The eyelids contain many different glands which can become blocked and superinfected. 
The resulting condition is termed hordeolum.


  • redness, swelling, and pain in the eyelid 
  • they may be associated conjunctivitis and purulent discharge


  • The visual acuity is normal unless the swelling is big and right in the centre of the upper lid which can distort vision through its mass effect on the cornea.
  • The swelling  may be at the base of an eyelash (sty or external hordeolum) or deep within the lid (meibomianitis or internal hordeolum)


  • Topical antibiotic such as chloramphenicol drop is instilled into the lower conjunctival sac four times a day.
  • If the lid swelling is extensive and severe, consider superimposed orbital cellulitis which require systemic antibiotics
  • Referrals are not neccessary as the conditions resolves within 

  • a few days.
  • Referred to the minor operating list if the swelling fails to resolve after one week. This is mostly seen in internal hordeolum in which a granuloma (chalazion) had developed. The treatment is incision and curretage.
Figure 1.
This patient has a right upper lid chalazion. Note the localized nature of the 
swelling. This can be treated with topical chloramphenicol by the GP. If  the 
swelling fails to resolve, refer the patient to the minor operating list for
incision and curettage

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