When should a hordeolum be referred to an ophthalmologist?

A hordeolum, commonly known as a stye, is typically a localized infection or inflammation of the eyelid glands, often presenting as a painful, swollen bump. Referral to an ophthalmologist is necessary under specific circumstances to ensure appropriate management and to prevent complications.

In cases where a hordeolum is large and painful, it can indicate a more severe infection or a potential for complications such as abscess formation. This scenario warrants an ophthalmologist's evaluation to assess the need for possible drainage, further treatment options, or to rule out other conditions that may mimic a hordeolum but require different interventions. Prompt specialist care can help alleviate pain, reduce inflammation, and ensure the infection does not spread.

Considering the other scenarios, if the hordeolum is improving with treatment, it generally indicates that conservative management is effective, and no further intervention is required. If it drains on its own, this may also be a normal course of the condition, leading to symptom relief without specialist intervention. Lastly, a lack of swelling would suggest that the hordeolum is resolving or mild, thus not needing referral. Each of these situations typically allows for continued monitoring and management by the primary healthcare provider.