Several patients consulted me last week because of eyelid swelling. Some were worried because of sudden pain and redness, while others reported they’ve had the bump for a few months without discomfort. There are three common types of lid swelling or “kuliti” (here are sample photos) and each one is handled differently. To help us figure out these bumps, here’s a guide.

1. CHALAZION

A painless eyelid nodule that develops over time is called a chalazion. Some are small and resolve spontaneously while others become large and cause drooping of the lids. Patients may have had a similar experience in the past.

Here, the oil glands on our lids get blocked. The oil collects and forms a non-infectious nodule.

For smaller chalazia, warm compress and eyelid hygiene may be enough to resolve it. For bigger ones, patients may opt for minor surgery. They can also become infected for which topical antibiotics are given.

2. HORDEOLUM

Also known as stye, a hordeolum looks like a pimple and may have a pus-filled tip (“mata”). It is painful, red and occurs within 24 hours. The oil glands are also blocked, but this is caused by a bacterial infection. There are two kinds of hordeola: internal and external, depending on the glands involved.

When you experience this, apply warm compress, do eyelid scrub and a topical antibiotic may be prescribed to treat it.

3. PRESEPTAL CELLULITIS

The eyelid can at times swell, involving the entire upper or lower lid, sometimes both, and may also involve the cheek on the same side. The eyelid becomes inflamed due to infections from trauma, an insect bite or spread from nearby structures such as a stye or infected chalazion. If this occurs, we are dealing with preseptal cellulitis. This is more dangerous because the infection can spread further into the eye and even affect the brain. In this case, oral antibiotics will be given on top of the treatment mentioned for the two other conditions.

What preventive measures can we do? Hand hygiene is very important. Wash your hands thoroughly before touching your face and eyes. For those who wear eye makeup, remove it completely before going to bed. Gentle washing of the eyelids with mild soap and water can also reduce the incidence of oil gland blockage.

If you do get lid swelling, the first thing to do is apply warm compress 2-3x a day to the affected eyelid. Perform the eyelid scrub as well, to relieve the oil obstruction. Monitor for 24 hours. If the swelling improves, continue management until it resolves completely. If the swelling worsens, it is better to err on the side of caution and consult an ophthalmologist.

The three types listed are the most common causes of eyelid swelling. There are others that masquerade like them but are more sinister, such as cancer. If you’re unsure of what you’re dealing with, consult your eye doctor today.