Differential Diagnosis for Persistent Internal and External Hordeolum
Single Most Likely Diagnosis
- Chalazion: A chalazion is a common, benign condition that can cause persistent internal hordeolum. It is a granulomatous inflammation of the meibomian gland, which can cause a painful, swollen nodule on the eyelid. External hordeolum, also known as a stye, can occur concurrently or separately.
Other Likely Diagnoses
- Blepharitis: A chronic inflammatory condition of the eyelids that can cause persistent hordeolum, as well as other symptoms such as itching, burning, and crusting of the eyelids.
- Meibomian Gland Dysfunction: A condition where the meibomian glands become clogged or inflamed, leading to recurrent hordeolum and other eye symptoms.
- Demodex Infestation: A parasitic infestation of the eyelashes and eyelids that can cause persistent hordeolum, as well as other symptoms such as itching and burning.
Do Not Miss Diagnoses
- Orbital Cellulitis: A serious bacterial infection of the tissues surrounding the eye that can cause persistent hordeolum, as well as other symptoms such as fever, swelling, and proptosis (bulging of the eye).
- Malignant Tumor: Although rare, a malignant tumor such as basal cell carcinoma or squamous cell carcinoma can cause persistent hordeolum, and it is essential to rule out this possibility to avoid delayed diagnosis and treatment.
Rare Diagnoses
- Sarcoidosis: A systemic inflammatory disease that can cause granulomatous inflammation of the eyelids, leading to persistent hordeolum.
- Tuberculosis: A rare cause of persistent hordeolum, which can occur in people with tuberculosis or those who have been exposed to someone with the disease.
- Leishmaniasis: A parasitic infection that can cause persistent hordeolum, as well as other symptoms such as skin lesions and fever.