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, which includes the iris, ciliary body, and choroid. Symptoms such as unilateral eye redness, blurry vision, photophobia, and ciliary flush are classic presentations. The presence of uveitis in the question strongly points towards this diagnosis.
Other Likely Diagnoses
- Acute Angle-Closure Glaucoma: This is an ocular emergency that presents with sudden onset of severe eye pain, redness, blurred vision, and photophobia, often accompanied by headache and nausea. The symptoms can mimic those of uveitis, but the presence of a mid-dilated pupil and elevated intraocular pressure can help differentiate it.
- Conjunctivitis: Although typically bilateral, severe conjunctivitis can cause significant discomfort, redness, and photophobia. However, the presence of ciliary flush and uveitis makes this less likely.
- Keratitis: Inflammation of the cornea can cause pain, redness, photophobia, and blurred vision. It can be due to infectious or non-infectious causes and should be considered, especially if there's a history of trauma or contact lens use.
Do Not Miss Diagnoses
- Endophthalmitis: This is a severe, vision-threatening infection within the eye that can occur post-surgically or following an intraocular infection. Symptoms include severe eye pain, redness, decreased vision, and photophobia. It's crucial to diagnose and treat promptly to preserve vision.
- Posterior Scleritis: Inflammation of the sclera can cause deep eye pain, redness, and decreased vision. It might not be as common but is important to consider due to its potential for severe complications if left untreated.
- Sympathetic Ophthalmia: A rare, bilateral granulomatous uveitis that can occur after penetrating eye injury or surgery. It's crucial to recognize and treat to prevent vision loss in the unaffected eye.
Rare Diagnoses
- Sarcoidosis: A systemic disease that can cause uveitis among other symptoms. It's less common but should be considered in the differential diagnosis, especially if there are systemic symptoms or a history suggestive of sarcoidosis.
- Tubulointerstitial Nephritis and Uveitis Syndrome (TINU): A rare condition characterized by uveitis and renal tubulointerstitial nephritis. It's more common in young women and can present with systemic symptoms like fever and weight loss.
- Masquerade Syndromes: These are conditions that mimic uveitis but are actually due to other causes like lymphoma or leukemia. They are rare but important to consider, especially in atypical presentations or lack of response to standard uveitis treatment.