Differential Diagnosis for the 18-year-old Female Patient

The patient presents with symptoms of left eye irritation, clear drainage, sensitivity to light, and a sensation that something is inside or poking her left eye. Given her history of wearing contact lenses and the sudden onset of symptoms after removing the left contact lens, the following differential diagnoses are considered:

• Single most likely diagnosis
  • Contact Lens-Related Infection or Irritation: The patient's symptoms started after removing her contact lens, suggesting a possible infection or irritation related to contact lens use. The clear drainage and sensitivity to light are consistent with this diagnosis.
• Other Likely diagnoses
  • Dry Eye Syndrome: The sensation of something being in the eye and irritation could be related to dry eye syndrome, especially if the patient has been wearing contact lenses for an extended period.
  • Allergic Conjunctivitis: The clear drainage and irritation could be indicative of an allergic reaction, possibly to the contact lens or lens cleaning solution.
  • Corneal Abrasion: Although the patient denies any foreign body entering her eye, a corneal abrasion could have occurred when she removed her contact lens, causing the sensation of something being in her eye.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Endophthalmitis: This is a severe infection of the inner eye that can occur after contact lens use. Although less likely, it is critical to consider due to its potential for severe vision loss and the need for prompt treatment.
  • Corneal Ulcer: A corneal ulcer can develop from an infection and may present with similar symptoms. It requires immediate medical attention to prevent serious complications, including vision loss.
• Rare diagnoses
  • Acute Angle-Closure Glaucoma: This condition is characterized by sudden onset of eye pain, redness, and vision loss, which could be confused with the patient's symptoms. However, it is less likely given the absence of reported vision loss or severe pain.
  • Uveitis: Inflammation of the uvea can cause eye pain, sensitivity to light, and vision problems. While it is a less common condition, it should be considered in the differential diagnosis due to its potential for serious complications if left untreated.