What causes pruritus (itching) of the eye?

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Differential Diagnosis for Itchy Eye

  • Single most likely diagnosis
    • Allergic conjunctivitis: This is the most common cause of itchy eyes, often associated with other allergic symptoms such as sneezing, runny nose, and nasal congestion. It occurs due to an allergic reaction to substances like pollen, dust mites, or pet dander.
  • Other Likely diagnoses
    • Dry eye syndrome: This condition can cause itchiness, irritation, and a sensation of grittiness in the eyes, often due to inadequate tear production or poor tear quality.
    • Blepharitis: Inflammation of the eyelids can lead to itchy, red, and swollen eyelids, often associated with crusting or scaling around the eyelashes.
    • Conjunctivitis (viral or bacterial): While not always itchy, some forms of conjunctivitis can cause itchiness along with redness, discharge, and irritation.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Acute angle-closure glaucoma: Although rare, this condition can present with severe eye pain, redness, and blurred vision, and sometimes itchiness. It's an emergency that requires immediate medical attention to prevent permanent vision loss.
    • Orbital cellulitis: A serious infection of the tissues surrounding the eye, which can cause pain, swelling, redness, and sometimes itchiness. Prompt treatment is necessary to prevent serious complications.
  • Rare diagnoses
    • Ocular rosacea: A condition characterized by inflammation of the eyes and eyelids, often associated with rosacea of the skin. It can cause itchiness, redness, and burning sensations.
    • Keratoconus: A progressive eye disease that can cause vision problems, eye irritation, and sometimes itchiness due to the irregular shape of the cornea.
    • Phlyctenular keratoconjunctivitis: A rare condition often associated with allergic reactions or immune system disorders, causing small, nodular lesions on the conjunctiva or cornea, which can be itchy.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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