Differential Diagnosis for a 67 Year Old Female with Painful Red Eye
- Single Most Likely Diagnosis
- Acute Angle-Closure Glaucoma: This condition is characterized by sudden onset of severe eye pain, redness, and decreased vision, often accompanied by nausea and vomiting. It is a medical emergency that requires immediate attention to prevent permanent vision loss. The patient's age and symptoms make this a highly plausible diagnosis.
- Other Likely Diagnoses
- Conjunctivitis: This is an inflammation or infection of the outer membrane of the eyeball and the inner eyelid. It can be caused by viruses, bacteria, or allergens and presents with redness, itching, and discharge.
- Keratitis: An inflammation of the cornea, which can be caused by infection, injury, or underlying diseases. Symptoms include pain, redness, and blurred vision.
- Uveitis: Inflammation of the uvea, the middle layer of the eye, which can cause pain, redness, and sensitivity to light.
- Do Not Miss Diagnoses
- Endophthalmitis: A severe inflammation of the interior of the eye, usually caused by infection. It is a medical emergency that can lead to vision loss if not promptly treated.
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can cause pain, redness, and swelling. It can lead to serious complications if not treated promptly.
- Scleritis: Inflammation of the sclera, the white part of the eye, which can be extremely painful and may be associated with underlying systemic diseases.
- Rare Diagnoses
- Ocular Malignancy: Although rare, certain types of eye cancer, such as uveal melanoma, can present with pain and redness.
- Wegener's Granulomatosis: A rare autoimmune disorder that can affect various parts of the body, including the eyes, causing inflammation and damage.
- Sympathetic Ophthalmia: A rare, inflammatory condition that can occur after penetrating eye injury or surgery, affecting both the injured and the uninjured eye.