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Differential Diagnosis for Watery, Itchy Eyes with Injected Sclera

Single Most Likely Diagnosis

  • Allergic Conjunctivitis: This condition is characterized by watery, itchy eyes and injected sclera, which matches the symptoms described. It is a common and benign condition often associated with allergies.

Other Likely Diagnoses

  • Viral Conjunctivitis: This condition can cause watery eyes, itchiness, and an injected sclera. It's highly contagious and can be caused by various viruses, including adenovirus.
  • Blepharitis: Although primarily causing dryness and irritation, some forms of blepharitis can lead to watery eyes and itchiness due to the body's response to the condition.
  • Dry Eye Syndrome: Paradoxically, dry eye can sometimes cause watery eyes as the body overcompensates for the lack of tears. Itchiness and mild injection can also be present.

Do Not Miss Diagnoses

  • Acute Angle-Closure Glaucoma: Although the fundoscopic exam is normal, this condition can cause sudden onset of watery, painful eyes with blurred vision and injected sclera. It's an emergency that requires immediate treatment.
  • Keratitis: Inflammation of the cornea can cause pain, watery eyes, and injection. Certain types, like herpes simplex keratitis, can lead to serious complications if not promptly treated.
  • Uveitis: Inflammation of the uvea can cause eye pain, sensitivity to light, and injection. It can be associated with systemic diseases and requires prompt diagnosis and treatment.

Rare Diagnoses

  • Sjögren's Syndrome: An autoimmune disorder that can cause dry eyes but also occasionally presents with watery eyes due to overcompensation. It's associated with other systemic symptoms.
  • Mycobacterial or Fungal Infections: These can cause chronic conjunctivitis or keratitis with similar symptoms, especially in immunocompromised patients or after trauma.
  • Ocular Rosacea: A condition that can cause eye irritation, itchiness, and injection, often associated with skin rosacea.

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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