Chalazion (meibomian cyst) and hordeolum (stye)

A chalazion (meibomian cyst) is a focal inflammatory lesion on the eyelid caused by obstruction of the meibomian glands, which are sebaceous glands at the margin of the eyelids (see Diagram of the eye). Chalazia are usually associated with blepharitis. The lesions are generally not tender unless there is acute inflammation. They can be managed conservatively with repeated warm compresses, and usually resolve within 1 month.

Hordeolum presents as a tender, inflamed mass at the eyelid margin; it may be external (stye) or internal, and is usually caused by staphylococci. An external hordeolum involves obstruction and secondary infection of the glands of Zeiss or Moll. An internal hordeolum involves acute infection of a meibomian gland. Hordeola are managed with repeated warm compresses, which usually result in spontaneous discharge.

Topical antibiotics are not indicated for chalazia and hordeola.

Oral antistaphylococcal antibiotic therapy is indicated for accompanying cellulitis – see drug regimens for periorbital cellulitis. Incision and drainage may be necessary for persistent lesions.