Differential Diagnosis for 72-year-old Female with Left Eye Drainage and Redness
- Single most likely diagnosis:
- Viral conjunctivitis: This is the most likely diagnosis given the patient's symptoms of eye drainage and redness, recent exposure to grandchildren (suggesting a possible infectious cause), and improvement with warm compresses. The absence of severe symptoms such as photophobia, eye pain, or fever also supports this diagnosis.
- Other Likely diagnoses:
- Bacterial conjunctivitis: Although less likely than viral conjunctivitis due to the lack of purulent discharge description, it remains a possibility, especially if the condition does not improve with supportive care.
- Allergic conjunctivitis: Given the seasonal variability and potential exposure to allergens, this could be considered, especially if the patient reports itchiness or a history of allergies.
- Blepharitis: This condition involves inflammation of the eyelids and could present with similar symptoms, including redness and discharge, particularly if associated with meibomian gland dysfunction.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Acute angle-closure glaucoma: Although the patient denies photophobia, severe eye pain, and visual changes, this condition is an emergency and must be ruled out due to its potential for permanent vision loss.
- Orbital cellulitis: The absence of fever and severe pain makes this less likely, but it's crucial to consider due to its potential severity and need for prompt antibiotic treatment.
- Herpes zoster ophthalmicus: Given the patient's age, this condition, which involves shingles affecting the eye, could lead to serious complications, including vision loss, and should be considered even in the absence of a clear rash.
- Rare diagnoses:
- Dacryocystitis: Inflammation of the lacrimal sac, which could cause eye redness and discharge, but is less common and typically associated with a specific history of nasolacrimal duct obstruction.
- Sjögren's syndrome: An autoimmune disorder that can cause dry eyes and potentially some discharge, but would be unusual as a new presentation in this context without other systemic symptoms.
- Foreign body: Although the patient denies injury, a small foreign body could potentially cause irritation and should be considered, especially if symptoms persist or worsen.