Hordeolum Workup

Updated: Feb 12, 2021
  • Author: Michael P Ehrenhaus, MD; Chief Editor: Edsel B Ing, MD, PhD, MBA, MEd, MPH, MA, FRCSC  more...
  • Print

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. [8]