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The Eyelids 
The primary function of the eyelids is to protect the surface of the eye.  Another important function of the eyelids is to spread tears on the surface of the eye to keep it lubricated.  Two common conditions that affect the glands of the eyelids are a chalazion and hordeolum.

Chalazion 
A chalazion results from a blockage of one or more of the small oil producing glands (meibomian glands) that are found in the upper and lower eyelid margins.  This obstruction causes an infection within the lid causing a bump on the eyelid that is usually painless.  Conditions that cause abnormal meibomian gland secretions (dry eye, acne rosacea) increase the risk of meibomian gland obstruction and development of a chalazion.

Hordeolum 
A hordeolum is an acute, localized, painful swelling of the eyelid that may be under the skin in the front of the lid or under the lid.  It is usually caused by a bacterial infection of an eyelid gland.  Most are external and result from obstruction and infection of an eyelash follicle and adjacent glands of Zeis or Moll.  An internal hordeolum, occurs deeper in the eyelid and results from an infection of a meibomian gland.  These infections cause the eyelids to become red, swollen and painful.

Management of Chalazion and Hordeolum 
In some instances, both a chalazion and hordeolum may come to a head and drain on their own without treatment.  However, in most instances they do not.  We may recommend:
 
  • Warm compresses applied to the closed eyelid with a Bruder heat mask at least four times a day for 10-15 minutes.
  • In some cases, hordeola do not respond to warm compresses alone.  Oral antibiotics may be needed to prevent the infection from spreading to the entire eyelid.  Antibiotic and/or steroid eye drops or ointments may also be needed. 
  • When a chalazion does not respond to therapy, steroid medications may be injection into or adjacent to the site of the chalazion.  A chalazion may also need to be treated with surgical removal if unresponsive to other therapies.
 
Usually, a chalazion and hordeolum respond well to treatment.  However, if left untreated, they may lead to other problems.  They may recur and are often associated with chronic eyelid disease.  We may recommend long-term treatment to prevent their recurrence.