Differential Diagnosis for Eye Pain, Redness, Watering, Photophobia in a Patient Who Slept in Contact Lens
- Single Most Likely Diagnosis
- Contact Lens-Related Infection (e.g., microbial keratitis): This is the most likely diagnosis given the patient's history of sleeping in contact lenses, which increases the risk of microbial keratitis. Symptoms such as eye pain, redness, watering, and photophobia are consistent with this condition.
- Other Likely Diagnoses
- Contact Lens Irritation or Allergic Reaction: Sleeping in contact lenses can also cause irritation or an allergic reaction, leading to similar symptoms.
- Dry Eye Syndrome: Prolonged wear of contact lenses, especially overnight, can exacerbate dry eye, causing discomfort, redness, and sensitivity to light.
- Conjunctivitis: Both viral and bacterial conjunctivitis can present with redness, watering, and discomfort, and could be considered in the differential, especially if the patient has been exposed to someone with conjunctivitis.
- Do Not Miss Diagnoses
- Endophthalmitis: Although less common, endophthalmitis is a severe, sight-threatening infection that can occur after trauma, surgery, or, rarely, as a complication of contact lens use. It presents with severe eye pain, redness, and vision loss, and is a medical emergency.
- Acute Angle-Closure Glaucoma: This condition is characterized by sudden, severe eye pain, redness, blurred vision, and often accompanied by nausea and vomiting. It is a medical emergency requiring immediate treatment to prevent permanent vision loss.
- Corneal Ulcer: A corneal ulcer can develop from an infection and presents with severe pain, redness, and photophobia. It is a serious condition that can lead to vision loss if not promptly treated.
- Rare Diagnoses
- Scleritis: Inflammation of the sclera, which can cause severe eye pain, redness, and tenderness. It is less common but should be considered in the differential diagnosis of severe eye pain.
- Uveitis: Inflammation of the uvea, which can present with eye pain, redness, and sensitivity to light. While it can be associated with various systemic diseases, it is less directly related to sleeping in contact lenses compared to other diagnoses listed.