hordeolum
Enable an agent to recognise a suspected hordeolum, track its eyelid location and clinical course, and identify appropriate care or reassessment.
Research draft, second pass
A second pass drafted this model: the structure a model of this thing needs, and what is known about it in the world. The line under this one says how the second half was obtained - researched against sources, or recalled without web access, in which case nothing here was read anywhere and every claim is a lead to verify. Unreviewed either way.
recalled by Codex without web access - no source was read
Researched by: Codex
Purpose and description
Enable an agent to recognise a suspected hordeolum, track its eyelid location and clinical course, and identify appropriate care or reassessment.
A hordeolum, commonly called a stye, is an acute, localized, usually bacterial infection of an eyelid gland or eyelash follicle that produces a tender inflammatory swelling and may form an abscess.
It can be Represent a suspected stye while preserving alternative diagnoses and missing examination evidence.; Track lesion location, pain, drainage and swelling across an episode.; Provide source-linked conservative-care information and record whether it was followed.; Flag concerning changes for clinician assessment using an applicable care pathway.; Document clinician-directed treatment and subsequent response.; Link recurrent episodes and prompt review of persistent or repeatedly affected sites..
Distinguishing features
Acute focal eyelid tenderness with inflammatory swelling supports hordeolum; an established painless nodule favours chalazion, although early appearances overlap. [Merck Manual](https://www.merckmanuals.com/professional/eye-disorders/eyelid-and-lacrimal-disorders/chalazion-and-hordeolum-stye)
A lash-associated focus supports external hordeolum; a meibomian gland focus on the inner lid supports internal hordeolum. [Merck Manual](https://www.merckmanuals.com/professional/eye-disorders/eyelid-and-lacrimal-disorders/chalazion-and-hordeolum-stye)
For medial lesions, locate maximal tenderness relative to the lid, punctum and lacrimal sac to distinguish lacrimal infection. [Merck Manual](https://www.merckmanuals.com/professional/eye-disorders/eyelid-and-lacrimal-disorders/chalazion-and-hordeolum-stye)
Visual disturbance or spreading inflammation challenges classification as an uncomplicated stye and warrants urgent assessment. [NHS](https://www.nhs.uk/conditions/stye/)
Scope
+ External and internal hordeolum as subtypes of one registered condition
+ Affected eye, eyelid, lesion location and suspected gland involvement
+ Pain, swelling, suppuration and episode progression
+ Evidence supporting or challenging a hordeolum diagnosis
+ Conservative care, clinician-directed treatment and escalation decisions
+ Recurrence and links to associated eyelid conditions
- Chalazion as an independently managed condition
- Blepharitis, rosacea and meibomian gland dysfunction beyond their relationship to the episode
- Preseptal and orbital cellulitis beyond recognition and referral boundaries
- Lacrimal drainage infections and eyelid tumours beyond differential assessment
- General ocular anatomy, antimicrobial prescribing protocols and surgical technique
Characteristics
- Anatomical focus
- Right or left eye; upper or lower lid; medial, central or lateral location; lash margin or inner lid; unknown permitted Localises the episode and supports subtype and differential assessment.
- Hordeolum subtype
- External; internal; undetermined Preserves clinically meaningful anatomy without creating separate registry things.
- Diagnostic assessment
- Suspected; clinician-diagnosed; uncertain; revised; with assessor and evidence Prevents an eyelid photograph or symptom report from becoming an unsupported definitive diagnosis.
- Episode duration
- Days since reported onset, with onset uncertainty Makes persistence and response interpretable.
- Lesion extent
- Maximum visible diameter in mm, when reliably measurable Supports comparison over time without imposing an unvalidated diagnostic size threshold.
- Tenderness and pain
- Patient-reported scale with scale name; pain location; examination tenderness separately recorded Distinguishes reported discomfort from examined findings and tracks change.
- Local course
- Inflamed; pustular; draining; improving; resolved; persistent lump; worsening Separates reduced symptoms from complete resolution or diagnostic revision.
- Escalation observations
- Vision change, spreading swelling, severe pain and systemic symptoms: present, absent or not assessed Makes missing safety observations visible.
- Recurrence pattern
- Links to prior episodes, with same-site versus different-site recurrence Distinguishes a new episode from a lesion that never resolved.
- Care exposure
- Linked compress use, lid care, prescriptions or clinician procedures with dates and response Connects observed progress to what was actually attempted.
