The patient complains of redness, nodular swelling, and pain in the eyelid, perhaps at the base of an eyelash (stye or external hordeolum) or deep within the lid (meibomitis, meibomianitis, or internal hordeolum, which is best appreciated with the lid everted) and perhaps with conjunctivitis and purulent drainage. In some cases, the complaint may be that of generalized edema and erythema of the lid (cellulitis). There may be a history of similar problems.

 

Examination most commonly reveals a localized tender area of swelling, often with a pointing eruption on either the internal or the external side of the eyelid (Fig. 20.1).