Differential Diagnosis for a 43-year-old Female with Right Eye Sensitivity and Pain
Single most likely diagnosis
- Dry Eye Syndrome: This is a common condition that can cause eye sensitivity and pain, especially if the patient has a history of dry eyes or has been exposed to dry environments. The symptoms of dryness, irritation, and pain are consistent with this diagnosis.
Other Likely diagnoses
- Conjunctivitis: This is an inflammation or infection of the outer membrane of the eyeball and the inner eyelid. It can be caused by a virus, bacteria, or allergens, and symptoms include redness, itching, and discharge, which could explain the sensitivity and pain.
- Blepharitis: An inflammation of the eyelids that can cause eye sensitivity, pain, and redness. It's often associated with a bacterial or demodex mite infestation.
- Corneal Abrasion: A scratch on the surface of the eye that can cause significant pain, sensitivity to light, and a feeling of something being in the eye.
Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Acute Angle-Closure Glaucoma: A medical emergency that requires immediate attention. Symptoms include severe eye pain, blurred vision, headache, nausea, and vomiting, along with eye redness and sensitivity. Missing this diagnosis can lead to permanent vision loss.
- Endophthalmitis: A severe inflammation of the interior of the eye, usually caused by infection. Symptoms include severe eye pain, redness, decreased vision, and swelling. It's a rare but potentially devastating condition that requires prompt treatment.
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can cause pain, swelling, redness, and decreased eye movement. It can lead to serious complications if not treated promptly.
Rare diagnoses
- Scleritis: A severe inflammatory disease that affects the sclera (the white part of the eye). It can cause severe pain, redness, and sensitivity to light, and is often associated with systemic autoimmune disorders.
- Uveitis: Inflammation of the uvea, the middle layer of the eye, which can cause eye pain, sensitivity to light, and vision problems. It can be associated with systemic diseases or infections.
- Optic Neuritis: Inflammation of the optic nerve, which can cause pain with eye movement, vision loss, and sensitivity to light. It's often associated with demyelinating diseases like multiple sclerosis.