Differential Diagnosis for Eyelid Swelling and Bumps

The symptoms described, including eyelid swelling, soreness, development of styes, and a bump on the inside of the lower lid, suggest several potential diagnoses. Here's a categorized differential diagnosis:

• Single Most Likely Diagnosis

  • Blepharitis or Meibomian Gland Dysfunction: This condition often leads to eyelid swelling, soreness, and can predispose to stye formation. The presence of a bump on the inside of the lower lid, which could be a meibomian gland cyst or an internal hordeolum, further supports this diagnosis. The condition tends to be chronic and can wax and wane, which might explain the improvement without treatment.

• Other Likely Diagnoses

  • Stye (Hordeolum): Already diagnosed, but the presence of multiple styes and the bump on the inside of the lid could indicate a more complex or chronic infection.
  • Chalazion: A lump in the eyelid that occurs due to a blocked oil gland. It's possible the bump on the inside of the lower lid could be a chalazion, especially if it's not painful and has been present for a while.
  • Allergic Conjunctivitis: Could cause eyelid swelling and might be associated with other symptoms like itching or redness of the eyes.

• Do Not Miss Diagnoses

  • Orbital Cellulitis: An infection of the tissues surrounding the eye, which can cause swelling, pain, and redness of the eyelids. It's a serious condition that requires prompt medical attention.
  • Basal Cell Carcinoma or Other Eyelid Tumors: Though less likely, any new, persistent lump on the eyelid should be evaluated for the possibility of skin cancer, especially in older adults or those with significant sun exposure.

• Rare Diagnoses

  • Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the eyes, leading to swelling and lumps.
  • Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can affect many parts of the body, including the eyes, and cause a variety of symptoms including eyelid swelling and nodules.

Given the symptoms and the potential for serious conditions, even if the symptoms seem to be improving, it's advisable to consult a doctor for a proper evaluation and diagnosis. A healthcare professional can provide a definitive diagnosis and recommend appropriate treatment.