Differential Diagnosis for Corneal Irritation without an Eyelash in the Eye

• Single Most Likely Diagnosis
  • Dry eye syndrome: This condition is characterized by insufficient lubrication of the eye, leading to irritation, discomfort, and sometimes a sensation of having something in the eye, even when there's no foreign body present.
• Other Likely Diagnoses
  • Allergic conjunctivitis: An allergic reaction can cause irritation, redness, and a sensation of discomfort in the eye, which might be mistaken for a foreign body sensation.
  • Corneal abrasion: A scratch on the cornea can cause significant pain, irritation, and a feeling of having something in the eye.
  • Blepharitis: Inflammation of the eyelids can lead to irritation, redness, and discomfort, potentially causing a sensation similar to having a foreign body in the eye.
• Do Not Miss Diagnoses
  • Acute angle-closure glaucoma: Although less common, this condition is an emergency and can present with severe eye pain, blurred vision, and sometimes a sensation of irritation. Missing this diagnosis can lead to permanent vision loss.
  • Corneal ulcer: An infection of the cornea can cause severe pain, redness, and irritation. It's crucial to diagnose and treat promptly to prevent serious complications, including vision loss.
• Rare Diagnoses
  • Neurotrophic keratopathy: A rare condition where there's damage to the nerves of the cornea, leading to decreased sensation and potentially chronic irritation due to decreased protective mechanisms of the eye.
  • Ectropion or entropion: Abnormal positioning of the eyelid can cause chronic irritation and discomfort, potentially leading to a sensation of having something in the eye due to abnormal lid function and exposure of the eye.