From the Guidelines
A chalazion and a hordeolum are distinct eyelid lesions with different etiologies, symptoms, and management strategies. The key differences between these two conditions lie in their causes, clinical presentations, and treatments. A chalazion is characterized as a painless, firm nodule resulting from the blockage and inflammation of an oil gland in the eyelid, typically presenting as a slow-growing lump away from the eyelid margin and not usually infected 1. In contrast, a hordeolum is a painful, red, localized infection of an eyelid gland, which can be external (involving the base of an eyelash) or internal (affecting a meibomian gland), and is typically more painful, red, and acute in onset compared to chalazia.
Key Differences and Treatments
- Cause: Chalazion - blockage and inflammation of an oil gland; Hordeolum - bacterial infection, often by Staphylococcus species.
- Symptoms: Chalazion - painless, firm nodule; Hordeolum - painful, red, localized infection.
- Treatment: Chalazion - warm compresses for 10-15 minutes, 4-6 times daily, with possible surgical incision and drainage for persistent cases; Hordeolum - warm compresses, and may require antibiotic ointments like erythromycin or bacitracin applied to the eyelid margin 2-3 times daily for 7-10 days, with severe or recurrent cases possibly needing oral antibiotics.
Given the information from the most recent study on blepharitis preferred practice pattern 1, it's clear that understanding the history of symptoms, including the presence of hordeolum or chalazion, is crucial for diagnosing and managing eyelid and ocular surface diseases effectively. The distinction between these two conditions is vital for appropriate treatment and prevention of complications, highlighting the importance of a thorough patient history and examination in clinical practice.
From the Research
Difference between Chalazeon and Hordoleum
- A chalazion is a non-inflammatory process that develops due to retained secretion of the meibomian or Zeis glands 2
- A hordeolum, on the other hand, is a common, painful, inflammation of the eyelid margin that is usually caused by bacterial infection 3
- Hordeolum can be internal or external, with internal hordeolum affecting the oil glands of the eyelid and external hordeolum, also known as styes, affecting the eyelid margin 3
- Chalazion and hordeolum can occur in association with underlying diseases causing Meibomian gland dysfunction and/or chronic blepharitis 4
- The diagnosis of chalazion and hordeolum can mostly be clinically established due to their typical morphological features and clinical course 4
- The majority of these lesions resolve spontaneously over time, but in some instances, surgical intervention is unavoidable 4
Treatment Options
- Treatment options for chalazion include application of warm compress onto eyelids, lid hygiene, using local antibiotic ointment with or without steroids, injecting steroid solution into the lesion, and surgical removal of the lesion by incision and curettage 2
- Hot compresses alone or in combination with tobramycin or tobramycin/dexamethasone drops and ointment are effective first-line treatment options for chalazia 5
- The addition of an antibiotic to conservative measures for a chalazion or hordeolum is not associated with an increased likelihood of treatment success 6
Key Differences
- Chalazion is a non-inflammatory process, while hordeolum is an inflammatory process 3, 2
- Chalazion develops due to retained secretion of the meibomian or Zeis glands, while hordeolum is usually caused by bacterial infection 3, 2
- Chalazion and hordeolum have different treatment options, with chalazion often being treated with conservative measures and hordeolum often requiring antibiotic treatment 3, 6, 2, 5