What is the diagnosis for bilateral conjunctival injection, pruritus (itching), dryness, and blurred vision, in the absence of ocular discharge, rhinorrhea (nasal drip), nasal mucopus, and cough?

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Differential Diagnosis

The patient presents with bilateral eye redness, itching, dryness, and blurred vision, without any signs of eye drainage, nasal drip, nasal mucus, or cough. Based on these symptoms, the following differential diagnoses can be considered:

  • Single most likely diagnosis
    • Dry Eye Syndrome: This condition is characterized by insufficient tear production or poor tear quality, leading to dryness, redness, itching, and blurred vision. The absence of nasal symptoms and eye drainage supports this diagnosis.
  • Other Likely diagnoses
    • Allergic Conjunctivitis: Although the patient does not have nasal symptoms, allergic conjunctivitis can still occur without systemic allergic symptoms. Itching and redness are common symptoms, but the absence of eye drainage makes this diagnosis less likely.
    • Blepharitis: This condition involves inflammation of the eyelids, which can cause redness, itching, and dryness. However, it often presents with crusting or discharge, which is not mentioned in the patient's symptoms.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Acute Angle-Closure Glaucoma: This is a medical emergency that can cause blurred vision, redness, and eye pain. Although the patient does not have typical symptoms like severe eye pain or headache, it is essential to rule out this condition due to its potential for vision loss.
    • Sjögren's Syndrome: This autoimmune disorder can cause dry eye syndrome, but it can also be associated with other systemic symptoms. Although it is less likely, missing this diagnosis could lead to delayed treatment of underlying conditions.
  • Rare diagnoses
    • Thygeson's Superficial Punctate Keratitis: This condition is characterized by small, superficial lesions on the cornea, which can cause blurred vision, redness, and eye discomfort. It is a rare condition, but it should be considered in patients with persistent symptoms.
    • Graft-Versus-Host Disease (GVHD): This condition can occur in patients who have undergone bone marrow or stem cell transplants. It can cause dry eye syndrome, among other symptoms. Although it is rare, it is essential to consider this diagnosis in patients with a relevant medical history.

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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