Differential Diagnosis for Tess's Condition

Single Most Likely Diagnosis

• Blepharitis: This is the most likely diagnosis given the recurring swelling, redness, and discharge in both eyelids, which are characteristic symptoms of blepharitis. The condition is often chronic and can cause the eyes to stick shut in the morning due to the discharge.

Other Likely Diagnoses

• Conjunctivitis: This could be either viral or bacterial, given the symptoms of redness, swelling, and discharge. The fact that it affects both eyes and causes morning stickiness suggests a possible infectious cause.
• Dry Eye Syndrome: Although Tess mentions discharge, some forms of dry eye can lead to an increase in the wrong type of tears, which might cause stickiness and discomfort. The use of eye drops might not be fully effective if they are not tailored to her specific condition.
• Allergic Conjunctivitis: Despite Tess not having a known history of allergies, it's possible she has developed an allergy. Allergic conjunctivitis can cause redness, itching, and discharge, although the absence of specific triggers makes this less likely.

Do Not Miss Diagnoses

• Orbital Cellulitis: This is a serious infection of the tissues surrounding the eye, which can cause swelling, redness, and discharge. It's crucial to rule out this condition due to its potential for serious complications, including vision loss and spread of infection.
• Keratitis: An inflammation of the cornea, which can be caused by infection or injury. It's a critical diagnosis to consider because it can lead to vision loss if not properly treated.
• Angioedema: Although less common, angioedema can cause sudden swelling of the eyelids and face, which might be accompanied by other systemic symptoms. It's a condition that requires immediate medical attention, especially if it involves the respiratory tract.

Rare Diagnoses

• Ocular Rosacea: A condition associated with rosacea that can cause eye symptoms similar to blepharitis, including redness, swelling, and discharge. It's less common but should be considered, especially if Tess has a history of rosacea.
• Graft-Versus-Host Disease (GVHD): In individuals who have undergone bone marrow or stem cell transplants, GVHD can cause a range of symptoms, including eye problems like dryness, redness, and discharge. This would be extremely rare and dependent on Tess's medical history.