Differential Diagnosis for Corneal Haziness with Neovascularization and Watery Discharge

• Single Most Likely Diagnosis
  • Keratoconjunctivitis Sicca (Dry Eye Syndrome): This condition often presents with corneal haziness due to inflammation and can lead to neovascularization as a result of chronic inflammation. The watery discharge can be a reflex response to the irritation, although the primary issue is a lack of the aqueous layer of the tear film.
• Other Likely Diagnoses
  • Allergic Conjunctivitis: This condition can cause significant discomfort, watery discharge, and may lead to corneal changes including neovascularization if left untreated or if severe. The allergic response can cause chronic inflammation.
  • Blepharitis: Chronic inflammation of the eyelids can lead to corneal complications, including neovascularization and haziness, due to the constant irritation and potential for secondary infections.
  • Corneal Ulcer: An ulcer on the cornea can present with haziness, neovascularization as the body attempts to heal the defect, and a watery discharge. The cause can be infectious (bacterial, viral, or fungal) or non-infectious.
• Do Not Miss Diagnoses
  • Acute Angle-Closure Glaucoma: Although less common, this condition is an emergency and can present with corneal edema (leading to haziness), severe eye pain, and a mid-dilated pupil. The watery discharge might not be the primary symptom, but the condition's severity warrants its inclusion.
  • Herpes Simplex Keratitis: This viral infection can cause corneal inflammation, leading to haziness and neovascularization. It's crucial to diagnose and treat promptly to prevent long-term vision loss.
• Rare Diagnoses
  • Lymphangiectasia: A rare condition where there's an abnormal formation of lymphatic vessels in the cornea, potentially leading to corneal edema and neovascularization.
  • Interstitial Keratitis: Inflammation of the corneal stroma, which can be caused by various factors including infections (syphilis, tuberculosis) or systemic diseases, leading to corneal haziness and neovascularization.