Differential Diagnosis for Normal Eye Crusting in the Early Morning

• Single Most Likely Diagnosis
  • Normal tear secretion and eye discharge: This is the most common and likely explanation for eye crusting in the morning. During sleep, the eyes produce less tears, and the normal bacteria on the eye can multiply, leading to the formation of a crust.
• Other Likely Diagnoses
  • Dry eye syndrome: This condition can cause an increase in eye discharge and crusting, especially in the morning.
  • Blepharitis: Inflammation of the eyelids can lead to crusting and discharge, which may be more noticeable in the morning.
  • Allergic conjunctivitis: Seasonal or environmental allergies can cause eye discharge and crusting, which may be worse in the morning.
• Do Not Miss Diagnoses
  • Conjunctivitis (infectious): Bacterial or viral conjunctivitis can cause significant eye discharge and crusting, and if left untreated, can lead to serious complications.
  • Corneal ulcer: A corneal ulcer can cause severe eye pain, discharge, and crusting, and if not treated promptly, can lead to vision loss.
  • Endophthalmitis: A rare but serious infection of the inner eye that can cause severe eye pain, discharge, and crusting, and if not treated promptly, can lead to vision loss.
• Rare Diagnoses
  • Sjögren's syndrome: An autoimmune disorder that can cause dry eye syndrome and other systemic symptoms.
  • Graft-versus-host disease: A rare condition that can occur after bone marrow transplantation, causing eye symptoms including crusting and discharge.
  • Ocular rosacea: A condition that causes inflammation of the eyes and eyelids, leading to crusting and discharge.