From the Research
Treatment approaches for chalazia and hordeola differ significantly, with chalazia being managed with warm compresses, gentle massage, and potentially intralesional steroid injections or surgical incision and curettage, while hordeola are treated with warm compresses and antibiotic therapies due to their infectious nature. The primary distinction in treatment stems from the underlying causes of these conditions: chalazia are non-infectious blockages of meibomian glands, whereas hordeola are acute bacterial infections of eyelid glands. For chalazia, initial management involves applying warm compresses to the eyelid for 10-15 minutes, 4-6 times daily, along with gentle massage to facilitate drainage of the blocked gland, as supported by general medical principles and studies like 1. Over-the-counter pain relievers such as ibuprofen or acetaminophen can be used to manage discomfort. If the chalazion persists beyond 2-4 weeks, medical intervention may include intralesional steroid injection (triamcinolone 2-4 mg) or surgical incision and curettage under local anesthesia, with studies like 2 indicating the effectiveness of intralesional triamcinolone acetonide injection compared to incision and curettage. On the other hand, hordeola, being infectious, require antibiotic treatments in addition to warm compresses, including topical antibiotic ointments like erythromycin or bacitracin applied 2-3 times daily for 7-10 days, or oral antibiotics for more severe cases, as generally recommended in the treatment of bacterial infections 1. Both conditions benefit from good eyelid hygiene, including gentle cleansing with baby shampoo diluted in warm water, and avoiding eye makeup during the healing process. Given the most recent and highest quality evidence, intralesional steroid injection is considered as effective as incision and curettage for primary chalazia, offering a less invasive alternative 2. In the context of real-life clinical medicine, prioritizing the least invasive yet effective treatment approach is crucial for minimizing morbidity, mortality, and improving quality of life for patients with these conditions. Key considerations include:
- The size and location of the chalazion or hordeolum
- The presence of any underlying conditions that may affect treatment outcomes
- The patient's overall health status and ability to tolerate different treatment options
- The potential for complications or recurrence with each treatment approach. Ultimately, the choice between intralesional steroid injection and incision and curettage for chalazia, or the specific antibiotic regimen for hordeola, should be tailored to the individual patient's needs and circumstances, guided by the most current and robust clinical evidence available 1, 2.