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Answers: 2004 series -  October 26, 2004 Lecture 10 of 50  NEXT»

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This 3-year-old girl was noted to have redness and swelling of her left upper lid for the past five days.  This is the first time she has had anything like this.  Her eye examination is otherwise normal. The child is said to be healthy, and has no known allergies, or trauma.

1.  The most likely diagnosis is:  

c -- The acute onset of this type of swelling in an otherwise healthy young child is external hordeolum or stye.  This is differentiated from an internal hordeolum which usually "points" internally at the tarsal conjunctiva.  Large internal styes can "point"  eventually in both directions, conjunctiva and skin.

2.  The process primarily involves  

a -- The glands of Zeis' and Moll.  The hordeolum is caused by stasis and then eventual bacterial infection. (Current Ocular Therapy, Fraunfelder and Roy. W.B. Saunders, Philadelphia, 2000, p.435)

3.  Treatment for this condition would include:
  d -- Hot, moist compresses four times a day and if there is not prompt resolution, drainage through the skin is the treatment of choice for an external hordeolum like this. Only in cases of chronic or recurrent styes with risk to the health of the lids would it be necessary to resort to topical steroids.  In some chronic cases systemic antibiotics would be used.  


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