Eye Pain in a Woman With Multiple Health Conditions

Byung Josh Kim, OD; Case Series Editor: Jean Marie Pagani, OD


March 24, 2014

Differential Diagnosis

Because of the presentation and symptoms, episcleritis was the most likely diagnosis.

Viral conjunctivitis is a possibility, but it typically presents with watery discharge and edematous eyes, and shows signs of follicle as well as preauricular node swelling.

Because the patient has seasonal allergies, allergic conjunctivitis is another possible diagnosis. However, allergic conjunctivitis is usually bilateral, and patients often experience itchiness and a burning sensation. Papillae are also a typical finding on the conjunctivae.

Pingueculae were not observed on the examination. Pingueculitis presents with redness and pain isolated at the site of the pinguecula (temporal or nasal). This patient presented with a diffuse injection.

Iritis was ruled out because there was no anterior chamber reaction.

Ocular rosacea is usually associated with the diagnosis of rosacea, which presents with skin involvement of the face. Eyelid, corneal, and conjunctival involvement are common. The patient had no symptoms of any problems with the skin on her face or anywhere else on her body. Rosacea is typically recognized more often in fair-skinned individuals, whereas this patient had dark skin.


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