What is the diagnosis for a 66-year-old male patient with a painful, swollen, and tearing left eye, which is his only good eye, with symptoms of blurring and pain starting on Tuesday, April 29, 2025, and a history of working as a welder and grinder in the metal shop (CI - Correctional Institution)?

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Differential Diagnosis for 66 yo Male Patient with Left Eye Symptoms

Single Most Likely Diagnosis

  • Foreign Body (FB) in the Eye: The patient's occupation as a welder and grinder in the metal shop increases the risk of foreign bodies entering the eye, causing pain, tearing, and swelling. The patient's symptoms of a foreign body sensation, pain, and blurred vision in the affected eye support this diagnosis.

Other Likely Diagnoses

  • Conjunctivitis: The patient's symptoms of tearing, redness, and discomfort in the eye could be indicative of conjunctivitis, which is a common condition that can be caused by infection, allergy, or irritation.
  • Corneal Abrasion: A corneal abrasion could cause the patient's symptoms of pain, tearing, and blurred vision, especially if a foreign body has scratched the cornea.
  • Dry Eye Syndrome: The patient's symptoms of dryness and discomfort in the eye could be indicative of dry eye syndrome, which is a common condition in older adults.

Do Not Miss Diagnoses

  • Chemical Burn: Although less likely, a chemical burn to the eye could have severe consequences, including permanent vision loss. The patient's occupation in the metal shop increases the risk of exposure to chemicals.
  • Endophthalmitis: This is a rare but potentially devastating infection of the inner eye that can cause severe pain, redness, and vision loss. It is essential to consider this diagnosis, especially if the patient has a history of recent eye surgery or trauma.
  • Acute Angle-Closure Glaucoma: This is a medical emergency that can cause severe eye pain, redness, and vision loss. Although less likely, it is crucial to consider this diagnosis, especially if the patient has a history of glaucoma or other risk factors.

Rare Diagnoses

  • Scleritis: This is a rare inflammatory condition that can cause severe eye pain, redness, and vision loss. It is often associated with systemic diseases, such as rheumatoid arthritis.
  • Uveitis: This is a rare inflammatory condition that can cause eye pain, redness, and vision loss. It can be associated with systemic diseases, such as sarcoidosis or rheumatoid arthritis.

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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