Differential Diagnosis for Unilateral Eye Discharge, Progressive Blurred Vision, and Eyelid Swelling
Single Most Likely Diagnosis
- Blepharitis or Conjunctivitis: These conditions are common and can cause unilateral eye discharge, blurred vision due to irritation, and eyelid swelling. The chronic nature (3 weeks) suggests a possible infectious or inflammatory cause.
Other Likely Diagnoses
- Dry Eye Syndrome: Can cause blurred vision and discharge, though typically bilateral. However, it can be asymmetric, and eyelid swelling might occur due to associated blepharitis.
- Uveitis: Inflammation of the uvea can cause blurred vision and eye pain. Discharge might not be a primary symptom, but it can occur, especially if there's associated conjunctivitis.
- Orbital Cellulitis: An infection of the tissues surrounding the eye, which can cause eyelid swelling, discharge (if the infection involves the conjunctiva), and blurred vision due to inflammation.
Do Not Miss Diagnoses
- Endophthalmitis: A severe, sight-threatening infection within the eye. Symptoms can include severe eye pain, blurred vision, and discharge. It's less common but critical to diagnose early.
- Acute Angle-Closure Glaucoma: A medical emergency that can cause blurred vision, eye pain, and sometimes discharge if associated with corneal edema. It's less likely to cause significant eyelid swelling but is crucial to rule out due to its potential for permanent vision loss.
- Malignant Ophthalmic Tumors: Though rare, tumors like adenocarcinoma of the lacrimal gland or other orbital tumors can cause progressive symptoms including blurred vision, discharge, and eyelid swelling.
Rare Diagnoses
- Sarcoidosis: A systemic disease that can affect the eyes, causing uveitis, conjunctivitis, or lacrimal gland inflammation, leading to the described symptoms.
- Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect the eyes, sinuses, and kidneys, potentially causing the symptoms described.
- Syphilis: Can cause a wide range of ocular symptoms, including uveitis, conjunctivitis, and retinitis, potentially leading to blurred vision, discharge, and eyelid swelling, especially in the secondary stage.