FIGURE 123.13 Acute stye (external hordeolum) Both conditions may present acutely with localized lid swelling, erythema, and tenderness Styes are associated with swelling and purulent drainage at or near the lid margin ( Fig 123.13 ) More than one lesion may occur simultaneously, and more than one lid may be involved An acute chalazion causes swelling and redness in the body of the eyelid and may be associated with drainage on the conjunctival surface of the eyelid with or without a red eye It may also drain via the skin ( Fig 123.14 ) A chalazion typically enters a chronic granulomatous phase in which there is a nontender, noninflamed, mobile pea-sized nodule within the body of the eyelid ( Fig 123.15 ) History can be helpful in establishing these diagnoses because patients often have had recurrent lesions in the same or other eyelid