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Seen in the ED: Headache and Eye Pain in a Young Adult Man
The man, in his 30s, has seen 2 specialists, received 2 diagnoses, and is now in the ED for persistent pain that is worsened by eye motion. Can you dx?
History of present illness
A man in his 30s presents to the emergency department with 2 days of ongoing left ocular pain with associated headache. He was seen 2 days ago earlier by a local ophthalmologist and was diagnosed with dry eyes. Yesterday he was seen by your EM colleague and diagnosed with a migraine. He denies any visual disturbance, blurry vision, or double vision, but his pain is worse with eye motion.
Vital signs & physical examination
Vital signs are normal. Physical exam is otherwise normal except for images shown below. Intraocular pressure is 12 mm Hg in each eye (normal <21 mm Hg).
What is the most likely diagnosis?
Podcast: New Treatments for Headache: IHC Research Highlights
March 29th 2009Highlights from the International Headache Congress are presented by Stephen D. Silberstein, MD, professor of neurology at Jefferson Medical College and director of the headache center at Thomas Jefferson University, Philadelphia, as well as chair of the congress organizing committee.
