What is the cause of erythema (redness) under the lower eyelid without accompanying pain or changes in vision?

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Differential Diagnosis for Redness under Bottom Eye Lid

Single most likely diagnosis

  • Allergic conjunctivitis: This is the most likely diagnosis due to the presence of redness under the bottom eyelid without pain or vision change, which are common symptoms of an allergic reaction.

Other Likely diagnoses

  • Blepharitis: Inflammation of the eyelids can cause redness and swelling, and it's a common condition that may not necessarily be accompanied by pain or vision changes.
  • Dry eye syndrome: Insufficient tear production or poor tear quality can lead to redness and irritation under the eyelids, often without significant pain or vision changes.
  • Ectropion or entropion: Abnormal positioning of the eyelid can cause redness and irritation under the eyelid, especially if the eyelid is not functioning properly.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed)

  • Basal cell carcinoma or other eyelid tumors: Although rare, eyelid tumors can present with redness and swelling under the eyelid, and early detection is crucial for effective treatment.
  • Orbital cellulitis: A severe infection of the tissues surrounding the eye can cause redness, swelling, and pain, but early stages may not have significant pain or vision changes.
  • Angioedema: A severe allergic reaction can cause rapid swelling of the eyelids and face, which can be life-threatening if not treated promptly.

Rare diagnoses

  • Sjögren's syndrome: An autoimmune disorder that can cause dry eye syndrome and other ocular symptoms, including redness under the eyelid.
  • Sarcoidosis: A systemic inflammatory disease that can affect the eyes and cause redness, swelling, and other symptoms under the eyelid.
  • Relapsing polychondritis: A rare autoimmune disorder that can cause inflammation of the cartilage and other tissues, including the eyelids, leading to redness and swelling.

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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