Hordeolum: Acute abscess within an eyelid sebaceous gland

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TABLE 1

Differences between chalazion and hordeolum

	Chalazion	Hordeolum
Description	Chronic lipogranuloma due to leakage of sebum from an obstructed meibomian gland	Acute abscess within an eyelid gland, usually staphylococcal in origin. Subdivided into internal (meibomian gland) and external (gland of Zeis or Moll)
Risk factors and associations	Blepharitis, seborrheic dermatitis, acne rosacea	Diabetes, blepharitis, seborrheic dermatitis, acne rosacea, high serum lipids
Presentation	Any age, gradually enlarging painless lesion	Any age, acute painful lesion
Signs	Nontender, variable size, roundish, firm lesion within the tarsal plate	Internal: tender, painful swelling within the tarsal plate; may enlarge and discharge anteriorly (through the skin) or posteriorly (through the conjunctiva) External: tender, painful swelling in the eyelid margin pointing anteriorly through the skin
Treatment options	Warm compresses and massage	Internal: Warm compresses and massage
	Corticosteroid injection	Oral antibiotics (if associated with preseptal cellulitis)
	Incision and curettage	Incision and curettage
		External: Warm compresses and massage Oral antibiotics (if associated with preseptal cellulitis) Epilation of infected follicle
When to refer to an ophthalmologist	No improvement or resolution with conservative measures	No improvement or resolution with conservative measures
	Interferes with vision	Signs of preseptal or orbital cellulitis
	Recurrent nodules	Suspected cancer
	Suspected cancer