Hordeoleum vs Preseptal cellulitis

[Karnak]

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First, I will begin with a case history, then ask my question.
20 year old male industrial worker, gets unknown foreign body in L eye and has severe pain, is unable to open L eye for 15 minutes. After that 15 minutes, the eye is fine, and no pain or discomfort occurs for the next two days. The third day following the incident the man wakes up with severe pain (4/10), redness and oedema of the L superior lid, with a small amount of weeping but no clear purulent discharge. The patient finds it difficult to see out of the L eye because of the degree of swelling.

Upon examination there is no L proptosis, no abnormalities in excursions/eye movements. The patient is afebrile. Slit lamp examination finds no foreign body, no sign of trauma and no staining on with fluoroscein. Pupillary responses are normal OU. The entire upper lid is oedematous and extremely painful upon palpation.

Diagnosis of preseptal cellulitis was made, and the patient was referred.

At referral to local hospital, oral flucloxacillin was prescribed, and the report from the ophthalmologist stated a diagnosis of an "infected stye."

So what's the go? How would one discriminate between an "infected stye" or preseptal cellulitis, or did he mean the same thing?

 

[orbitsurgMD]

. . .
Upon examination there is no L proptosis, no abnormalities in excursions/eye movements. The patient is afebrile. Slit lamp examination finds no foreign body, no sign of trauma and no staining on with fluoroscein. Pupillary responses are normal OU. The entire upper lid is oedematous and extremely painful upon palpation.

Diagnosis of preseptal cellulitis was made, and the patient was referred.

At referral to local hospital, oral flucloxacillin was prescribed, and the report from the ophthalmologist stated a diagnosis of an "infected stye."

So what's the go? How would one discriminate between an "infected stye" or preseptal cellulitis, or did he mean the same thing?

[Bolds mine.]

They can be the same. A "stye" is an abscess, by itself focal, by definition infectious, often associated in the eyelid with chalazia, but can also be associated with no preexisting pathology or as a result of trauma. If the inflammatory process becomes more general to the eyelid, no longer focally isolated to the immediate abscess lesion, with the clinical suspicion of extension of infecting organisms and associated inflammation to the whole eyelid soft tissue, then it is a cellulitis, and if not extending posterior to the plane of the septum, is also preseptal. So it is a matter of degree. Technically a stye is also an acute cellulitis but calling it that is not helpful in describing its focal nature.