Differential Diagnosis for Stabbing Pain behind One Eye
Single most likely diagnosis
- Migraine: This is the most likely diagnosis given the symptoms of stabbing pain behind one eye, blurry vision, and aggravation by lights and sounds. Migraines are common in adolescents and can present with a variety of symptoms, including unilateral pain, visual disturbances, and sensitivity to environmental stimuli.
Other Likely diagnoses
- Cluster headache: Although less common than migraines, cluster headaches can cause severe, unilateral pain behind the eye and are often accompanied by autonomic symptoms such as nasal congestion or lacrimation. However, they tend to occur in clusters or cycles, which may not fit perfectly with the described frequency.
- Tension headache: Tension headaches can cause pain behind the eyes, but it is typically bilateral and described as a band or squeezing sensation rather than stabbing. However, some individuals may experience unilateral tension headaches, making this a possible, though less likely, diagnosis.
- Sinusitis: Sinus infections can cause pain behind the eyes, especially if the ethmoid or frontal sinuses are involved. However, this would typically be accompanied by other symptoms such as nasal congestion, fever, or facial pressure.
Do Not Miss diagnoses
- Giant Cell Arteritis (GCA): Although rare in a 17-year-old, GCA can cause severe, unilateral headaches and visual disturbances, including blurry vision. It is essential to consider this diagnosis due to the risk of permanent vision loss if left untreated.
- Idiopathic Intracranial Hypertension (IIH): IIH can cause headaches, blurry vision, and sensitivity to light and sound. It is more common in obese females but can occur in anyone. The diagnosis is crucial due to the potential for permanent vision loss.
- Brain tumor: A brain tumor can cause a variety of symptoms, including headaches, visual disturbances, and sensitivity to light and sound. Although rare, this diagnosis is critical to consider due to its potential impact on morbidity and mortality.
Rare diagnoses
- Trigeminal neuralgia: This condition causes sudden, severe, stabbing pain along the trigeminal nerve, which could include pain behind the eye. However, it is rare in adolescents and typically does not cause blurry vision or sensitivity to light and sound.
- Optic neuritis: Optic neuritis can cause pain behind the eye and blurry vision, but it is typically accompanied by other symptoms such as loss of color vision or aching pain with eye movement. It is more common in young adults and is often associated with multiple sclerosis.
- Ocular migraine: Ocular migraines can cause visual disturbances, including blurry vision, and may be accompanied by headache. However, the visual symptoms are usually more prominent than the headache, and the condition is less common than other types of migraines.