Differential Diagnosis for Grey Patches on Sclera
- Single Most Likely Diagnosis
- Pinguecula: This is the most common condition associated with grey or yellowish patches on the sclera, typically found near the limbus. It is caused by the deposition of lipofuscin-like substances and is often related to UV exposure and aging.
- Other Likely Diagnoses
- Scleral melanosis: This condition involves the deposition of melanin in the sclera, leading to grey or blue-grey patches. It is more common in individuals with darker skin pigmentation.
- Scleromalacia perforans: This is a rare form of scleritis characterized by the thinning and necrosis of the sclera, which can appear as greyish patches due to the loss of scleral tissue.
- Do Not Miss Diagnoses
- Scleral malignancy (e.g., scleral metastasis): Although rare, malignancies can present with grey patches on the sclera. Missing this diagnosis could have severe consequences, making it crucial to consider in the differential diagnosis.
- Sarcoidosis: This systemic disease can cause granulomatous inflammation in the eyes, including the sclera, leading to grey patches. It is essential to recognize and treat sarcoidosis promptly due to its potential for serious complications.
- Rare Diagnoses
- Ochronosis: This condition results from the accumulation of homogentisic acid in the body, leading to the deposition of pigment in various tissues, including the sclera, which can appear as grey or blue-grey patches.
- Alkaptonuria: A rare genetic disorder that affects the metabolism of tyrosine and phenylalanine, leading to the accumulation of homogentisic acid and potential ochronosis, including scleral pigmentation.