From the Guidelines
A hordeolum is a painful, red bump that forms at the base of an eyelash or inside the eyelid due to an infection of an oil gland, often associated with symptoms such as redness, irritation, burning, tearing, itching, crusting of eyelashes, and recurrent hordeolum 1. When considering the diagnosis of a hordeolum, it is essential to take a thorough patient history, including questions about symptoms and signs, time of day when symptoms are worse, duration of symptoms, and unilateral or bilateral presentation 1. Key characteristics of a hordeolum include:
- Painful, red bump at the base of an eyelash or inside the eyelid
- Infection of an oil gland
- Associated symptoms such as redness, irritation, burning, tearing, itching, and crusting of eyelashes
- Recurrent hordeolum is a possible symptom of underlying conditions such as blepharitis 1. It is crucial to differentiate a hordeolum from other conditions, such as blepharitis, to provide appropriate treatment and management. In clinical practice, a hordeolum is often diagnosed based on patient history and physical examination, and treatment typically involves warm compresses and over-the-counter pain relievers, with antibiotic eye drops or ointment prescribed in severe cases 1.
From the Research
Definition of Hordeolum
- Hordeolum is a common, painful inflammation of the eyelid margin that is usually caused by a bacterial infection 2, 3, 4.
- The infection affects oil glands of the eyelid and can be internal or external 2, 3, 4.
- Internal hordeolum occurs when the meibomian gland in the tarsal plate is affected, while external hordeolum, or stye, occurs when the glands of Zeis or Moll associated with eyelash follicles are affected 5.
Characteristics of Hordeolum
- The onset of hordeolum is usually self-limited, and may resolve in about a week with spontaneous drainage of the abscess 5.
- In many cases, the lesion drains spontaneously and resolves untreated; however, the inflammation can spread to other ocular glands or tissues, and recurrences are common 2, 3, 4.
- If unresolved, acute internal hordeolum can become chronic or develop into a chalazion 2, 3, 4.
Diagnosis and Treatment
- The diagnosis of hordeolum can mostly be clinically established due to the typical morphological features and clinical course 6.
- The majority of these lesions resolve spontaneously over time, but in some instances, surgical intervention is unavoidable 6.
- In persistent, recurrent, or clinically atypical cases, malignant tumors must be excluded as a differential diagnosis by excisional biopsy and histopathological assessment 6.