Also called
Where this came from
wikidata · CC0 1.0
Drafted structure
Bundle to layer to finding to question, as the second pass will find it: 6 bundles · 12 layers · 18 findings · 29 questions.
Lesion identity and anatomy Establish what eyelid lesion is being represented and where it arises.
External and internal hordeola share a registry identity but require anatomical distinction.
Eyelid localisation
Locate each lesion independently of general eyelid swelling.
Lesion site
Record eye, lid and focal position, separating direct examination from patient description.
- Which eye and eyelid contain the focal lesion, and are multiple lesions present? measurement
- Was its position established by examination, photograph or patient report? provenance
Gland origin
Represent subtype only to the extent supported by the observed anatomy.
External or internal
External disease involves a lash follicle and adjacent glands; internal disease involves a meibomian gland. [Merck Manual](https://www.merckmanuals.com/professional/eye-disorders/eyelid-and-lacrimal-disorders/chalazion-and-hordeolum-stye)
- Does the observed focus support external, internal or undetermined hordeolum? definition
- What examination evidence supports the proposed gland origin? provenance
Diagnostic fit and mimics Assess whether the episode fits hordeolum and retain meaningful alternatives.
An eyelid lump alone does not establish an infected eyelid gland.
Focal inflammatory pattern
Combine onset, tenderness and lesion appearance without requiring every feature.
Supporting observations
Keep observed inflammation and discharge separate from inferred infection or organism identity.
- What onset, tenderness, swelling and pustule or drainage observations support hordeolum? measurement
- Which claims are directly observed, clinician-assessed or inferred, including any claimed pathogen? provenance
Alternative eyelid lesions
Resolve overlap through location, evolution and examination.
Chalazion and other mimics
Early chalazion and hordeolum can be indistinguishable; preserve uncertainty rather than forcing a label. [Merck Manual](https://www.merckmanuals.com/professional/eye-disorders/eyelid-and-lacrimal-disorders/chalazion-and-hordeolum-stye)
- Does the evolving lesion favour hordeolum, chalazion, diffuse lid inflammation or a lacrimal drainage infection? boundary
- What additional examination or follow-up would resolve the remaining diagnostic uncertainty? action
Episode course and recurrence Track change from onset through recovery, persistence or another episode.
The trajectory determines whether the initial interpretation and care remain appropriate.
Local evolution
Compare symptoms and visible findings using dated observations.
Inflammation and drainage trajectory
Record changes in tenderness, lesion size, swelling and drainage without treating drainage alone as cure.
- How have pain, focal size and surrounding swelling changed since onset and the previous assessment? measurement
- Has drainage occurred, and what symptoms or lump remain afterward? measurement
Persistence and return
Distinguish incomplete recovery from a new lesion.
Episode outcome
Retain residual-lump status and exact-site history when deciding whether to close an episode.
- Did the lesion fully disappear before the reported recurrence, and is the site the same? boundary
- Does persistence or repeated same-site disease require diagnostic reassessment under the applicable pathway? action
Extension and urgent assessment Identify when a local eyelid episode requires a broader clinical assessment.
The hordeolum label must not conceal spreading disease or unexplained visual symptoms.
Spread beyond the focus
Record the distribution and progression of inflammation.
Spreading inflammation
Spreading infection or marked pain and swelling warrants urgent clinical advice. [NHS](https://www.nhs.uk/conditions/stye/)
- Is inflammation confined to the focal lesion or extending across the eyelid or surrounding area? measurement
- What urgency and receiving service does the local pathway specify for the observed spread and severity? action
Ocular and systemic concerns
Assess symptoms that cannot safely be attributed to the visible lump alone.
Visual and systemic status
Keep visual function and systemic symptoms explicit, including whether they were assessed.
- Are vision changes, pain within the eye, fever or systemic illness present, absent or unassessed? measurement
- Do these findings require urgent eye assessment or transfer to a cellulitis or other ocular-condition pathway? action
Care and predisposing lid context Connect conservative care, clinical intervention and relevant eyelid history.
Actions depend on subtype, progression and the condition of the surrounding lid.
Conservative care
Represent practical care with source, tolerability and observed response.
Compresses and contact precautions
NHS advice includes warm compresses, avoiding contact lenses and eye makeup until healed, and not squeezing or puncturing the lesion. [NHS](https://www.nhs.uk/conditions/stye/)
- Which source-supported compress and hygiene instructions were given, and can the person follow them safely? action
- What care was actually used, and did discomfort or swelling improve? measurement
Clinician-directed management
Record the rationale for treatment beyond conservative measures.
