33 yr old F, left temporal severe pain, L eye pain, double vision, nausea, face pain, scalp tender to touch only direct pressure helps. Thoughts?

Headache + eye pain. I am concerned with your symptoms of unilateral headache, visual changes, and scalp tenderness. At 33 y of age, not likely to be a vascular disease. Diagnoses to consider include orbital infection (cellulitis), optic neuritis (inflammation of the optic N.); disorders of the facial nerve (5th nerve, trigeminal neuralgia). Middle ear infection could also be considered. Migraines & headache dz's too.