Differential Diagnosis for Swollen Right Upper Eyelid with Pain

• Single most likely diagnosis
  • Blepharitis: This condition is characterized by inflammation of the eyelids, which can cause swelling, pain, and tenderness. The pain can radiate to the head and cheek, and it often occurs without fever. Given the symptoms of a swollen right upper eyelid with pain traveling to the head and cheek, blepharitis is a plausible diagnosis due to its common presentation and the fact that it can be non-tender and occur in the absence of fever.
• Other Likely diagnoses
  • Hordeolum (Stye): A stye is an infection of the sebaceous glands of Zeis at the base of the eyelashes or an apocrine sweat gland of Moll. It can cause localized pain, swelling, and redness of the eyelid. While it's typically tender, some styes may not be as painful, fitting the non-tender description.
  • Chalazion: This is a small bump on the eyelid due to a blocked oil gland. It can cause swelling and, occasionally, pain that might radiate, although it's often more localized. Chalazia are usually non-tender and can grow large enough to cause discomfort and swelling of the eyelid.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Orbital Cellulitis: Although the patient is afebrile and the swelling is described as non-tender, orbital cellulitis is a serious infection that requires prompt treatment. It can cause eyelid swelling, pain (which can radiate), and proptosis. The absence of fever does not rule out this diagnosis, especially in its early stages or in partially treated cases.
  • Cavernous Sinus Thrombosis: This is a rare but potentially life-threatening condition that can arise from facial infections, including those of the eyelid. Symptoms can include eyelid swelling, pain, and neurological signs. Early recognition is crucial for effective management.
• Rare diagnoses
  • Sarcoidosis: This systemic disease can cause uveitis, conjunctivitis, and eyelid swelling among its many manifestations. While rare, it should be considered in cases where common diagnoses do not fit or when there are systemic symptoms.
  • Wegener's Granulomatosis (Granulomatosis with Polyangiitis): This is a form of vasculitis that can affect various parts of the body, including the eyes. It can cause a range of ocular symptoms, including eyelid swelling and pain, though it is much less common than other causes listed here.