Treatment indication and review
Link prescriptions or drainage to the clinician's assessment, subtype and applicable guidance.
- What findings justify clinician-directed medication, drainage or specialist review for this episode? action
- Who selected the intervention, under which guidance, and what response or review interval was expected? provenance
Associated lid conditions
Relate the episode to established surrounding conditions without asserting an individual cause.
Blepharitis and rosacea links
Blepharitis and rosacea are associated with increased stye likelihood; their presence does not prove the cause of an episode. [NHS](https://www.nhs.uk/conditions/stye/)
- Is blepharitis or rosacea documented, suspected or absent, and on what evidence? provenance
- Should recurrent episodes prompt assessment or management of an associated lid condition? action
Evidence and external alignment What the world already says about this thing, gathered so the model can be checked against it.
A model that cannot be lined up against existing standards, identifiers and practice cannot be adopted by anyone who already uses them.
Reported evidence
Findings from the breadth pass, kept separate from the structural claims.
Check these first
Recalled without web access and unsourced; every item is a lead to verify.
- This describes the ophthalmic condition; no separate registry sense was supplied.
- The content is recalled knowledge, not a report of sources read.
- Verify the applicable national coding system before using H00.0 for administrative purposes.
- Which of these check these first hold for the sense of hordeolum this model covers, and on what evidence? provenance
Kinds and varieties
Recalled without web access and unsourced; every item is a lead to verify.
- External hordeolum: involves an eyelash follicle and associated glands of Zeis or Moll.
- Internal hordeolum: involves a meibomian gland within the eyelid's tarsal plate.
- Which of these kinds and varieties hold for the sense of hordeolum this model covers, and on what evidence? provenance
Identifiers and schemes
Recalled without web access and unsourced; every item is a lead to verify.
- ICD-10 - H00.0 - WHO category for hordeolum and other deep inflammation of the eyelid; national clinical modifications may add specificity.
- Which of these identifiers and schemes hold for the sense of hordeolum this model covers, and on what evidence? provenance
Real-world use
Recalled without web access and unsourced; every item is a lead to verify.
- Clinical diagnosis of an acute, localized, painful eyelid swelling.
- Distinguishing eyelid gland infection from chalazion and more extensive periocular infection.
- Diagnostic coding in clinical records and health statistics.
- Which of these real-world use hold for the sense of hordeolum this model covers, and on what evidence? provenance
Failure modes and hazards
Recalled without web access and unsourced; every item is a lead to verify.
- Local abscess formation.
- Spread of infection into surrounding eyelid tissues, causing preseptal cellulitis.
- Residual gland obstruction and inflammation may leave a chalazion.
- Recurrent or atypical lesions may be misclassified, delaying recognition of another eyelid disorder.
- Which of these failure modes and hazards hold for the sense of hordeolum this model covers, and on what evidence? provenance
Regional variation
Recalled without web access and unsourced; every item is a lead to verify.
- Diagnostic coding detail varies between WHO ICD-10 and national clinical modifications.
- Which of these regional variation hold for the sense of hordeolum this model covers, and on what evidence? provenance
Neighbouring kinds and how to tell them apart
Recalled without web access and unsourced; every item is a lead to verify.
- chalazion - A chalazion is primarily chronic lipogranulomatous inflammation associated with retained gland secretions, usually less tender than an acute infectious hordeolum.
- blepharitis - Blepharitis affects the eyelid margins more diffusely; a hordeolum is a focal infection, although both can coexist.
- preseptal cellulitis - Preseptal cellulitis is a spreading infection of eyelid tissues anterior to the orbital septum rather than a localized gland or follicle infection.
- orbital cellulitis - Orbital cellulitis involves tissues behind the orbital septum and may impair eye movement or vision; a hordeolum is localized to the eyelid.
- Which of these neighbouring kinds and how to tell them apart hold for the sense of hordeolum this model covers, and on what evidence? provenance
What the second pass must settle
- What minimum examination evidence reliably distinguishes early internal hordeolum from inflamed chalazion, especially during remote assessment?
- What evidence supports particular warm-compress regimens and antimicrobial indications separately for external and internal hordeolum?
- Which persistence and same-site recurrence criteria should trigger specialist reassessment across age groups?
- How should escalation thresholds change with immune compromise, diabetes or inability to examine the eye adequately?
- Which episode-resolution and recurrence measures are sufficiently consistent for comparing outcomes across care settings?