Differential Diagnosis for Conjunctivitis with Red Cheeks but No Tenderness Around the Eye

• Single Most Likely Diagnosis
  • Allergic conjunctivitis: This condition is characterized by inflammation of the conjunctiva due to an allergic reaction, often presenting with redness, itching, and tearing. The absence of tenderness around the eye and the presence of red cheeks could be indicative of an allergic reaction, possibly to environmental allergens or irritants.
• Other Likely Diagnoses
  • Viral conjunctivitis: This is a highly contagious infection of the conjunctiva, usually caused by adenovirus. It presents with redness, tearing, and sometimes a watery discharge. The lack of tenderness could suggest a viral etiology, although viral conjunctivitis can sometimes cause mild discomfort.
  • Bacterial conjunctivitis: Although this condition often presents with a purulent discharge and can cause some tenderness, mild cases might not have significant discomfort around the eye. The presence of red cheeks could be part of a systemic response to infection.
• Do Not Miss Diagnoses
  • Orbital cellulitis: Although this condition typically presents with significant tenderness around the eye, early stages or less severe cases might not have pronounced tenderness. It's crucial to consider this diagnosis due to its potential for serious complications, including vision loss and intracranial spread of infection.
  • Sjögren's syndrome: An autoimmune disorder that can cause conjunctivitis among other symptoms. While it might not typically cause tenderness around the eye, its chronic nature and potential for systemic involvement make it a diagnosis not to miss.
• Rare Diagnoses
  • Kawasaki disease: A rare condition in children that can cause conjunctivitis, along with other symptoms like fever, rash, and red cheeks. The absence of tenderness around the eye and the specific combination of symptoms could suggest this diagnosis, especially in pediatric patients.
  • Erythema multiforme: A skin condition that can involve the eyes and cause conjunctivitis. It's characterized by target lesions on the skin and can be associated with systemic symptoms. The presence of red cheeks could be part of the skin manifestations of this condition.