Differential Diagnosis for Gritty Red Eyes Painful

• Single most likely diagnosis
  • Dry eye syndrome: This condition is characterized by inflammation of the ocular surface and lacrimal gland, leading to symptoms of gritty, red, and painful eyes due to insufficient tear production or poor tear quality.
• Other Likely diagnoses
  • Conjunctivitis (viral or bacterial): Infection or inflammation of the conjunctiva can cause redness, grittiness, and pain in the eyes.
  • Blepharitis: Inflammation of the eyelids can lead to symptoms of redness, irritation, and a gritty sensation in the eyes.
  • Corneal abrasion or ulcer: Damage to the cornea can cause severe pain, redness, and a sensation of grittiness.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Acute angle-closure glaucoma: A medical emergency that can cause severe eye pain, redness, and vision loss if not promptly treated.
  • Endophthalmitis: A severe infection within the eye that can lead to vision loss and requires immediate medical attention.
  • Orbital cellulitis: An infection of the tissues surrounding the eye that can cause pain, redness, and vision changes, potentially leading to serious complications if not treated.
• Rare diagnoses
  • Sjögren's syndrome: An autoimmune disorder that can cause dry eyes and other systemic symptoms.
  • Stevens-Johnson syndrome: A rare but serious disorder of the skin and mucous membranes that can cause eye symptoms, including pain and redness.
  • Trachoma: A rare infectious disease caused by Chlamydia trachomatis that can lead to chronic eye inflammation and vision loss if left untreated.