Differential Diagnosis for Right Sided Temple Pain, Blurry Vision, and Bulge over Right Temple
- Single Most Likely Diagnosis
- Temporal Arteritis: This condition is characterized by inflammation of the temporal arteries, leading to headache, visual disturbances, and sometimes a palpable mass or bulge over the affected artery. The combination of temple pain, blurry vision, and a bulge over the right temple, especially in an individual over 50, makes temporal arteritis a strong consideration.
- Other Likely Diagnoses
- Migraine with Aura: Migraines can cause severe headaches, often unilateral, and may be accompanied by visual auras, which could explain the blurry vision. However, the presence of a bulge is less typical.
- Cluster Headache: These are extremely painful headaches that occur in cycles or clusters, often on one side of the head, and can be associated with autonomic symptoms like ptosis or lacrimation, but a bulge is not a common feature.
- Orbital Pseudotumor (Idiopathic Orbital Inflammatory Disease): This condition involves inflammation of the tissues around the eye without an identifiable cause, leading to pain, swelling, and sometimes visual disturbances.
- Do Not Miss Diagnoses
- Giant Cell Arteritis with Ophthalmic Artery Involvement: Similar to temporal arteritis but with a higher risk of blindness if not promptly treated. The visual symptoms are particularly alarming and necessitate immediate investigation.
- Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can cause headache, visual disturbances, and sometimes a bulge due to venous congestion. It requires urgent diagnosis and treatment.
- Meningioma or Other Intracranial Tumors: Although less common, tumors can cause localized pain, visual disturbances due to compression of nearby structures, and sometimes a palpable mass if they erode through the skull.
- Rare Diagnoses
- Trigeminal Neuralgia: Characterized by intense pain along a branch of the trigeminal nerve, which could potentially cause unilateral facial pain. However, visual symptoms and a bulge are not typical features.
- Eosinophilic Granuloma (Langerhans Cell Histiocytosis): A rare condition that can cause localized bony lesions, potentially leading to pain and a bulge, but it's less commonly associated with the specific combination of symptoms described.
- Arteriovenous Malformation (AVM): An abnormal connection between arteries and veins, which can cause a variety of symptoms depending on its location, including headache and visual disturbances if it affects the brain or eye structures.