How do you differentiate a corneal abrasion from a corneal foreign body?

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Differential Diagnosis for Corneal Abrasion vs Foreign Body in Cornea

Single Most Likely Diagnosis

  • Corneal abrasion: This is the most likely diagnosis due to the high frequency of corneal abrasions from minor trauma, such as rubbing the eye or getting poked by a finger. Symptoms include pain, redness, and sensitivity to light.

Other Likely Diagnoses

  • Foreign body in cornea: A small foreign object, like dust, dirt, or an eyelash, can become lodged in the cornea, causing discomfort, redness, and vision problems. The presence of a foreign body is often accompanied by a history of exposure to debris.
  • Corneal ulcer: An open sore on the cornea, usually caused by infection, can present with symptoms similar to a corneal abrasion or foreign body, including pain, redness, and blurred vision.
  • Conjunctivitis: Inflammation or infection of the conjunctiva, the membrane covering the white part of the eye, can cause redness, itching, and discharge, which might be confused with corneal issues.

Do Not Miss Diagnoses

  • Corneal laceration: A deeper injury to the cornea that can lead to serious complications, including vision loss. It's crucial to distinguish this from a simple abrasion or foreign body due to the potential for severe consequences if not properly treated.
  • Uveitis: Inflammation of the uvea, the middle layer of the eye, which can be caused by trauma, infection, or autoimmune disorders. Uveitis can lead to severe vision loss if not promptly addressed.
  • Endophthalmitis: A severe, sight-threatening infection within the eye that requires immediate medical attention. Though less common, it's a critical diagnosis not to miss, especially in the context of recent trauma or surgery.

Rare Diagnoses

  • Corneal dystrophy: A group of rare, genetic diseases that affect the cornea, leading to progressive vision loss. While not directly related to acute trauma, they can cause chronic symptoms that might be confused with more common corneal issues.
  • Arc eye (photokeratitis): Damage to the cornea caused by intense ultraviolet (UV) radiation, such as from welding without proper eye protection or prolonged exposure to the sun at high altitudes. Symptoms can mimic those of a corneal abrasion or foreign body.

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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