Differential Diagnosis for Swollen Eyes
The patient presents with sudden onset of bilateral eye swelling, tender eyelids, and a mild headache. The following differential diagnosis is organized into categories:
- Single Most Likely Diagnosis
- Allergic reaction (e.g., angioedema): The patient's symptoms of sudden onset of swelling, particularly after getting up from a supine position, and tender eyelids could suggest an allergic reaction. However, she denies any known allergies or new exposures to potential allergens.
- Other Likely Diagnoses
- Blepharitis: This condition involves inflammation of the eyelids and can cause swelling, tenderness, and redness. Although the patient denies redness, blepharitis could still be a consideration.
- Conjunctivitis (viral or bacterial): The patient's symptoms of stuck-together eyes and swelling could be indicative of conjunctivitis, although she denies any eye drainage or redness.
- Periorbital cellulitis: This is an infection of the skin and tissue around the eyes, which could cause swelling, tenderness, and redness.
- Do Not Miss Diagnoses
- Orbital cellulitis: A more severe infection that involves the tissue within the orbit, which can lead to serious complications if not promptly treated.
- Cavernous sinus thrombosis: A rare but potentially life-threatening condition that can cause eye swelling, headache, and other neurological symptoms.
- Hypothyroidism: Although less likely, hypothyroidism can cause periorbital edema and should be considered, especially given the patient's age and medical history.
- Rare Diagnoses
- Thyroid ophthalmopathy: A condition associated with Graves' disease, which can cause eye swelling, bulging, and other ocular symptoms.
- Sarcoidosis: A systemic disease that can cause uveitis, conjunctivitis, and other ocular symptoms, including eye swelling.
- Wegener's granulomatosis: A rare autoimmune disorder that can cause eye inflammation, swelling, and other systemic symptoms.
It is essential to conduct a thorough medical history, physical examination, and diagnostic tests (e.g., complete blood count, blood cultures, imaging studies) to determine the underlying cause of the patient's symptoms and guide further management.