Differential Diagnosis
The patient's symptoms of pain behind the eye, red eye, head pressure, and pain in the jaw and teeth on the right side can be attributed to various conditions. Here's a categorized differential diagnosis:
- Single most likely diagnosis
- Cluster headache: This condition is characterized by severe, unilateral pain typically centered around the eye, accompanied by autonomic symptoms like conjunctival injection (red eye) and nasal congestion. The pain can radiate to the jaw and teeth, and the absence of tooth infections or cavities supports this diagnosis.
- Other Likely diagnoses
- Migraine: Migraines can cause unilateral head pressure, pain behind the eye, and jaw pain. They are often accompanied by sensitivity to light and sound, but these symptoms are not mentioned.
- Temporomandibular joint (TMJ) disorder: TMJ disorders can cause jaw pain, pain in the teeth, and referred pain to the face and eye area due to the complex innervation of the trigeminal nerve.
- Sinusitis: Inflammation of the sinuses can cause pain behind the eye, head pressure, and facial pain, including jaw pain. However, sinusitis typically presents with other symptoms like nasal congestion and discharge.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Acute angle-closure glaucoma: This is an ophthalmic emergency that presents with severe eye pain, redness, and decreased vision. It requires immediate medical attention to prevent permanent vision loss.
- Cerebral venous sinus thrombosis: This condition can cause headache, facial pain, and eye pain due to increased intracranial pressure. It is a rare but potentially life-threatening condition.
- Giant cell arteritis: This condition can cause headache, jaw claudication, and visual disturbances, including pain behind the eye. It is a medical emergency due to the risk of permanent vision loss if not promptly treated.
- Rare diagnoses
- Trigeminal neuralgia: This condition causes sudden, severe, shock-like pain around the eye, lips, or nose, typically triggered by light touch. It is less likely given the constellation of symptoms but should be considered if other diagnoses are ruled out.
- Raeder's syndrome: A rare condition characterized by a combination of symptoms including unilateral facial pain, ptosis (drooping eyelid), and miosis (constricted pupil), often associated with a Horner's syndrome. It is due to a lesion in the middle cranial fossa affecting the sympathetic nerves.