A 10-year-old presents with a central, painless swelling on the left upper eyelid with mild erythema. The most likely diagnosis is:

A 10-year-old presents with a central, painless swelling on the left upper eyelid with mild erythema. The most likely diagnosis is:

• A. Blepharitis
• B. Chalazion
• C. External Hordeolum
• D. Coloboma of the eyelid

Answer: (B)

A chalazion is a noninfectious blockage of a meibomian gland in the eyelid that forms a firm, localized, usually painless lump within the eyelid, often with only mild surrounding redness or edema. The presentation described—a central, painless swelling on the upper eyelid with mild erythema in a child—fits this pattern well. In contrast, an external hordeolum (stye) is typically painful and red, located at the lash line with possible purulent discharge, reflecting an acute infection of the eyelid margin. An internal hordeolum is similar but located inside the eyelid and can be tender. Blepharitis causes diffuse lid-margin irritation, redness, and crusting rather than a discrete lump. A coloboma is a congenital lid defect, appearing as a notch rather than a swollen mass. Management focuses on gentle, conservative measures: warm compresses several times daily to promote gland drainage and lid hygiene. If the lesion persists, enlarges, or affects vision, refer to ophthalmology for possible drainage or other interventions. Avoid squeezing the lump, and treat any associated lid inflammation if present.

A chalazion is a noninfectious blockage of a meibomian gland in the eyelid that forms a firm, localized, usually painless lump within the eyelid, often with only mild surrounding redness or edema. The presentation described—a central, painless swelling on the upper eyelid with mild erythema in a child—fits this pattern well.

In contrast, an external hordeolum (stye) is typically painful and red, located at the lash line with possible purulent discharge, reflecting an acute infection of the eyelid margin. An internal hordeolum is similar but located inside the eyelid and can be tender. Blepharitis causes diffuse lid-margin irritation, redness, and crusting rather than a discrete lump. A coloboma is a congenital lid defect, appearing as a notch rather than a swollen mass.

Management focuses on gentle, conservative measures: warm compresses several times daily to promote gland drainage and lid hygiene. If the lesion persists, enlarges, or affects vision, refer to ophthalmology for possible drainage or other interventions. Avoid squeezing the lump, and treat any associated lid inflammation if present.