Differential Diagnosis for Hordeolum with Pus and Pain
- Single most likely diagnosis
- Stye (Hordeolum): This is the most likely diagnosis given the presentation of a painful, pus-filled lesion on the eyelid, which is characteristic of a stye. Styes are usually caused by a bacterial infection, often Staphylococcus aureus, and can be external (on the outside of the eyelid) or internal (on the inside of the eyelid).
- Other Likely diagnoses
- Chalazion: Although typically less painful and less likely to have pus, a chalazion (a blocked oil gland in the eyelid) can sometimes become infected and present similarly to a hordeolum. It's essential to differentiate between the two as treatment approaches may vary.
- Blepharitis: This is an inflammation of the eyelids that can cause redness, itching, and swelling. While it might not directly cause a pus-filled lesion, it can increase the risk of developing a stye or chalazion and may present with similar symptoms.
- Conjunctivitis: Although conjunctivitis (pink eye) primarily affects the conjunctiva, severe cases can cause significant discomfort and pus-like discharge, potentially mimicking some symptoms of a hordeolum.
- Do Not Miss diagnoses
- Orbital Cellulitis: This is a serious infection of the tissues surrounding the eye, which can present with eyelid swelling, redness, and pain. While less common than a stye, it's a critical diagnosis not to miss due to the potential for serious complications, including vision loss.
- Dacryocystitis: An infection of the lacrimal sac, which can cause pain, swelling, and discharge in the area of the eye. It's less common but can be serious if not properly treated.
- Rare diagnoses
- Malignant Tumors: Rarely, a lesion on the eyelid could be a sign of a malignant tumor. Although extremely uncommon, it's essential to consider in the differential diagnosis, especially if the lesion does not respond to typical treatments for styes or chalazia.
- Parasitic Infections: Certain parasitic infections, such as those caused by Demodex mites, can lead to eyelid inflammation and could potentially mimic some symptoms of a hordeolum, although this would be quite rare.