Migraine: Migraines can cause visual disturbances, including floaters, and are often accompanied by headaches. The floaters in this case could be part of a migraine aura.
  • Dry Eye Syndrome: While less directly related to floaters, dry eye can cause discomfort that might be described as headache and could exacerbate existing conditions leading to increased awareness of floaters.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Giant Cell Arteritis (GCA): This condition can cause headaches and visual disturbances, including floaters, and is a medical emergency due to the risk of blindness if not promptly treated.
  • Central Nervous System Lymphoma: Although rare, CNS lymphoma can present with a variety of symptoms including headaches and visual disturbances. It's crucial to consider in the differential due to its severity and the importance of early diagnosis.
  • Pituitary Apoplexy: A rare but potentially life-threatening condition that can cause sudden headache and visual disturbances due to a hemorrhage or infarction of the pituitary gland.
• Rare diagnoses
  • Ocular Lymphoma: A rare condition that can cause a variety of ocular symptoms, including floaters and headaches, due to lymphoma involving the eye.
  • Choroidal Melanoma: Although rare, this is the most common primary malignant tumor of the eye in adults and can cause visual disturbances, including new onset of floaters, especially if it involves the retina or vitreous.