Approach to Eye Pain: Differential Diagnosis and Work Up for the Neurologist.

IF 4.8 2区医学 Q1 CLINICAL NEUROLOGY

Current Neurology and Neuroscience Reports Pub Date : 2025-07-12 DOI:10.1007/s11910-025-01436-4

Jennifer Robblee, Jay N Patel

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Abstract

Purpose of review: Eye pain is a common but diagnostically complex symptom. The underlying etiologies span neurologic, ophthalmologic, and systemic conditions that range from benign to vision- or life-threatening. This review aims to provide a neurologist-oriented approach to the differential diagnosis of eye pain, emphasizing clinical reasoning and red flag identification.

Recent findings: Ocular inflammation and surface disorders are commonly diagnosed etiologies for eye pain but neurologic disorders including primary headaches may be underrecognized sources of eye pain. Clinical clues like the pain description and location, patterns of visual disturbances, and other associated symptoms can guide diagnosis. Exam clues like optic disc edema, cranial nerve abnormalities, red eye pattern, ocular bruit, and intraocular pressure can guide localization and referral urgency. Integration of targeted history, key physical exam findings, and judicious use of investigations are critical for identifying vision- or life-threatening pathology. Using a focused history with targeted neurologic and ophthalmologic examinations, neurologists will be able to choose appropriate investigations and identify when urgent ophthalmology referral is required. This review outlines a systematic, symptom-based approach to eye pain so that neurologists can identify urgent conditions, improve diagnostic efficiency, and collaborate effectively with ophthalmology.

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眼痛的方法：神经科医生的鉴别诊断和工作。

回顾目的：眼痛是一种常见但诊断复杂的症状。潜在的病因包括神经、眼科和全身疾病，从良性到视力或危及生命。这篇综述的目的是提供一个以神经学家为导向的方法来鉴别诊断眼痛，强调临床推理和危险信号识别。最近发现：眼炎症和眼表疾病是眼痛的常见病因，但包括原发性头痛在内的神经系统疾病可能是眼痛的未被充分认识的病因。临床线索，如疼痛的描述和位置，视觉障碍的模式，以及其他相关症状可以指导诊断。视盘水肿、颅神经异常、红眼、眼瘀伤、眼压等检查线索可指导定位和转诊急症。整合目标病史、关键体检结果和明智地使用调查对于识别视力或危及生命的病理至关重要。通过有针对性的神经和眼科检查，神经科医生将能够选择适当的调查，并确定何时需要紧急眼科转诊。这篇综述概述了一种系统的，基于症状的方法来治疗眼痛，以便神经科医生能够识别紧急情况，提高诊断效率，并与眼科有效合作。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Neurology and Neuroscience Reports 医学-临床神经学

CiteScore

9.20

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Current Neurology and Neuroscience Reports provides in-depth review articles contributed by international experts on the most significant developments in the field. By presenting clear, insightful, balanced reviews that emphasize recently published papers of major importance, the journal elucidates current and emerging approaches to the diagnosis, treatment, management, and prevention of neurological disease and disorders. Presents the views of experts on current advances in neurology and neuroscience Gathers and synthesizes important recent papers on the topic Includes reviews of recently published clinical trials, valuable web sites, and commentaries from well-known figures in the field.