What is the cause of a 4-day history of unilateral eye redness, blurry vision, and photophobia with mild headache?

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Differential Diagnosis for Unilateral Eye Redness, Blurry Vision, and Photophobia

Single Most Likely Diagnosis

  • Acute Anterior Uveitis: This condition is characterized by inflammation of the uvea, leading to symptoms such as unilateral eye redness, blurry vision, photophobia, and mild headache. The acute onset and combination of these symptoms make it a highly plausible diagnosis.

Other Likely Diagnoses

  • Conjunctivitis: Although conjunctivitis typically presents with bilateral symptoms, it can occasionally be unilateral. The presence of redness and photophobia could suggest a severe form of conjunctivitis, such as gonococcal or herpetic conjunctivitis.
  • Corneal Ulcer: A corneal ulcer can cause severe pain, redness, photophobia, and blurred vision, primarily in one eye. The symptoms can develop rapidly, making it a likely consideration in this scenario.
  • Acute Angle-Closure Glaucoma: While typically associated with more severe pain and vision loss, acute angle-closure glaucoma can present with unilateral redness, photophobia, and blurred vision. The mild headache mentioned could be a part of the glaucoma's symptomatology.

Do Not Miss Diagnoses

  • Endophthalmitis: This is a severe, vision-threatening infection within the eye that requires immediate medical attention. Symptoms can include severe eye pain, redness, photophobia, and vision loss. Although less common, missing this diagnosis could result in significant morbidity.
  • Retinal Detachment: While the primary symptom of retinal detachment is a sudden increase in floaters or flashes of light, it can also cause blurred vision and, in some cases, mild eye discomfort. The potential for severe vision loss makes it a critical diagnosis not to miss.
  • Orbital Cellulitis: This infection of the tissues surrounding the eye can cause redness, swelling, pain, and vision changes. It is a medical emergency due to the risk of spreading to other areas, including the brain.

Rare Diagnoses

  • Scleritis: Inflammation of the sclera can cause severe eye pain, redness, and photophobia. It is less common than other conditions listed but should be considered, especially if other diagnoses are ruled out.
  • Sympathetic Ophthalmia: A rare, bilateral granulomatous uveitis that can occur after penetrating eye injury or surgery. It is crucial to consider in patients with a history of eye trauma or surgery, although it is much less likely given the unilateral presentation in this case.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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