eMedicine Specialties > Ophthalmology > Lid
Hordeolum: Differential Diagnoses & Workup
Updated: May 21, 2009
- Overview
- Differential Diagnoses & Workup
- Treatment & Medication
- Follow-up
Differential Diagnoses
Basal Cell Carcinoma, Eyelid
Cellulitis, Preseptal
Chalazion
Sebaceous Gland Carcinoma
Squamous Cell Carcinoma, Eyelid
Workup
Laboratory Studies
- The diagnosis is based on history and clinical examination, and cultures are not indicated in uncomplicated cases.
- There is no indication to check serum lipid levels, as the association among hordeola, chalazia, and hypercholesterolemia remains unclear.
Histologic Findings
Histopathology of a hordeolum reveals an abscess or a focal collection of polymorphonuclear leukocytes and necrotic tissue.
Histologically, chalazia represent a lipogranulomatous inflammatory reaction. Histiocytes, multinucleated giant cells, lymphocytes, plasma cells, and neutrophils surround an optically clear space. This optically clear space represents lipids that were dissolved by solvents during tissue processing.
Basal cell carcinoma or sebaceous cell carcinoma of the eyelid can be misdiagnosed clinically as a recurrent hordeolum or chalazion; therefore, histopathologic examination is very important in determining the diagnosis, especially in patients with a persistent or recurrent lesion.
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Differential Diagnoses & Workup: Hordeolum |
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References
American Academy of Ophthalmology. Infectious diseases of the external eye: clinical aspects. In: External Disease and Cornea. 8. San Francisco, CA: LEO; 2006-2007.
American Academy of Ophthalmology. Eyelids. In: Ophthalmic Pathology and Intraocular Tumors. 4. San Francisco, CA: LEO; 2007-2008.
Destafeno JJ, Kodsi SR, Primack JD. Recurrent Staphylococcus aureus chalazia in hyperimmunoglobulinemia E (Job's) syndrome. Am J Ophthalmol. Dec 2004;138(6):1057-8. [Medline].
Hosal BM, Zilelioglu G. Ocular complication of intralesional corticosteroid injection of a chalazion. Eur J Ophthalmol. Nov-Dec 2003;13(9-10):798-9. [Medline].
Katowitz WR, Shields CL, Shields JA, Eagle RC Jr, Mulvey LD. Pilomatrixoma of the eyelid simulating a chalazion. J Pediatr Ophthalmol Strabismus. Jul-Aug 2003;40(4):247-8. [Medline].
Kiratli HK, Akar Y. Multiple recurrent hordeola associated with selective IgM deficiency. J AAPOS. 2001;5(1):60-1. [Medline].
Lederman C, Miller M. Hordeola and chalazia. Pediatr Rev. Aug 1999;20(8):283-4. [Medline].
Raskin EM, Speaker MG, Laibson PR. Blepharitis. Infect Dis Clin North Am. Dec 1992;6(4):777-87. [Medline].
Shields JA, Demirci H, Marr BP, Eagle RC Jr, Shields CL. Sebaceous carcinoma of the eyelids: personal experience with 60 cases. Ophthalmology. Dec 2004;111(12):2151-7. [Medline].
Further Reading
Keywords
hordeola, external hordeola, internal hordeola, chalazion, chalazia, stye, styes, eyelid disorder, eyelid infection
Differential Diagnoses & Workup: Hordeolum