In a Medscape Journal article, Dr. Jane Fansler states that a sore, swollen eyelid is one of the most common presenting complaints at a primary care doctor's office. In addition to feeling self-conscious about their appearance, patients with a sore swollen eyelid will worry that they might have an infection and will be concerned about loss of vision. Three categories cover possible causes of such a condition: infectious, allergic and mechanical blockage.
A sty is a red, swollen and painful lump at the edge of the eyelid, where the eyelashes come out. A sty is a collection of pus, which means a bacterial infection is present. Proper treatment includes application of warm, moist compresses to the affected area and use of eye antibiotics, which can be prescribed in liquid dropper or ointment form.
A chalazion is an enlarged nodule on a patient's eyelid and is caused by a blocked oil gland, which leads to a backup effect. As the chalazion enlarges, it tends to cause redness, swelling and pain. Treatment consists of frequent warm compresses and massage to unblock the gland. Because a chalazion is not caused by a bacterial infection, antibiotics are not indicated.
Blepharitis is an inflammation of the eyelids, in which the edges of the eyelids become red and itchy, and accumulation of dandruff-like scales occurs on the lashes. It is a common eye disorder, usually caused by a skin condition known as seborrhea. However, bacterial infection can exacerbate the problem. Treatment involves warm compresses once again, followed by a light scrubbing of the eyelashes with a mixture of water and baby shampoo.
Allergies can produced sore swollen eyelids. The patient might be suffering from severe hay fever or pollen allergy or she might have a contact allergy such as that caused by an allergic reaction to new makeup or exposure to a cat or dog. In such cases, the swelling is more diffuse, as opposed to the focal swelling seen with styes and chalazions.
Periorbital cellulitis is a bacterial infection of the skin and soft tissues around the eye. In the early phase, the patient will often start with a sore swollen eyelid, but this will rapidly progress to involve all of the area surrounding the eye, and possibly the orbit itself. It is critical that patients seek medical attention immediately with this condition.
Herpetic Infections of the Eye
Two types of herpes virus infections cause sore swollen eyelids: herpes simplex, and herpes zoster. H simplex is the same virus that causes cold sores. If present on the eyelid, it will develop a cluster of small blisters on top of a red rash spot. H zoster, also known as shingles, causes a similar lesion but the blisters tend to be larger. Both conditions cause extreme pain, and warrant medical attention.