TABLE 1

Differences between chalazion and hordeolum

ChalazionHordeolum
DescriptionChronic lipogranuloma due to leakage of sebum from an obstructed meibomian glandAcute abscess within an eyelid gland, usually staphylococcal in origin. Subdivided into internal (meibomian gland) and external (gland of Zeis or Moll)
Risk factors and associationsBlepharitis, seborrheic dermatitis, acne rosaceaDiabetes, blepharitis, seborrheic dermatitis, acne rosacea, high serum lipids
PresentationAny age, gradually enlarging painless lesionAny age, acute painful lesion
SignsNontender, variable size, roundish, firm lesion within the tarsal plateInternal: 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 optionsWarm compresses and massageInternal:
 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 ophthalmologistNo improvement or resolution with conservative measuresNo improvement or resolution with conservative measures
Interferes with visionSigns of preseptal or orbital cellulitis
Recurrent nodulesSuspected cancer
Suspected cancer