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Pain in the quiet (not red) eye
David C Fiore1, Andrew V Pasternak, Rabab M Radwan
1University of Nevada School of Medicine, Reno, Nevada 89557, USA. dfiore@medicine.nevada.edu
American Family Physician
|July 2, 2010
Summary
Eye pain without redness can signal serious issues like acute narrow-angle glaucoma or giant cell arteritis. A systematic approach is crucial for diagnosing these quiet eye pain causes.
Area of Science:
- Ophthalmology
- Neurology
- Vascular Medicine
Background:
- Eye pain can occur with a "quiet eye," meaning without visible redness or injection.
- This "quiet eye" presentation can mask serious underlying conditions, necessitating careful evaluation.
Purpose of the Study:
- To outline the differential diagnosis of eye pain in the context of a quiet eye.
- To emphasize the importance of a systematic approach to identify potentially vision-threatening or systemic conditions.
Main Methods:
- Review of ophthalmologic and non-ophthalmologic causes of eye pain.
- Discussion of emergent conditions requiring immediate treatment and referral.
- Consideration of referred pain and neurological conditions.
Main Results:
- Quiet eye pain can indicate emergent conditions like acute narrow-angle glaucoma.
- Systemic conditions such as giant cell arteritis, carotid artery disease, and neurological disorders (e.g., trigeminal neuralgia, migraine) can cause referred eye pain.
- A broad differential diagnosis is essential for accurate patient management.
Conclusions:
- Eye pain in a quiet eye requires a thorough and systematic diagnostic evaluation.
- Prompt recognition and management of underlying causes are critical to prevent vision loss and address systemic health.
- The differential diagnosis encompasses ophthalmologic, vascular, and neurologic conditions.
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