What is the cause of a 34-year-old female's left eye irritation, which began after rubbing her eye, with no improvement after flushing, and no associated symptoms such as visual changes, drainage, or fever, in a patient who wears contact lenses (contact lens wearer) sporadically?

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Differential Diagnosis for Left Eye Irritation

  • Single most likely diagnosis
    • Foreign body (e.g., eyelash or other small particle): The patient's symptoms started after rubbing her eye, and she has tried flushing it with no improvement, which suggests a foreign body could be the cause.
  • Other Likely diagnoses
    • Dry eye: As a contact lens wearer, even sporadically, the patient may be prone to dry eye, which could cause irritation.
    • Allergic conjunctivitis: Although the patient doesn't report any associated symptoms like itching or redness, allergic conjunctivitis could still be a possibility, especially if she has allergies.
    • Blepharitis: This is an inflammation of the eyelids that can cause irritation, and it's common in people who wear contact lenses.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Corneal ulcer: Although the patient denies any visual changes or significant pain, a corneal ulcer could be a possibility, especially if she has a history of contact lens use, which increases the risk.
    • Acute angle-closure glaucoma: This is a medical emergency that can cause eye pain, redness, and vision changes, but sometimes the symptoms can be subtle, so it's essential to consider it in the differential diagnosis.
    • Endophthalmitis: This is a rare but serious infection of the inner eye that can occur in contact lens wearers, and it requires prompt treatment to prevent vision loss.
  • Rare diagnoses
    • Sjögren's syndrome: This is an autoimmune disorder that can cause dry eye and other symptoms, but it's relatively rare and would require further evaluation to diagnose.
    • Episcleritis: This is an inflammation of the episclera, a thin layer of tissue on the white part of the eye, which can cause irritation and redness, but it's not as common as other causes of eye irritation.

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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