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Hordeolum & Chalazion

o Acute , purulent inflammation of the glands / eyelash follicles of the eyelid
o Most commonly caused by Staphylococcus aureus
o Seen more in children than in adults
o Hordeolum  the most common eyelid lessions in clinical practice
o No sexual & race predilection in hordeolum
Thickening and stasis of gland secretions

Secondary infection (usually by staphylococcus


Acute pyogenic inflammation with PMN +

pustule formation
Internal •Infection in the
hordeolum Meibomian gland

External •Infection in the gland of

hordeolum zeis / moll
Internal hordeolum vs External Hordeolum
Risk factors
o Poor eyelid hygiene
o History of recurrent hordeolum
o Chronic inflammation of the eyelid (blepharitis)
Each child may experience symptoms differently
The most common symptoms are :
o Swelling of the eyelid
o Redness at the edge of the eyelid
o Pain over the affected area
o Tenderness
o most hordeolum will heal spontaneously within 1 – 2 weeks
o Applying warm & wet compresses to the target eye (15 minutes) several times a day
o antibiotic ointments  can help stop the spread of the infection to other parts of
the eye
o Oral antibiotics  appropriate only for cases with cellulitis
Differential Diagnosis

chalazion Dacryocystitis Cellulitis preseptal

o Firm , non-tender nodular lesion of the eyelid
o Resulting from obstruction and subsequent chronic granulomatous inflammation of
Meibomian gland
Thickening and stasis of gland secretions

Lipid breakdown from sebaceous secretions (sebum)  leaked

into tarsus and surrounding tissue

enlarge and break through the tarsal plate to the external portion
of the lid

Incite a non-infectious granulomatous inflammatory reaction

(histiocytes, lymphocytes)
o An obstruction of the Meibomian gland that can form a cyst with concurrent
granulomatous inflammation
o Also can formed by an inflamed hordeolum that scar and harden with time
Each child may experience symptoms differently
The most common symptoms are :
o Swelling on the eyelid but painless
o Non – tender
o Sensitivity to light
o Eye discomfort
o Increased tearing
o Heaviness of the eyelid
o Non-infection condition  antibiotic are not indicated
o Small chalazion  resolve on its own
o Large chalazion  will spontaneously clear in weeks to month, but if the lession
persistent, refer to an ophthalmologist to be treated by surgical incision
Hordeolum VS Chalazion
Hordeolum VS Chalazion
o Avoid rubbing eyes
o Wash hands before touching eyes and putting in contact lenses
o Protect eyes from dust and air pollutin
o Replace eye makeup (mascara) every 6 months (bacteria can grow in makeup) and
don’t share makeup with others
Thank you