Differential Diagnosis for Eyelid Swollen Shut

Single Most Likely Diagnosis

• Blepharitis or Conjunctivitis: These are common conditions that can cause eyelid swelling. Blepharitis is an inflammation of the eyelids, while conjunctivitis (pink eye) is an infection or inflammation of the outer membrane of the eyeball and the inner eyelid. Both conditions can lead to swelling that may cause the eyelid to swell shut.

Other Likely Diagnoses

• Allergic Reaction: An allergic reaction to makeup, contact lenses, or other substances can cause eyelid swelling.
• Insect Bite or Sting: A bite or sting near the eye can lead to significant swelling of the eyelid.
• Stye or Chalazion: A stye is an infection of an oil gland or hair follicle on the eyelid, while a chalazion is a blockage of one of these glands. Both can cause localized swelling that may lead to the eyelid swelling shut.
• Cellulitis: This is a bacterial infection of the skin and tissues beneath. Around the eye, it can cause significant swelling and redness.

Do Not Miss Diagnoses

• Orbital Cellulitis: A more serious infection than preseptal cellulitis, orbital cellulitis involves the tissues surrounding the eye, including the eye socket. It requires prompt medical attention to prevent serious complications, including vision loss.
• Angioedema: A severe allergic reaction that can cause rapid swelling of the face, lips, tongue, and throat, which can lead to airway obstruction. It's a medical emergency.
• Herpes Zoster (Shingles): When shingles affects the eye (herpes zoster ophthalmicus), it can cause significant pain, swelling, and potentially lead to serious complications if not treated promptly.

Rare Diagnoses

• Graves' Disease: An autoimmune disorder that can cause bulging of the eyes (exophthalmos) and swelling of the eyelids, among other symptoms.
• Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the eyes, leading to swelling and other symptoms.
• Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect various parts of the body, including the eyes, and cause swelling and other serious symptoms.

Each of these diagnoses has distinct features and requires different management approaches. A thorough medical evaluation is necessary to determine the underlying cause of an eyelid swollen shut.