What are the causes of a watery eye (epiphora) and eye pain (oculargia)?

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Differential Diagnosis for Watery Eye and Painful Eye

  • Single Most Likely Diagnosis
    • Conjunctivitis: This is the most likely diagnosis due to the common presentation of watery eyes and pain, which can be caused by viral or bacterial infections.
  • Other Likely Diagnoses
    • Dry Eye Syndrome: Although it seems counterintuitive, dry eye syndrome can cause watery eyes as a reflex to the dryness, and it can also cause pain.
    • Blepharitis: Inflammation of the eyelids can cause watery eyes and pain due to the irritation of the eyelids and the conjunctiva.
    • Corneal Abrasion: A scratch on the cornea can cause severe pain and watery eyes due to the irritation of the cornea.
  • Do Not Miss Diagnoses
    • Acute Angle-Closure Glaucoma: This is a medical emergency that can cause severe eye pain and watery eyes, and if missed, can lead to permanent vision loss.
    • Orbital Cellulitis: A bacterial infection of the tissues surrounding the eye can cause pain, watery eyes, and swelling, and if not treated promptly, can lead to serious complications.
    • Endophthalmitis: A severe infection of the inner eye can cause pain, watery eyes, and vision loss, and requires prompt treatment to prevent permanent damage.
  • Rare Diagnoses
    • Sjögren's Syndrome: An autoimmune disorder that can cause dry eyes and mouth, but can also cause watery eyes as a reflex to the dryness.
    • Trigeminal Neuralgia: A rare condition that affects the trigeminal nerve and can cause severe pain in the face, including the eyes.
    • Cluster Headaches: A rare type of headache that can cause severe pain around the eye and watery eyes.

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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