What is a Chalazion and a Hordeolum?

by Sep 29, 2021


Many of us experience, or at least have heard of, a stye.

Styes are painful little red bumps of the eyelid. But what are these? Do they carry any serious risk of long-term harm?



The official medical name for a stye is a hordeolum.

Within the eyelid there are many different glands that create oils to contribute to the different layers of the tear film.

Specifically, there are 7 major glands within the eyelids—Meibomian, Zeiss, Moll, the main lacrimal gland, accessory glands of Krause and Wolfring, and goblet cells.

Hordeolums occur when certain glands become clogged and the oils remain stagnant within the gland itself. Over time, this stagnant oil can backflow and grow bacteria and become infected—hence creating the swollen, inflamed, painful bump within the eyelid.

Hordeolums can be further classified into internal hordeolums or external hordeolums, depending on what gland is affected.

An internal hordeolum involves infection of a Meibomian gland.

An external hordeolum involves infection of either a gland of Moll or gland of Zeiss.

Hordeolum is the name given to an active infection. Often times, hordeolums are self-resolving and will typically dissipate within 2 weeks without treatment.

However, hordeolums are painful and cosmetically unappealing. Treatments for hordeolums can help to resolve the problem within days. Treatment focuses on getting the gland to open-up and express out any unwanted microbes and inflammatory materials while avoiding secondary corneal infections.

Therefore, anything to liquify the gland to lead to easier expression is beneficial for relieving an active hordeolum. This can be accomplished through applying a warm compress for 30 minutes three to four times a day in conjunction with a gentle massage of the eyelids.

Bruder masks are specialized eye masks made to maintain the perfect temperature for a warm compress without the need to constantly re-heat a wet washcloth. They are available for purchase at most pharmacies or on Amazon.

In some circumstances antibiotics may be prescribed to help quicken the recovery period and “dry out” the system.

Prevention is the best way to avoid hordeolums. It is recommended to use a warm washcloth at the end of each day to gentle clean the lash line to help prevent the glands from clogging up.

If an individual wears make-up always remove makeup prior to going to bed each night.

Baby shampoo or lid scrubs are available to help further clean the lid margins in individuals who are prone to gland capping or excess build up.


Chalazions Explained

Chalazions occur when residual material remains in the impacted gland post-hordeolum.

Chalazions are painless bumps in the area of a previous hordeolum. Many individuals think chalazions are styes that just won’t go away. This is partially correct, but a hordeolum (stye) is an active infection whereas chalazions are more like scar tissue left over from an active infection.

Chalazions do not typically cause problems as they are not painful. They can be an area of cosmetic concern, however.

Eye doctors typically recommend continuation of warm compresses with mechanical massage to see if the tissue will loosen up and express on its own. Your doctor will likely also prescribe an oral antibiotic in an attempt to get the residual material to re-absorb into the body.

For stubborn cases an steroid injection can be inserted into the chalazion in an attempt to break down the remaining tissue and help the lesion to resolve.

If, after several months of treatment, the chalazion has not resolved, your doctor may recommend surgery to remove the chalazion.

In chalazion removal surgery, the eye is numbed using topical anesthetic drops.

A clamp is applied to evert the eyelid and expose the chalazion.

A small incision is made to the outer wall of the chalazion, exposing the innards of the lesion.

The doctor will then gently scoop out the remaining debris and fluid, essentially draining out the chalazion.

Stitches are typically not required and the incision will heal on its own after several days.

It is important to note that chalazion removal surgery cannot be implemented if the infection is active—i.e. in the hordeolum stage.

The best way to prevent chalazions is to prevent hordeolums from occurring. If you experience a hordeolum, it is best to initiate treatment as quickly as possible.

If you have recurrent chalazion development in the same spot, be sure to discuss this with your doctor as it could indicate something more serious.


Dr. Nathan Abraham and the staff of the Abraham Eye Center specializes in cataract surgery, LASIK, PRK, and various corneal surgeries.  Call our ophthalmologist in Valencia, CA today at 661-977-7377 or schedule an appointment online if you are interested in learning more about chalazions or hordeolums.  Our eye doctor provides only the highest quality eye care and surgical services amongst eye doctors in the Valencia California area.

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