Chalazion (Sty, Hordeolum)

Definition: 

Sty (hordeolum) a focal acute infection arising within the meibomian gland or other glands at the eyelid margins

Chalazion is a focal chronic inflammation of a meibomian gland that occurs as a result of a resolved sty.

Signs/Symptoms: 

• Eyelid pain
• Swelling
• Localized tenderness and redness  

Differential Diagnosis:

• Preseptal cellulitis of the anterior lids
• Pyogenic granuloma
• Tumors of the eyelid:
  • Sebaceous gland carcinoma
  • Basal cell carcinoma
  • Squamous cell carcinoma

Causes:  

• Commonly caused by staphylococcal organisms colonized in the meibomian glands of the eyelids. 
• Can be associated with blepharitis

Evaluation:

 History

Visual acuity

Examination of the eyelids for nodules

If a slit lamp is available evaluate the meibomian gland orifices for clogging.

Treatment:

Warm compresses for 20 minutes 4 times a day

Lid scrubs with mild soap (Johnson’s baby shampoo) twice a day           

Consider topical antibiotic erythromycin ointment at bid.

Incision and curettage are preformed if chalazian not resolved.

Prognosis:

This is not generally a debilitating problem

The patient may return to work and perform the warm compresses in the workspace.   

This section provided by CAPT Robert B. North, Jr., MC, USN

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