Differential Diagnosis for Lower Eyelid Swelling
Single Most Likely Diagnosis
- Blepharitis: This is a common condition characterized by inflammation of the eyelids, often resulting from a bacterial or demodex mite infestation. The presence of lower eyelid swelling with minimal clear drainage and a clear, non-injected sclera supports this diagnosis, as blepharitis typically does not cause significant ocular discharge or injection.
Other Likely Diagnoses
- Allergic Conjunctivitis: Although the sclera is clear and non-injected, allergic reactions can sometimes present with eyelid swelling. The minimal clear drainage could be consistent with allergic conjunctivitis, especially if the patient has a history of allergies.
- Hordeolum (Stye): A localized infection or inflammation of the eyelid margin, which could cause swelling. However, a stye usually presents with more localized pain and possibly a visible abscess.
- Chalazion: A blocked oil gland in the eyelid can cause swelling. It is usually painless and can present with minimal to no discharge.
Do Not Miss Diagnoses
- Orbital Cellulitis: Although less likely given the absence of significant injection or vision changes, orbital cellulitis is a serious infection that requires prompt treatment. It can present with eyelid swelling, and even if the sclera appears clear, the potential for severe complications makes it a "do not miss" diagnosis.
- Thyroid-Associated Orbitopathy: This condition can cause eyelid swelling among other symptoms. While it might not be the first consideration, missing this diagnosis could lead to delayed treatment of a significant underlying condition.
Rare Diagnoses
- Sarcoidosis: A systemic disease that can affect the eyes, causing uveitis, conjunctivitis, or eyelid swelling. It's less common but should be considered in the differential, especially if other systemic symptoms are present.
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect various parts of the body, including the eyes, and cause a range of symptoms including eyelid swelling. Given its rarity and potential severity, it remains a diagnosis to consider in complex or atypical presentations.