A 10-year-old girl with a red bump and swelling on the lower eyelid

The image is consistent with a diagnosis of a hordeolum (also known as a stye). 

• A hordeolum is an acute purulent inflammation of a gland within the eyelid, analogous to a pimple on the skin.
• Hordeola can be categorized by location:
  • External: inflammation of an eyelash follicle (or associated gland of Zeis or Moll)
  • Internal: inflammation of a meibomian gland
• Risk factors include:
  • Poor hygiene: such as frequent touching of the face without handwashing, or improper makeup removal
  • Chronic conditions: such as diabetes, seborrheic dermatitis, meibomian gland disease, blepharitis, or rosacea

• Provide conservative treatment, such as using warm compresses, washing the eyelid with a gentle soap, and possibly adding topical antibiotics.
• Follow up with the patient in a few days or weeks to ensure that the patient is appropriately responding to treatment.
• Refer the patient to an ophthalmologist:
  • if concerned for other conditions such as cellulitis or sebaceous cell carcinoma (in adults) 
  • if the stye is large or chronic (chronic styes are also known as ) 

• Perform a slit-lamp examination.
• Monitor the patient for possible preseptal cellulitis.
• Assess for and rule out other conditions on the differential such as sebaceous cell carcinoma (in adults), cellulitis, or cysts.
• Perform incision and drainage for larger styes or chalazia.

• Conservative treatment:
  • frequent warm compress use
  • washing the eyelid with a gentle soap
  • antibiotic (+/- steroid) ointment (this requires monitoring of eye pressure)
• For non-resolving styes (chalazia):
  • incision and drainage
• Oral antibiotics may be needed if there is secondary infection of the eyelids (preseptal cellulitis)

Stye

Eye anatomy

Interactive case: Painful red eye

Ophthalmology Subspecialties