Clinical review: the differential diagnosis of pain in the quiet eye.
BACKGROUND
Eye pain, periorbital and retro-orbital pain, and headache or facial pain referred to the orbital region are common presenting complaints.


RESULTS
In this review, we discuss the etiologies of eye pain in the quiet eye, which is defined clinically as one with a clear cornea without redness or irritation of the conjunctiva or sclera.


CONCLUSIONS
The causes of eye pain may be divided into two groups: (1) those associated with abnormal localizing ophthalmologic and neuro-ophthalmologic findings (including trigeminal neuropathies);(2) those with a normal ophthalmologic and neurologic examinations. The latter group is further divided into the following subgroups: (1) specific short-lasting or long-lasting headache or eye pain syndromes; (2) pain referred to the eye from other pathologic processes (secondary eye pain) sometimes distant from structures concerned with vision; and (3) pain from orbital, superior orbital fissure, cavernous sinus, or intracranial infiltrative, neoplastic, or inflammatory disease processes with normal ophthalmologic and neuro-ophthalmologic exam. Unfortunately, in some patients, no etiology for the pain syndrome is discerned and one is left with a diagnosis of idiopathic eye pain, eye strain, or atypical facial pain.
Brazis
Paul W
PW
Department of Neurology, Mayo Clinics-Jacksonville, Jacksonville, Florida 32224, USA. Brazis.paul@mayo.edu
Lee
Andrew G
AG
Stewart
Michael
M
Capobianco
David
D