Differential Diagnosis for 92-year-old Female with Left Eye Redness and Swelling
- Single most likely diagnosis:
- Blepharitis: This condition is characterized by inflammation of the eyelids, which can cause redness, swelling, and irritation, particularly of the lower eyelid. The absence of conjunctival or scleral redness, drainage, fever, pain, or vision changes supports this diagnosis, as blepharitis often presents with localized symptoms to the eyelid.
- Other Likely diagnoses:
- Hordeolum (Stye): A localized infection or inflammation of the eyelid margin, which can cause redness, swelling, and irritation. The lack of reported pain or fever might make this less likely, but it remains a consideration.
- Chalazion: A small bump on the eyelid due to a blocked oil gland, which can cause swelling and redness. It is usually painless but can become inflamed, leading to symptoms similar to those described.
- Allergic Conjunctivitis: Although the patient denies redness of the conjunctiva or sclera, mild forms of allergic conjunctivitis could potentially present with eyelid symptoms without significant conjunctival involvement.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.):
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can lead to severe complications if not promptly treated. Although the patient denies fever, pain, or vision changes, any sign of eyelid swelling and redness warrants consideration of this potentially serious condition.
- Herpes Zoster Ophthalmicus: Shingles affecting the eye, which can present with eyelid swelling and redness, among other symptoms. It's crucial to consider this diagnosis due to the potential for serious ocular complications.
- Rare diagnoses:
- Sarcoidosis: A systemic disease that can affect the eyes, causing uveitis, conjunctivitis, or eyelid swelling. It would be an unusual presentation but should be considered in the differential diagnosis of unexplained eyelid swelling.
- Malignancy (e.g., Basal Cell Carcinoma, Squamous Cell Carcinoma): Although rare, certain types of skin cancers can present with swelling and redness of the eyelid. Given the patient's age, it's essential to consider malignant causes, especially if the condition does not respond to initial treatments.