Differential Diagnosis for Eye Pain and Redness with Ciliary Flush
Single Most Likely Diagnosis
- Acute Angle-Closure Glaucoma: This condition is characterized by sudden onset of eye pain, redness, and ciliary flush, often accompanied by blurred vision, headache, and nausea. The presence of ciliary flush, which is a ring of injection around the cornea, is highly suggestive of this diagnosis.
Other Likely Diagnoses
- Conjunctivitis: Both viral and bacterial conjunctivitis can cause eye redness and pain, though ciliary flush is less common. However, the presence of significant discomfort and redness, especially if accompanied by discharge, makes this a plausible diagnosis.
- Keratitis: Inflammation of the cornea can cause pain, redness, and photophobia. Ciliary flush may be present, especially if the keratitis is severe or central.
- Iritis (Anterior Uveitis): This is an inflammation of the iris and can cause eye pain, redness, and sensitivity to light. Ciliary flush is a common finding.
Do Not Miss Diagnoses
- Acute Angle-Closure Glaucoma (already mentioned, but included here for emphasis due to its urgency and potential for vision loss if not promptly treated).
- Endophthalmitis: A severe infection within the eye that can follow surgery, trauma, or blood-borne infection. It presents with severe eye pain, redness, and decreased vision, making prompt diagnosis and treatment critical to preserve vision.
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can cause pain, redness, swelling, and potentially serious complications if not treated aggressively.
Rare Diagnoses
- Scleritis: A severe inflammatory disease that affects the sclera (the white part of the eye). It can cause severe pain, redness, and tenderness to the touch, and is often accompanied by ciliary flush.
- Corneal Ulcer: An open sore on the cornea, usually caused by infection, which can lead to pain, redness, and vision loss if not properly treated.
- Posterior Scleritis: Inflammation of the back part of the sclera, which can mimic other conditions but may cause ciliary flush and severe pain. It is less common and can be challenging to diagnose.