Presentation:

• redness, swelling, and pain in the eyelid 
• they may be associated conjunctivitis and purulent discharge

Examination:

• The visual acuity is normal unless the swelling is big and right in the centre of the upper lid which can distort vision through its mass effect on the cornea.
• The swelling  may be at the base of an eyelash (sty or external hordeolum) or deep within the lid (meibomianitis or internal hordeolum)

Management:

• Topical antibiotic such as chloramphenicol drop is instilled into the lower conjunctival sac four times a day.
• If the lid swelling is extensive and severe, consider superimposed orbital cellulitis which require systemic antibiotics
• Referrals are not neccessary as the conditions resolves within 

a few days.
• Referred to the minor operating list if the swelling fails to resolve after one week. This is mostly seen in internal hordeolum in which a granuloma (chalazion) had developed. The treatment is incision and curretage.

Figure 1. This patient has a right upper lid chalazion. Note the localized nature of the  swelling. This can be treated with topical chloramphenicol by the GP. If  the  swelling fails to resolve, refer the patient to the minor operating list for incision and curettage

Return to swollen lids