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A hordeolum is a small infection of the glands in the eye, located in the eyelids. The infection causes a red bump on the eyelid that may look like a pimple. This type of infection is also known as a stye, and is usually quite painful. There are two types of hordeolums:

External- occurs when the infection is external to the lash line.

Internal- occurs when the infection is inside of the lash line.

Hordeolums are often easily diagnosed and prompt treatment often prevents progression of the infection. Contact your doctor if you think you may have a hordeolum.

A hordeolum is caused by a blockage in the small glands located along the eyelid margin. These glands produce oil and the blockage prevents normal drainage of the gland. If bacteria are trapped in the gland, an infection can develop and the development of fluid and pus cause the area to become red and inflamed. In 90-95% of cases, the resulting infection is caused by the bacteria called Staphylococcus aureus (sometimes known as “staph”). It is possible to have more than one hordeolum at a time, and it is common for them to reoccur.

Risk Factors:
Hordeolum is a common condition, although the exact incidence in the U.S. is not known. Some conditions may increase the risk of developing a hordeolum, these include:
  • Poor eyelid hygiene
  • Chronic illness
  • Previous hordeolum (hordeolums often recur in the same eye)
A hordeolum usually begins as a red and swollen area on, or in the eyelid. Often, the area is very tender and painful. In addition to the red, painful bump, some other symptoms of hordeolums include:
  • Tearing of the eye
  • Blurred vision
  • A sensation of a foreign body or scratchiness in the eye
  • Sometimes, there is a point or yellowish spot on the swollen area. (This is where the discharge of pus will occur when the hordeolum drains.)

Internal hordeolums are usually more painful, and are less likely to come to a point without the assistance of a doctor. If you experience redness and painful swelling in the eye, it is important to contact your physician. These symptoms may be caused by other health conditions as well.

In most cases, a simple eye exam is all that is necessary to confirm the diagnosis of a hordeolum. Other than looking at your eye, special tests are not usually necessary for diagnosis.

Often hordeolums resolve spontaneously on their own. In these cases, only hot compresses to assist the drainage are needed. However, if they do not drain on their own, hordeolums often respond very quickly to simple treatment from your doctor. It is important to get treatment as soon as possible. If untreated, the infection may continue to grow or lead to other conditions, including cellulitis. Chalazions occur when the gland is blocked, but no infection is present. Cellulitis occurs when the infection spreads to the tissues of the eyelid or beyond. This can become a true emergency!

Drainage – Drainage of the lesion is the first step in treating the hordeolum. If the hordeolum does not drain on its own, your doctor may assist drainage of the infection by lancing the hordeolum. The pus and contents of the swollen area can then be drained. It is important never to try to lance the hordeolum without the assistance of a doctor, permanent damage to the eye can occur.

Antibiotics – In some cases, antibiotics are also given to ensure that the entire infection is destroyed. Antibiotics may be given in oral form, or as eye drops/eye ointment. In most cases, antibiotics alone are ineffective.

The best prevention against developing a hordeolum is to keep the area around the eye as clean as possible. Always wash your hands thoroughly before touching your eyes, and refrain from rubbing your eyes.

Although it may not be possible to prevent the development of every hordeolum, obtaining prompt treatment when one occurs is the best way to prevent future recurrences. It is important that you do not attempt to drain the hordeolum yourself. Any squeezing or poking at the hordeolum may cause more damage. The infection may be spread inadvertently, or damage to the eye could result.

Be sure to call your doctor immediately if:

  • You have vision problems
  • There is a blister or crusting on the eyelid
  • The white of the eye becomes red
  • The hordeolum bleeds
  • You have pain
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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