Differential Diagnosis for Bilateral Eye Redness
Single Most Likely Diagnosis
- Allergic Conjunctivitis: This is the most likely diagnosis given the symptoms of itching, irritation, and intense injection of the conjunctiva without ciliary flush, which are characteristic of allergic reactions. The presence of tearing and blurring of vision also supports this diagnosis, as these are common complaints in patients with allergic conjunctivitis.
Other Likely Diagnoses
- Viral Conjunctivitis: This condition could also present with redness, itching, and tearing. However, it often starts in one eye and then spreads to the other, and may be accompanied by a watery discharge.
- Blepharitis: This is an inflammation of the eyelids that can cause redness, itching, and irritation of the eyes. It may also lead to blurring of vision due to the inflammation affecting the tear film.
- Dry Eye Syndrome: Although this condition is more common in older adults, it can occur in younger individuals, especially with prolonged use of digital devices. Symptoms include dryness, irritation, and blurring of vision.
Do Not Miss Diagnoses
- Acute Angle-Closure Glaucoma: Although the patient does not have pain with extraocular movements and the pupils are symmetric and reactive, which makes this less likely, acute angle-closure glaucoma is a medical emergency that can present with redness, blurred vision, and tearing. The absence of severe pain and a mid-dilated pupil makes this less likely, but it should always be considered in the differential for red eye.
- Keratitis: Inflammation of the cornea can cause redness, pain, and blurred vision. The absence of pain with extraocular movements and the lack of ciliary flush makes this less likely, but it's a condition that requires prompt treatment to prevent complications.
Rare Diagnoses
- Sjögren's Syndrome: An autoimmune disorder that can cause dry eyes and dry mouth. While it's less common and typically presents in older adults, it could be considered in a differential diagnosis for chronic eye irritation and dryness.
- Sarcoidosis: A condition that can affect multiple parts of the body, including the eyes, causing uveitis, conjunctivitis, or other ocular symptoms. It's rare and would typically be associated with other systemic symptoms.