Differential Diagnosis for a Patient Feeling Like Something is Stuck in Their Eye

Single Most Likely Diagnosis

• Dry Eye Syndrome: This condition is characterized by insufficient lubrication of the eye, leading to a sensation of something being stuck in the eye. The fact that drops don't help could indicate that the drops are not adequately addressing the underlying issue, or the patient might not be using them correctly.

Other Likely Diagnoses

• Foreign Body Sensation: Actual presence of a foreign body in the eye, such as dust, an eyelash, or a small piece of debris, which the patient might not be able to see but feels.
• Blepharitis: Inflammation of the eyelids that can cause irritation, itchiness, and a sensation of having something in the eye.
• Conjunctivitis: Inflammation or infection of the outer membrane of the eyeball and the inner eyelid, which can cause discomfort and a foreign body sensation.
• Corneal Abrasion: A scratch on the cornea, which can be very painful and cause a sensation of something being in the eye.

Do Not Miss Diagnoses

• Acute Angle-Closure Glaucoma: A medical emergency that can cause severe eye pain, blurred vision, and a sensation of something being in the eye, along with nausea and vomiting. It requires immediate treatment to prevent permanent vision loss.
• Corneal Ulcer: An open sore on the cornea, usually caused by infection, which can lead to severe pain, redness, and a foreign body sensation. If left untreated, it can lead to serious complications, including vision loss.
• Uveitis: Inflammation of the uvea, the middle layer of the eye, which can cause eye pain, sensitivity to light, and a sensation of having something in the eye. It can lead to complications like glaucoma or vision loss if not properly treated.

Rare Diagnoses

• Phlyctenular Keratoconjunctivitis: A rare condition characterized by the presence of small nodules on the conjunctiva or cornea, often associated with an allergic or immune response, which can cause irritation and a foreign body sensation.
• Sjögren's Syndrome: An autoimmune disorder that can cause dry eyes among other symptoms, leading to a sensation of something being stuck in the eye due to lack of tear production.
• Trichiasis: A condition where eyelashes grow inward toward the eye, causing irritation and a sensation of having something in the eye.