Hordeolum (Stye)

A hordeolum is an acute purulent inflammation of the eyelid, most commonly due to Staphylococcus aureus, that comes in two forms.

1. An external hordeolum or stye arises from the glands of Moll or glands of Zeis.
2. An internal hordeolum (less common) is an inflammation of a meibomian gland, most typically at the palpebral conjunctiva.

The appearance of an acute painful, erythematous, and purulent nodule can be worrying to patients, but the condition typically resolves after 1–2 weeks.

Tx

Warm compresses

If not responding after 48 hours, then perform I&D

DDx - dacryocystis, which can have similar presentation;

However, unlike stye, which arises from the upper eyelid, dacryocystitis arises from the lacrimal sac, which is located below the medial canthus of the eye.

Chalazion

initially presents as a painful swelling (hordeolum) that progresses to a nodular rubbery lesion

This is a chronic granulomatous condition that develops when a meibomian gland becomes obstructed.

Patients with rosacea may experience ocular symptoms. Complications frequently include a burning or foreign body sensation, blepharitis, keratitis, conjunctivitis, episcleritis, and recurrent chalazion.

Persistent or recurrent chalazion may be due to meibomian gland carcinoma (sebaceous carcinoma).

Additionally, BCC frequently presents as a solitary nodule on the lid margin, and may initially be clinically difficult to distinguish from a chalazions.

Mx

Histopathologic examination to rule out malignancy

Direct steroid injection

Incision and curettage