Differential Diagnosis for a 22-year-old Contact Lens Wearer with Eye Redness, Excessive Tearing, and Pain with Light

• Single Most Likely Diagnosis
  • Contact Lens-Related Irritation or Infection: This is the most likely diagnosis given the patient's history of contact lens wear. Irritation or infection from the contact lenses can cause eye redness, excessive tearing, and pain, especially with light exposure (photophobia).
• Other Likely Diagnoses
  • Dry Eye Syndrome: Prolonged wear of contact lenses can lead to dry eye syndrome, which causes eye irritation, redness, and excessive tearing.
  • Allergic Conjunctivitis: An allergic reaction to the contact lenses or the cleaning solution can cause similar symptoms.
  • Blepharitis: Inflammation of the eyelids can cause eye redness, irritation, and tearing, and is common in contact lens wearers.
• Do Not Miss Diagnoses
  • Corneal Ulcer: Although less likely, a corneal ulcer is a serious condition that can result from contact lens wear, especially if the lenses are not cleaned properly. It can cause severe pain, redness, and vision loss if not treated promptly.
  • Acute Angle-Closure Glaucoma: This is a medical emergency that can cause eye pain, redness, and vision loss. While it's less common in young individuals, it's crucial not to miss this diagnosis.
  • Herpes Simplex Keratitis: A viral infection that can cause eye pain, redness, and vision loss. It's essential to consider this diagnosis to prevent long-term complications.
• Rare Diagnoses
  • Sjögren's Syndrome: An autoimmune disorder that can cause dry eyes and mouth, but it's less common in young individuals.
  • Thygeson's Superficial Punctate Keratitis: A rare condition characterized by small, superficial lesions on the cornea, causing eye irritation and vision disturbances.