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.