Differential Diagnosis for Acute Red and Painful Eye
- Single most likely diagnosis
- Acute conjunctivitis: This is the most common cause of a red and painful eye, often presenting with discharge, tearing, and irritation. The acute onset and symptoms are consistent with this diagnosis.
- Other Likely diagnoses
- Acute angle-closure glaucoma: Although less common, this condition can cause severe eye pain, redness, and vision changes, often accompanied by nausea and vomiting. The short duration of symptoms could fit this diagnosis.
- Corneal ulcer: A corneal ulcer can cause significant pain, redness, and sensitivity to light, and can develop rapidly. Contact lens use or trauma could predispose to this condition.
- Episcleritis: This is an inflammatory condition of the episclera, a thin layer on top of the white part of the eye, which can cause redness and pain, but typically less severe than scleritis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Endophthalmitis: A severe, sight-threatening infection within the eye that requires prompt treatment. It is less common but critical to diagnose early due to its potential for severe vision loss.
- Scleritis: A more severe inflammatory condition than episcleritis, scleritis can cause intense pain, redness, and sensitivity to light. It is less common but can lead to serious complications if not treated properly.
- Orbital cellulitis: An infection of the tissues surrounding the eye, which can cause pain, redness, swelling, and vision changes. It is a medical emergency due to the risk of serious complications, including vision loss and cavernous sinus thrombosis.
- Rare diagnoses
- Uveitis: Inflammation of the uvea, the middle layer of the eye, which can cause pain, redness, and sensitivity to light. It is less common and can be associated with systemic diseases.
- Keratitis: Inflammation of the cornea, which can be caused by infection or injury, leading to pain, redness, and vision changes. Certain types, like herpes simplex keratitis, can have a more subacute presentation but are important to consider in the differential diagnosis of a red and painful eye.