Differential Diagnosis for a 9-Month-Old Girl with Left Eye Redness and Tearing
- Single Most Likely Diagnosis
- Glaucoma: The presence of a port-wine stain, along with the signs of conjunctival erythema, clear tearing, and a larger cornea and globe on the affected side, suggests Sturge-Weber syndrome, which is associated with glaucoma. The photophobia (indicated by frequent blinking and turning away from light) further supports this diagnosis.
- Other Likely Diagnoses
- Conjunctivitis: Given the symptoms of redness, tearing, and conjunctival erythema, conjunctivitis (either viral or bacterial) is a plausible diagnosis, although the presence of a port-wine stain and the specific characteristics of the eye (larger cornea and globe) make glaucoma more likely.
- Uveitis: Although less common in infants, uveitis could present with similar symptoms, including photophobia and conjunctival erythema. However, it would typically be accompanied by other signs such as pain or tenderness, which are not mentioned.
- Do Not Miss Diagnoses
- Retinoblastoma: Although rare and not directly suggested by the symptoms provided, any condition causing a red, painful eye in a child, especially with photophobia, warrants consideration of retinoblastoma due to its potential for severe consequences if missed.
- Orbital Cellulitis: The presence of a port-wine stain and signs of conjunctival erythema could potentially mask the early signs of orbital cellulitis, which is a medical emergency. The absence of warmth, tenderness, or pruritus makes this less likely, but it cannot be entirely ruled out without further evaluation.
- Rare Diagnoses
- Hemangioma with secondary glaucoma or other vascular malformations: While the port-wine stain suggests Sturge-Weber syndrome, other vascular malformations or hemangiomas could potentially cause similar ocular symptoms, including glaucoma or other complications affecting the eye.