A 5-year-old girl presented with a tender nodule on the lower eyelid for 3 days (Figure 10-1). The clinician diagnosed an external hordeolum (stye) and recommended that the mother apply warm moist compresses to the affected eyelid 4 times a day. Her hordeolum resolved within 7 days.

A hordeolum is an acute painful infection of the glands of the eyelid, usually caused by bacteria. Hordeola can be located on the internal or external eyelid. Internal hordeola that do not completely resolve become cysts called chalazia. External hordeola are commonly known as styes.

Stye (external hordeolum).

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  Unclear incidence or prevalence in the US, but often stated to be more common in school-age children.

  
  
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  In one study of school-age children in Brazil, the prevalence of chalazion was found to be 0.2 percent and that of hordeolum was 0.3 percent.¹

Hordeolum (Acutely Tender Nodule in the Eye)

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  Infection in the meibomian gland (internal hordeolum), often resolves into a chalazion (Figure 10-1).

  
  
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  Infection in the Zeiss or Moll gland (external hordeolum) (Figures 10-2 and 10-3).

  
  
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  Staphylococcus aureus is the causative agent in most cases.

Chalazion

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  Meibomian gland becomes blocked, often in a patient with blepharitis.

  
  
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  Blocked meibomian gland’s duct releases gland contents into the soft tissue of eyelid.

  
  
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  Gland contents cause a lipogranulomatous reaction (Figure 10-4).

  
  
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  Reaction can cause acute tenderness and erythema, which then resolves into a chronic nodule (Figure 10-5).