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What are the differences between chalazion and hordeolum?

Nov 18, 2025 Source: Cainiu Health
Dr. Liu Wenmin
Introduction
The main differences between chalazion and hordeolum generally include different causes, distinct symptoms, different affected sites, varying disease durations, and different treatment approaches. A chalazion is usually caused by poor secretion from the eyelid's sebaceous glands or meibomian glands, leading to accumulation of secretions and cyst formation, without obvious infectious factors. In contrast, a hordeolum is an acute suppurative inflammation caused by bacterial infection of the eyelash follicles or sebaceous glands of the eyelid.

The main differences between chalazion and hordeolum generally include different causes, different symptoms, different lesion locations, different disease durations, and different treatment methods. A detailed analysis is as follows:

1. Different causes: A chalazion is usually caused by poor secretion from the sebaceous glands or meibomian glands of the eyelid, leading to accumulation of secretions and cyst formation, without obvious infectious factors. In contrast, a hordeolum is an acute suppurative inflammation caused by bacterial infection of hair follicles or sebaceous glands of the eyelid, with *Staphylococcus aureus* being the most common causative pathogen.

2. Different symptoms: Chalazia are typically painless and present only as a localized firm nodule on the eyelid, with a hard texture and smooth surface. There is no significant tenderness upon palpation. In contrast, hordeolum presents with obvious redness, swelling, severe pain, and a burning sensation in the affected area of the eyelid. Palpation of the nodule increases pain, and some cases develop visible yellow pus points.

3. Different lesion locations: Chalazia may occur on the inner side of the eyelid or along the eyelid margin, located deeper within the tissue—some require eyelid eversion for visualization. Hordeola usually occur near the base of the eyelashes at the eyelid margin, are more superficial, and the red, swollen area can be directly observed with the naked eye.

4. Different disease durations: The course of a chalazion is relatively long; the nodule may persist for weeks or even months. Without intervention, it may remain indefinitely, either being gradually absorbed or increasing in size over time. A hordeolum has a shorter course, typically progressing to abscess formation and rupture within 1–2 weeks, after which symptoms usually resolve completely.

5. Different treatments: Early-stage chalazia may be treated with warm compresses to promote absorption. If persistent, surgical excision is required. Hordeolum requires prompt use of antibiotic medications to control infection. Once an abscess forms, incision and drainage are necessary, along with warm compresses to relieve symptoms and prevent the spread of infection.

When a hard nodule or swelling appears on the eyelid, it is important to first determine the specific condition to avoid inappropriate management. Antibiotics are unnecessary for chalazia, while timely anti-infective treatment is essential for hordeolum. If symptoms progressively worsen or affect vision, prompt ophthalmologic evaluation is recommended for accurate diagnosis and individualized treatment planning.

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