Differential Diagnosis
- Single most likely diagnosis
- Dacryostenosis: This condition is characterized by the blockage of the nasolacrimal duct, leading to excessive tearing and crusting around the eye. The presence of mucoid drainage from the tear duct upon massage and the absence of other symptoms such as fever, congestion, or changes in urination or bowel movements make this diagnosis the most likely.
- Other Likely diagnoses
- Bacterial conjunctivitis: Although the conjunctivae appear normal, bacterial conjunctivitis could still be a possibility, especially with the presence of yellowish crusting. However, the lack of eyelid or periorbital edema or erythema makes this less likely.
- Viral conjunctivitis: Similar to bacterial conjunctivitis, viral conjunctivitis is a possibility but less likely due to the absence of other symptoms such as fever or conjunctival injection.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Orbital cellulitis: Although the patient shows no signs of fever, congestion, or periorbital edema, orbital cellulitis is a serious condition that requires prompt attention. It is essential to monitor the patient's condition closely and be aware of any potential deterioration.
- Gonococcal ophthalmia neonatorum: This is a rare but serious condition that can occur in newborns, especially if the mother has gonorrhea. It is essential to consider this diagnosis, especially if the patient's condition worsens or does not respond to treatment.
- Rare diagnoses
- Blepharitis: This condition is characterized by inflammation of the eyelids, but the patient's eyelids appear normal, making this diagnosis less likely.
- Chalazion: A chalazion is a small bump on the eyelid due to a blocked oil gland, but there is no mention of a bump or swelling on the eyelid.
- Hordeolum: A hordeolum, or stye, is an infection of the eyelid margin, but there is no sign of a localized infection or swelling on the eyelid.