Differential Diagnosis for Eye Irritation

The patient presents with eye irritation, redness, droopiness, watery discharge, and light sensitivity, which have developed over two days. Considering the symptoms and the patient's history of frequent pink eye, the following differential diagnoses are possible:

• Single most likely diagnosis
  • Allergic conjunctivitis or viral conjunctivitis (pink eye): Given the patient's history of recurrent pink eye and the symptoms of redness, irritation, watery discharge, and light sensitivity, this is the most probable diagnosis. The fact that the symptoms have persisted and worsened over a day also aligns with the typical progression of conjunctivitis.
• Other Likely diagnoses
  • Blepharitis: This condition involves inflammation of the eyelids and can cause redness, irritation, and a sensation of something being in the eye. It's a common condition that could explain the patient's symptoms, especially if they have a history of eyelid margin disease.
  • Dry eye syndrome: Although less likely given the watery discharge, dry eye can cause irritation, redness, and light sensitivity. It's possible that the patient has a combination of dry eye and another condition.
  • Foreign body sensation: A small foreign body in the eye, such as an eyelash or dust particle, could cause irritation, redness, and a sensation of something being in the eye. However, this would typically be more acute in onset.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Acute angle-closure glaucoma: This is a medical emergency that can cause severe eye pain, redness, blurred vision, and light sensitivity. Although the patient's symptoms do not fully align with this condition, it's crucial to consider and rule out due to its potential for permanent vision loss.
  • Corneal ulcer: A bacterial or fungal infection of the cornea can cause severe pain, redness, and light sensitivity. This condition requires prompt treatment to prevent vision loss.
  • Endophthalmitis: A rare but serious infection within the eye that can cause severe pain, redness, and vision loss. This condition is more likely in patients who have recently undergone eye surgery or have a history of trauma.
• Rare diagnoses
  • Uveitis: Inflammation of the uvea, which can cause eye pain, redness, and light sensitivity. This condition is less common and might not fully explain the patient's symptoms, but it should be considered in the differential diagnosis.
  • Scleritis: Inflammation of the sclera, which can cause severe eye pain, redness, and light sensitivity. This condition is rare and typically associated with systemic diseases, but it should be considered in patients with persistent and severe symptoms.

Regarding working with patients today, it's essential to take precautions to avoid transmitting any potential infection. If the diagnosis is indeed conjunctivitis, the patient should practice good hygiene, such as frequent handwashing and avoiding touching their eyes. It's also crucial to follow proper infection control protocols when interacting with patients to minimize the risk of transmission.