Differential Diagnosis for a 3-Month-Old Pediatric Patient with Right Eye Crusting
Single Most Likely Diagnosis
- Nasolacrimal Duct Obstruction (NLDO): This condition is common in infants, where the tear duct fails to open, leading to crusting and discharge. It often resolves on its own but can be managed with massage or probing if necessary.
Other Likely Diagnoses
- Conjunctivitis (Viral or Bacterial): Infection of the conjunctiva can cause crusting, redness, and discharge. It's common in infants and can be contagious.
- Blepharitis: Inflammation of the eyelids can cause crusting, especially in the morning, and is often associated with skin conditions like eczema.
- Dry Eye: Insufficient tear production or poor tear quality can lead to eye irritation and crusting.
- Allergic Conjunctivitis: An allergic reaction can cause eye symptoms, including crusting, itching, and redness.
Do Not Miss Diagnoses
- Gonococcal Conjunctivitis: A severe and sight-threatening infection that requires immediate treatment. It's less common but critical to diagnose due to its potential for serious complications.
- Herpes Simplex Virus (HSV) Conjunctivitis: HSV can cause a severe and potentially blinding infection if not treated promptly.
- Chlamydial Conjunctivitis: Another serious infection that can lead to long-term vision problems if not properly managed.
Rare Diagnoses
- Dacryocystitis: An infection of the lacrimal sac, which can cause pain, swelling, and crusting around the eye.
- Ectropion or Entropion: Abnormalities of the eyelid that can cause crusting and discomfort due to improper eyelid positioning.
- Keratoconjunctivitis Sicca: A rare condition characterized by severe dryness of the eyes, which can lead to crusting and vision problems.
- Congenital Glaucoma: A rare condition that can cause eye symptoms, including crusting, due to increased intraocular pressure.