Differential Diagnosis for Swelling of the Left Eye in a 58-Year-Old Female
Single Most Likely Diagnosis
- Allergic Reaction: This is often the most common cause of sudden onset eye swelling, especially if it's unilateral and accompanied by other symptoms like itching, redness, and tearing. The reaction could be due to various allergens such as pollen, dust, or makeup.
Other Likely Diagnoses
- Blepharitis: An inflammation of the eyelids that can cause swelling, usually accompanied by redness, itching, and crusting around the eyelashes.
- Conjunctivitis (Pink Eye): An infection or inflammation of the outer membrane of the eyeball and the inner eyelid, which can cause swelling, redness, and discharge.
- Cellulitis (Periorbital or Orbital): A bacterial infection of the skin and tissues around the eye, which can cause swelling, redness, and pain. The distinction between periorbital (around the eye) and orbital (behind the eye) cellulitis is crucial due to differences in severity and treatment.
- Hordeolum (Stye): A localized infection or inflammation of the eyelid margin involving hair follicles of the eyelashes (external hordeolum) or meibomian glands (internal hordeolum).
- Chalazion: A small bump on the eyelid due to a blocked oil gland, which can cause swelling but is usually less acute and painful than a hordeolum.
Do Not Miss Diagnoses
- Orbital Cellulitis: While mentioned earlier, it's crucial to differentiate it from periorbital cellulitis due to its potential for serious complications, including vision loss and intracranial involvement.
- Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition that can cause swelling of the eye, among other symptoms, due to a blood clot in the cavernous sinus.
- Angioedema: A condition characterized by the rapid swelling of the dermis, subcutaneous tissue, mucosa, and submucosal tissues, which can be life-threatening if it involves the airway.
- Thyroid Ophthalmopathy (Graves' Disease): An autoimmune condition that can cause swelling of the tissues around the eye, including eyelid retraction, bulging of the eye (exophthalmos), and in severe cases, vision loss.
- Herpes Zoster Ophthalmicus: Shingles that affects the eye, which can lead to serious complications if not promptly treated, including vision loss and persistent pain.
Rare Diagnoses
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect various parts of the body, including the eyes, and cause swelling among other symptoms.
- Sarcoidosis: A condition in which inflammatory cells (granulomas) form in various organs, including the eyes, which can cause swelling and other ocular symptoms.
- Erythema Multiforme: A skin condition characterized by target lesions, which can also affect the eyes and cause swelling, usually in response to an infection or medication.
- Kawasaki Disease: Although more common in children, it can rarely occur in adults and cause swelling of the eyes among other symptoms.
- Relapsing Polychondritis: A rare disease that causes recurring episodes of cartilage inflammation, which can affect the eyes and cause swelling.