Specific Management: Hordeolum

Superficially, an acute hordeolum and chalazion will look similar. However, there are a number of differences, largely due to the infective nature of hordeolum as opposed to the granuloma of a chalazion.

Fig 1: Hordeolum Fig 2: Chalazion

Key differences

This table summarises the key differences between an hordeolum and a chalazion.

Hordeolum Chalazion
Duration Usually <7 days Can persist indefinitely
Onset Rapid; can appear overnight Gradual increase in size
Appearance Red swelling, pus collection may be visible Red/yellow swelling, more rounded
Discharge from lesion Yes; often noticeable in the morning No
Tenderness Tender Mild or no tenderness
Associated problems Can cause local cellulitis or conjunctivitis Usually none

Treatment

An uncomplicated hordeolum will rarely require antibiotic therapy. Application of a warm compress for 15 minutes at a time, four times a day, will encourage the collection to discharge. No review is needed in most cases.
Occasionally, complications arise from the spread of infection; preseptal cellulitis should be treated as per the page entitled ‘Specific (Preseptal Cellulitis)’, conjunctivitis will require topical antibiotic treatment.