Simple inflammation of the eye and adnexa can turn out to be a major disfigurement of the face. This lady approached us with a big firm to hard swelling over her left eyelid for the last 2 years which lead to mechanical drooping of her eyelid and gross disfigurement of her face. She had a history of recurrence of the swelling with a variation of size and homeopathy treatment long back when it was painful. She was examined and a decision was made to incise, drain the curette, and send biopy of the material obtained. She recovered beautifully with near normal eyelids and nothing significant in biopy but granulation tissue and a huge amount of thick pus extracted

Firm swelling of eyelids at a
point with mild to severe pain is frequently termed STYE by us. Common practice is to wait for spontaneous subsiding without medical help until it persists over months or has recurrence or if the first episode is very painful! A painful swelling may subside with medication but those that persist with dull or no pain do not. In recurrent cases usually, the size varies with an increase or decrease of infection or inflammation but with no permanent remedy! Often parallel streams of medicine are approached like homeopathy which might help. But in spite of all processes if a swelling persists more than 15 days it needs immediate medical attention as it is not simple STYE.
These swellings do not have a point for evacuation of pus due to infection of the hair root at eyelid margins extending upwards into the eyelid. The causes may be blepharitis (eyelid infection (due to dandruff, unremoved cosmetics, or dirt), hormonal disbalance, or other systemic diseases.
This is CHALAZION (Internal Hordeolum in medical terms). In long-standing cases can lead to Ptosis(drooping of eyelid and disturbed vision), degenerative changes, and growth of extra tissue (benign or malignant) around it. So the pus pent up needs to be evacuated after everting the lid and from inside the eyelid and thus, the help of an ophthalmic surgeon is a must. Else a disfigurement of the eyelid is possible
Do’s :
1. See an ophthalmologist immediately for a swelling of the eyelid persisting for more than a week
2. Remove cosmetics in total every day before sleep
3. Keep hairs free of dandruff, to avoid spreading to eyelid margins
4. In case of eyelid infection use non-tearing soapy water to clean eyelids regularly or consult a doctor for severe cases of eyelash loss.
5. In hormonal diseases with oily secretion more at the eyelids, regular cleaning of the hair roots of eyelid margins is a must
6. Clean eyelids separately if using 2-wheelers for long hours
7. Discuss with your Ophthalmologist the root cause and treat it.
Donts :
1. Don’t pinch or try to evacuate the pus by mechanical pressure. It might lead to disfigured eyelid
2. Avoid off-the-counter medication for more than 2 days
3. Avoid using cosmetics on swelled eyelids