RISK FACTORS: Predisposing blepharitis (low grade infections of the eyelid margin), Poor eyelid hygiene, Contact lens wearers, Application of make-up
GENERAL MEASURES
β’ Warm compresses to the area of infl ammation can help increase blood supply and potentiate spontaneous
drainage
β’ Good personal hygiene with attention to cleansing the eyelids on a daily basis to prevent recurrent infections
β’ Application of an antibiotic ointment (such as erythromycin) to the margin of the eyelid after proper cleansing.
(Except children under 12, where there is a risk of blurred vision and amblyopia.) Helps reduce bacterial
proliferation.
SURGICAL MEASURES If the infection becomes localized to a single gland, incision, drainage, and curettage is sometimes necessary. This is an in-offi ce procedure with a local anesthetic.
DRUG(S) OF CHOICE
β’ Erythromycin ophthalmic ointment
β’ Occasionally use of an aminoglycoside ophthalmic ointment such as gentamicin may be necessary if refractory to simpler treatment
β’ Oral dicloxacillin for 2 weeks if refractory to topical ointment
β’ Treat underlying dry eye with artifi cial tears
PATIENT MONITORING The patient should be seen within several weeks to assess the effectiveness
of therapy
PREVENTION/AVOIDANCE Eyelid hygiene
POSSIBLE COMPLICATIONS None expected. An internal hordeolum, if untreated, may lead to generalized cellulitis of the lid.
EXPECTED COURSE/PROGNOSIS
Responds well to treatment, but tends to recur in some patients