Differential Diagnosis for a 55-year-old Male with Right Eye Pain and Foreign Body Sensation
- Single most likely diagnosis:
- Corneal abrasion: The patient's symptoms of eye pain and foreign body sensation, along with the physical exam finding of a small corneal abrasion, make this the most likely diagnosis. The history of an insect flying into the eye and the subsequent rubbing of the eye also support this diagnosis.
- Other Likely diagnoses:
- Conjunctivitis: The patient's symptoms of eye pain and foreign body sensation could also be consistent with conjunctivitis, especially if the insect introduced bacteria or other irritants into the eye.
- Dry eye syndrome: The patient's mild blurry vision and foreign body sensation could be related to dry eye syndrome, which is common in older adults.
- Blepharitis: The patient's eye pain and foreign body sensation could also be related to blepharitis, an inflammation of the eyelids.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed):
- Endophthalmitis: Although unlikely, endophthalmitis is a serious infection of the inner eye that can occur after a foreign body injury, including an insect flying into the eye. It requires prompt treatment to prevent vision loss.
- Corneal ulcer: A corneal ulcer is a serious infection of the cornea that can occur after a foreign body injury or trauma to the eye. It requires prompt treatment to prevent vision loss.
- Acute angle-closure glaucoma: Although the patient denies any visual disturbances such as halos or vision tunneling, acute angle-closure glaucoma is a medical emergency that can cause eye pain and vision loss if not treated promptly.
- Rare diagnoses:
- Ocular rosacea: The patient's eye pain and foreign body sensation could be related to ocular rosacea, a condition characterized by inflammation of the eyes and eyelids.
- Sjögren's syndrome: The patient's dry eye symptoms could be related to Sjögren's syndrome, an autoimmune disorder that affects the exocrine glands, including the lacrimal gland.