A patient presents to the urgent care center with a painful, red lump on their eyelid. The lump has grown over the past two days and now has a central area of pus. What is the most likely diagnosis and recommended treatment?
The most likely diagnosis is a hordeolum, commonly known as a stye. Hordeola presents as painful, red lumps on the eyelid that can develop a central area of pus due to an infection of the sebaceous glands, such as the Meibomian glands. The recommended treatment includes applying warm compresses for 10-15 minutes daily to encourage drainage. If the condition does not improve with conservative measures or signs of secondary bacterial infection, a topical antibiotic ointment, such as erythromycin or bacitracin, can be applied to the eyelid margin. A chalazion is a painless lump caused by chronic obstruction and inflammation of a Meibomian gland. While warm compresses are also helpful, chalazia typically require surgical intervention if they persist. Allergic conjunctivitis is characterized by itchy, watery eyes and eyelid swelling but lacks the painful, focal lump with pus seen in a hordeolum. Its treatment involves antihistamine eye drops and avoiding allergens. Blepharitis causes crusting and irritation along the eyelid margin but does not present with a localized, tender lump; its management focuses on eyelid hygiene, such as cleaning with warm water and diluted baby shampoo.
A hordeolum (stye) is a painful, red lump on the eyelid caused by an infected sebaceous gland, often treated with warm compresses to promote drainage. Remember to differentiate it from a chalazion, which is painless, and focus treatment on hygiene and, if needed, topical antibiotics for secondary infection.