[35F] With sudden eye swelling, blurred vision, and hematuria

Patient Description

A 35-year-old female presents with sudden onset of left eye swelling, pain, and blurry vision that developed within an hour. The eye appears red and yellow where it is usually white. The patient also reports seeing thin worm-like threads in her eyes and nose, described as floaters. She has a headache on the left side, slight ringing in her ears, and sensitivity to bright lights. There is no fever, chills, nausea, or vomiting. The patient was recently treated with Permethrin 5% cream for suspected Demodex mites, but symptoms have worsened since using it. She has no known allergies, is not taking any medications, and has no significant past medical history or family history of autoimmune diseases, diabetes, cancer, or psychiatric illnesses. Additionally, she has had persistent sores on her face since November 2022 that have not healed despite multiple visits to urgent care. The patient also experienced pink, syrupy blood in her urine yesterday morning, which was very noticeable the first time but faded after the second urination.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, several potential diagnoses come to mind:

Eye Symptoms (Swelling, Pain, Clouded Vision, Worm-like Threads)

  • Eye Infection or Inflammation: The sudden swelling, pain, and redness in your eye could indicate an infection such as conjunctivitis or uveitis. The clouded vision and sensitivity to light are also concerning and could be related to these conditions.
  • Parasitic Infection: Given your concern about parasites and the use of Permethrin cream, it's possible that you might have a parasitic infection like Demodex mites, which can cause eye irritation and swelling.
  • Floaters: The worm-like threads you see could be floaters, which are usually harmless but can sometimes indicate a more serious condition if they appear suddenly.

Facial Sores

  • Chronic Skin Infection: Persistent sores that do not heal could be due to a chronic skin infection or an underlying dermatological condition.
  • Parasitic Infestation: If the sores are related to Demodex mites, they might persist despite treatment if the infestation is severe.

Blood in Urine

  • Urinary Tract Infection (UTI): Blood in the urine can be a sign of a UTI, especially if it is accompanied by other symptoms like pain or burning during urination.
  • Kidney Issues: Blood in the urine can also indicate a problem with your kidneys, such as a kidney infection or stones.

Headache and Ringing in Ears

  • Sinus Infection: A sinus infection could cause a headache on one side of your head and might also affect your ears.
  • Migraine: Migraines can cause headaches, sensitivity to light, and sometimes even ringing in the ears.

What you can do

Eye Symptoms

  • Seek Immediate Medical Attention: Given the sudden onset of your symptoms and the potential for serious conditions, you should see an eye specialist (ophthalmologist) as soon as possible.
  • Avoid Touching Your Eyes: To prevent further irritation or infection, avoid touching or rubbing your eyes.
  • Use Artificial Tears: Over-the-counter artificial tears can help soothe your eyes, but this is not a substitute for professional medical care.

Facial Sores

  • Follow Up with a Dermatologist: Persistent sores that do not heal should be evaluated by a dermatologist. They can provide a more targeted treatment plan.
  • Maintain Good Hygiene: Keep the affected areas clean and avoid picking at the sores to prevent further infection.

Blood in Urine

  • Consult a Doctor: Blood in the urine is a concerning symptom that should be evaluated by a healthcare provider. They may perform tests to determine the cause.
  • Stay Hydrated: Drinking plenty of water can help flush out your urinary system and may alleviate some symptoms.

Headache and Ringing in Ears

  • Over-the-Counter Pain Relief: Medications like ibuprofen or acetaminophen can help manage your headache.
  • Limit Exposure to Bright Lights: Since you are sensitive to light, try to stay in dimly lit environments to reduce discomfort.

What you should look out for

Given the severity and variety of your symptoms, you should seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Worsening Vision: If your vision continues to deteriorate or you experience sudden vision loss, seek immediate medical attention.
  • Severe Pain: If the pain in your eye or head becomes unbearable, go to the emergency room.
  • Increased Swelling or Redness: If the swelling or redness in your eye worsens, this could indicate a serious infection.
  • Persistent Blood in Urine: If you continue to notice blood in your urine, especially if it becomes more frequent or severe, consult a healthcare provider immediately.

Remember, while I can provide information and suggestions, I am not a substitute for professional medical advice. Please consult a healthcare provider for a formal diagnosis and treatment plan. You can also use MDandMe to journal your symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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4 mo ago


People Also Ask


What could cause sudden swelling and pain in one eye along with blurry vision?

Sudden swelling and pain in one eye with blurry vision could be due to an eye infection or inflammation, such as conjunctivitis or uveitis. It could also be related to a parasitic infection or an allergic reaction. Immediate medical attention is recommended to determine the cause.


Why might someone see floaters or worm-like threads in their vision?

Floaters, or worm-like threads in vision, are usually harmless and occur when tiny pieces of the eye's gel-like vitreous break loose within the inner back portion of the eye. However, if they appear suddenly, they could indicate a more serious condition like retinal detachment, and an eye specialist should be consulted.


What are possible reasons for persistent facial sores that do not heal?

Persistent facial sores that do not heal could be due to a chronic skin infection, an underlying dermatological condition, or a parasitic infestation such as Demodex mites. A dermatologist should evaluate these symptoms to provide appropriate treatment.


What could cause blood to appear in urine suddenly?

Blood in urine, known as hematuria, can be caused by a urinary tract infection, kidney stones, or other kidney issues. It is important to consult a healthcare provider for evaluation and diagnosis, as it can indicate a serious underlying condition.

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