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What is it?
A stye, or external hordeolum, is a focal inflammation of a lash follicle or its sebaceous gland in the eyelid. A similar process may occur with inflammation of the Meibomian glands more posterior in the eyelid. Styes are common in a setting of chronic blepharitis.

How does it present?
Styes are exquisitely painful. The pain spreads so widely that the patient will have trouble localizing it. But it comes from a mound of inflamed eyelid that develops over several days, often with pustule formation. The conjunctiva is usually mildly hyperemic.

What to do?
Reassure the patient that it is not serious and will resolve spontaneously within days. Warm compresses may make it more comfortable, but no treatment hastens its resolution.

Sometimes the stye resolves as a painless, hard lump called a "chalazion" (Greek word for hail stone). If it distorts the eyelid and looks ugly, it may have to be surgically excised. Chalazia do not grow. If the patient reports growth, worry about another cause such as a neoplasm.

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