Disorders of the Eyelid Glands

Disorders of the Eyelid Glands

Hordeolum

Definition

A hordeolum is the result of an acute bacterial infection of one or more eyelidglands.

Epidemiology and etiology:

Staphylococcus aureusis a common cause ofhordeolum. External hordeolum involves infection of the glands of Zeis or Moll. Internal hordeolum arises from infection of the meibomian glands. Hordeolum is often associated with diabetes, gastrointestinal disorders, or acne.

Symptoms and diagnostic considerations:

Hordeolum presents aspainfulnodules with a central core of pus. External hordeolumappears on the margin of the eyelid where the sweat glands are located (Fig. 2.17).Internal horde-olum of a sebaceous gland is usuallyonly revealed by everting the eyelidandusually accompanied by a more severe reaction such as conjunctivitis or che-mosis of the bulbar conjunctiva. Pseudoptosis and swelling of the preauricu-lar lymph nodes may also occur.

Differential diagnosis:

Chalazion (tender to palpation) and inflammation ofthe lacrimal glands (rarer and more painful).

Treatment:

Antibiotic ointments and application of dry heat (red heat lamp)will rapidly heal the lesion.

Clinical course and prognosis:

After eruption and drainage of the pus, thesymptoms will rapidly disappear. The prognosis is good. An underlying inter-nal disorder should be excluded in cases in which the disorder frequently recurs.

Chalazion

Definition

Firm nodular bulb within the tarsus.

Epidemiology and etiology:

Chalazia occur relatively frequently and arecaused by a chronic granulomatous inflammation due to buildup of secretion from the meibomian gland.

Symptoms:

The firm painless nodule develops very slowly. Aside from thecosmetic flaw, it is usually asymptomatic (Fig. 2.18).

Differential diagnosis:

Hordeolum (tender to palpation) and adenocarci-noma.

Treatment:

Surgical incision is usually unavoidable (Fig. 2.19).

After introducing the chalazion clamp, the lesion is incised either medi-ally, perpendicular to the margin of the eyelid, or laterally, perpendicu-lar to the margin of the eyelid (this is important to avoid cicatricial ectropion). The fatty contents are then removed with a curet.

Prognosis:

Good except for the chance of local recurrence.