A hordeolum is an acute infection affecting the meibomian, Zeis, or Moll glands of the eyelid. Stasis of the gland secretions predisposes the glands to bacterial infection. Staphylococcus aureus is the most common pathogen. The condition presents as a painful, localized, erythematous nodule in the anterior (external hordeolum) or posterior (internal hordeolum) lamella of the eyelid. A hordeolum usually resolves spontaneously and can be managed with warm compresses, massage, and lid hygiene. In certain cases of significant swelling, topical antibiotics with steroids may be needed. If a hordeolum does not resolve, the patient should be referred to ophthalmology for incision and drainage.
Last updated: Apr 28, 2023
|Gland of Zeis||Sebaceous gland Sebaceous Gland Small, sacculated organs found within the dermis. Each gland has a single duct that emerges from a cluster of oval alveoli. Each alveolus consists of a transparent basement membrane enclosing epithelial cells. The ducts from most sebaceous glands open into a hair follicle, but some open on the general surface of the skin. Sebaceous glands secrete sebum. Hordeolum (Stye)||Directly into the eyelash follicle||External hordeolum External Hordeolum Hordeolum (Stye)|
|Gland of Moll Gland of Moll Blepharitis||Modified sweat glands Modified Sweat Glands Hordeolum (Stye)||Between adjacent lashes||External hordeolum External Hordeolum Hordeolum (Stye)|
|Meibomian gland Meibomian Gland Chalazion||Modified sebaceous gland Modified Sebaceous Gland Hordeolum (Stye)||Behind eyelashes||Internal hordeolum Internal Hordeolum Hordeolum (Stye)|
Clinical trials and guidelines involving the management of hordeola are lacking; however, the following information is based on US and UK society recommendations. Additionally, management may vary depending on practice location. Please see your local practice guidelines.
Most hordeola resolve spontaneously, lasting up to 1–2 weeks.
Topical antibiotic and/or steroid ointment[5,6,8]
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