Plain language summary. A hordeolum is an acute bacterial infection of the glands of the eyelid. An internal hordeolum affects the Meibomian (oil) glands within ...submitYou'rehere:HomepageGuidanceClinicalManagementGuidelinesHordeolumHordeolumTheCMGsareguidelinesonthediagnosisandmanagementofarangeofcommonandrare,butimportant,eyeconditionsthatpresentwithvaryingfrequencyinprimaryandfirstcontactcare.ShareoptionsSavepageShareAetiologyTherearetwotypes:externalhordeolum(stye)–acutebacterialinfectionofthelashfollicleanditsassociatedglandofZeisorMollinternalhordeolum–acutebacterialinfectionofMeibomianglandTheseinfectionsareusuallystaphylococcalPredisposingfactorsChronicblepharitisSymptomsTenderlumpineyelidEpiphoraLocalrednessofeyeandlidSigns ExternalhordeolumTenderinflamedswellingofthelidmargin.MaypointanteriorlythroughtheskinOccasionally,multipleabscessesinvolveentireeyelidInternalhordeolumTenderinflamedswellingwithinthetarsalplate.Morepainfulthanastye.MaypointanteriorlythroughtheskinorposteriorlythroughtheconjunctivaDifferentialdiagnosisPreseptalcellulitisHaematomaofeyelidAcutedacryocystitisChalazion(blockageofMeibomianglandwithcystformation)SebaceouscellcarcinomaManagement byoptometristPractitionersshouldrecognisetheirlimitationsandwherenecessaryseekfurtheradviceorreferthepatientelsewhereGRADE*levelofevidenceandstrengthofrecommendationalwaysrelatestothestatement(s) immediatelyaboveNonpharmacologicalMostresolvespontaneouslyordischarge,followedbyresolutionInthecaseofexternalhordeola,itmayhelptoremovethelashassociatedwiththeinfectedfollicleTraditionalremediessuchashotspoonbathing and/orwarmcompresses,wetordry, mayrelievesymptomsManageassociatedblepharitiswithlidhygiene(seeClinicalManagementGuidelineonBlepharitis)(GRADE*:Levelofevidence=low;Strengthofrecommendation=strong)Rarely,referforincisionincasesthatdonotdischarge(commonerwithinternalhordeolum)Aninternalhordeolummayevolveintoachalazion(seeClinicalManagementGuidelineonChalazion)Advisepatienttoreturn/seekfurtherhelpifsym