What are the likely diagnoses for unilateral conjunctivitis (pink eye) with watery discharge, absent pruritus (itching)?

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Differential Diagnosis for Unilateral Pink Eye

Single Most Likely Diagnosis

  • Viral conjunctivitis: This is the most common cause of unilateral pink eye, characterized by watery discharge and the absence of itching. It is highly contagious and often accompanied by a viral upper respiratory infection.

Other Likely Diagnoses

  • Bacterial conjunctivitis: Although it typically presents with a thicker, more purulent discharge, some bacterial conjunctivitis cases can have a watery discharge, especially in the early stages.
  • Allergic conjunctivitis: While allergic conjunctivitis is usually itchy and bilateral, some cases can be unilateral and less itchy, especially if the allergen exposure is asymmetric.
  • Irritant conjunctivitis: Exposure to a chemical irritant or a foreign body in the eye can cause unilateral pink eye with watery discharge.

Do Not Miss Diagnoses

  • Acute angle-closure glaucoma: Although rare, this condition is an emergency that can present with unilateral redness, watery discharge, and severe eye pain. It requires immediate medical attention to prevent vision loss.
  • Herpes simplex keratitis: This viral infection can cause unilateral pink eye, and if left untreated, can lead to serious complications, including vision loss.
  • Corneal ulcer: A bacterial or fungal infection of the cornea can present with unilateral redness, watery discharge, and severe eye pain, requiring prompt medical attention to prevent vision loss.

Rare Diagnoses

  • Sjögren's syndrome: An autoimmune disorder that can cause unilateral or bilateral dry eye, but in some cases, can present with watery discharge due to inflammation.
  • Sarcoidosis: A systemic disease that can cause uveitis, which may present with unilateral pink eye and watery discharge.
  • Tuberculosis: Rarely, tuberculosis can cause conjunctivitis, which may present with unilateral pink eye and watery discharge.

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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