John has developed over a few days, a discharging right eye with increasing redness and soreness over the inner aspect of his upper cheek. His vision is normal. He has some tenderness over the red eyelid areas.



Ocular signs:

• Epiphora (from the duct obstruction preventing tear drainage)

• Red swollen nasal eyelid that is warm to touch and tender with gentle palpation.

• Dilated red nasal punctum

• Follicular conjunctivitis

• No corneal staining with fluorescein