Differential Diagnosis for a 79-year-old Male with Right Eye Redness, Itchiness, and Mild Discharge
Single Most Likely Diagnosis
- Allergic Conjunctivitis: This is the most likely diagnosis given the symptoms of redness, itchiness, and mild discharge. Allergic conjunctivitis is common and can be triggered by various allergens such as pollen, dust, or pet dander. The patient's age and otherwise healthy status also support this diagnosis.
Other Likely Diagnoses
- Blepharitis: This condition involves inflammation of the eyelids and can cause redness, itchiness, and discharge. It's a common condition that can be associated with skin conditions like rosacea or seborrheic dermatitis.
- Dry Eye Syndrome: This condition can cause redness, itchiness, and mild discharge, especially in older adults. It's related to decreased tear production or poor tear quality.
- Viral Conjunctivitis: Also known as pink eye, this is a highly contagious infection that can cause redness, itchiness, and discharge. It's common in all age groups and can be spread through direct contact with an infected person.
Do Not Miss Diagnoses
- Acute Angle-Closure Glaucoma: Although less likely, this is a medical emergency that requires immediate attention. Symptoms can include severe eye pain, redness, blurred vision, and nausea. If missed, it can lead to permanent vision loss.
- Corneal Ulcer: This is an open sore on the cornea that can cause redness, pain, and discharge. It's more common in contact lens wearers but can occur in anyone. If left untreated, it can lead to serious complications, including vision loss.
- Endophthalmitis: This is a rare but serious infection of the inner eye that can cause severe pain, redness, and vision loss. It's usually associated with recent eye surgery or trauma.
Rare Diagnoses
- Keratoconjunctivitis Sicca: A rare autoimmune disorder that affects the eyes and causes dryness, redness, and inflammation.
- Sjögren's Syndrome: An autoimmune disorder that can cause dry eyes and mouth, among other symptoms.
- Ocular Rosacea: A condition that causes inflammation of the eyes and eyelids, often associated with rosacea of the skin.
Treatment will depend on the final diagnosis but may include antihistamines, lubricating eye drops, antibiotics, or anti-inflammatory medications. Referral to an ophthalmologist may be necessary for further evaluation and management, especially if the diagnosis is uncertain or if there are signs of a more serious condition.