These are distinct from meibomian infections, being the result of infection of the lash root. The eyelid might swell up and become painful and at this stage, the site of the infection can be uncertain. However, a small yellow pointing area is eventually seen around the base of an eyelash.

Figure 5.11. A meibomian cyst. 03

Hot steaming, again, is effective treatment and once the pus is seen, the eyelash can be gently epilated, with resulting discharge and subsequent resolution of the infection.

Children aged from about six to ten years sometimes seem to go through periods of their lives when they can be dogged by recurrent styes and meibomian infections, much to the distress of the parents. Under these conditions, frequent baths and hairwashing are advised and sometimes a long-term systemic antibiotic might be considered. Recurrent lid infections can raise the suspicion of diabetes mellitus but in practice, this is rarely found to be an underlying cause.

Eyelid infections such as these rarely cause any serious problems other than a day or two off work and it is extremely unusual for the infection to spread and cause orbital cellulitis. Recurrent swelling of the eyelid in spite of treatment can indicate the need for a lid biopsy because some malignant tumours can, on rare occasions, present in a deceptive manner.

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