What was the initial management recommendation for the 54-year-old man with right upper eyelid swelling?

In cases of right upper eyelid swelling, particularly when the swelling is due to a suspected stye or chalazion, the initial management typically involves conservative measures. Heat compresses are recommended as they can help promote drainage of obstructed glands and reduce swelling and discomfort. The application of warm compresses for about 10 to 15 minutes several times a day can help soften any hardened secretions and encourage healing.

Topical antibiotic ointments may be considered if there is suspicion of a bacterial infection, but initial non-pharmacological management like heat compresses is often preferred for simple cystic lesions. Oral antihistamines might be useful if allergic reactions are suspected, but they are not typically the first line for localized swelling of the eyelid without an evident allergic component. Immediate referral to surgery is reserved for more complex cases that do not respond to conservative treatment or when there are concerns about significant underlying conditions, but it is not the routine first step in management.