Differential Diagnosis for a 53-year-old Female with Down Syndrome Presenting with a Red Eye

• Single Most Likely Diagnosis
  • Conjunctivitis: This is a common condition that can cause a red eye and is likely in this patient due to the high prevalence of eye problems in individuals with Down syndrome.
• Other Likely Diagnoses
  • Blepharitis: Inflammation of the eyelids can cause redness and is common in the general population, including those with Down syndrome.
  • Dry Eye Syndrome: Individuals with Down syndrome are at increased risk for dry eye due to decreased tear production or altered tear composition.
  • Keratoconus: Although not directly causing a red eye, keratoconus is more common in individuals with Down syndrome and can lead to eye discomfort or vision problems that might prompt an evaluation.
• Do Not Miss Diagnoses
  • Acute Angle-Closure Glaucoma: A medical emergency that can cause a red, painful eye and is more common in individuals with Down syndrome due to their shallower anterior chambers.
  • Endophthalmitis: A severe infection within the eye that requires prompt treatment to preserve vision.
  • Corneal Ulcer: Can cause a red, painful eye and is a risk in anyone, but especially in those who may have difficulty communicating symptoms or have pre-existing eye conditions.
• Rare Diagnoses
  • Sjögren's Syndrome: An autoimmune disorder that can cause dry eyes among other symptoms, less common but should be considered in the differential due to its potential for significant morbidity.
  • Uveitis: Inflammation of the uvea, which can cause eye pain, redness, and vision problems, and might be associated with systemic diseases or be idiopathic.