Chalazion vs Hordeolum - Understand Major Differences

A chalazion (also known as eyelid cyst or meibomian cyst) is a large, chronic, non-infectious cyst that develops on the eyelid. Generally less painful, a chalazion takes several weeks to develop. It usually forms on the upper eyelids and occasionally on the lower eyelids. A chalazion can result from either the blockage and inflammation of the meibomian glands (an oil gland in the eyelid) or start as a hordeolum. 

A hordeolum (also known as a stye) is a small, acute, infectious cyst that develops on the rim of the eyelid. It is more painful and tender to touch than a chalazion. Hordeolums can be internal or external. 

1. An internal hordeolum appears inside the eyelid and results from an infection of the meibomian gland. 
2. External hordeolum is an infection of the glands of Zeis (oil glands at the eyelash follicle) located near the base of the eyelash. 

A chalazion and hordeolum may look similar, but they feel different. Chalazion starts as a red and tender area on the eyelid that usually turns into a painless lump. On the other hand, a hordeolum is quite a painful lump. If a hordeolum is left untreated, it can turn into a chalazion. Hordeolum and chalazion differences are as follows:

Parameters	Chalazion	Hordeolum
Location	The conjunctival side, where meibomian glands are located	Rim of the eyelid
Size	Large	Small
Type	Chronic	Acute
Progression	A slow-growing lump	It may develop into a chalazion if not treated properly

If you have irritated eyes and a lump on the eyelid, it may be difficult to understand if you have a chalazion or hordeolum due to their similar signs and symptoms. While some signs of these conditions may be similar, they result from different causes. The following table compares chalazion vs hordeolum based on their symptoms, causes, and risk factors.

Parameters	Chalazion	Hordeolum
Symptoms	Painless bump on the eyelid Swollen eyelid Blurry vision Redness and swelling on the bump Mild irritation, causing the eyes to water	Painful bump on the eyelid Swollen eyelid Redness, swelling, and tenderness of the eyelid Sensitivity to light Visible pus at the centre of the lump A scratchy feeling in the eye The feeling of something in the eye Crusting along the affected eyelid More tears than usual
Causes	It develops when the meibomian glands (oil glands in the eyelid) become clogged. These glands keep the eye moist. When blocked, these glands start retaining oil. Eventually, the fluid drains and a hard lump develops on the eyelid.	It develops when Zeis glands (oil glands at the eyelash follicle) become infected. The infection is usually caused by a bacteria called Staphylococcus aureus.
Risk Factors	Blepharitis Rosacea Dandruff Demodex mite infestation Seborrheic dermatitis Low serum vitamin A levels Tuberculosis Viral infections Smoking tobacco	Blepharitis Rosacea Stress Chronic dry eyes Conditions that affect the immune system

 

Chalazion and hordeolum do not always require treatment from a doctor. However, if they bother you, you can visit a healthcare professional. The doctor may diagnose a chalazion if the lump is not tender to touch and there is little to no redness in the surrounding eyelid. They may diagnose a hordeolum if the lump is tender and there is swelling in one eyelid. The diagnosis and treatment of these lumps are similar. The following table shows the diagnosis, treatment, and complications of chalazion vs hordeolum. 

Parameters	Chalazion	Hordeolum
Diagnosis	Health history (to find underlying issues that may cause a chalazion) External eye exam (to examine the eye, eyelid, eyelashes, and skin texture) Thorough eyelid exam (use of bright light and magnification to look at the base of the eyelashes)	Evaluation of medical history (used to detect the underlying cause of a hordeolum) External eye examination (helps observe the eyelid, eyelashes, and the skin texture) Eyelid examination (helps look at the base of your eyelashes with the use of bright light and magnification)
Treatment	Warm compress treatment for 5-10 minutes several times a day Gentle eyelid massage a few times a day Corticosteroid injections (to reduce swelling) Surgery to drain the chalazion	Applying a warm compress for 5-10 minutes Massaging the eyelid gently   Topical antibiotics and ointments Corticosteroid injections Oral antibiotics (for eyelid infections) Surgical incision to drain the lump (when other treatments are ineffective)
Complications	A large chalazion can exert pressure on the cornea, leading to blurred vision and astigmatism.  Small chalazion on the inner eyelid can exert pressure to deform a weakened cornea in patients after laser eye surgery.	Though rare, complications include: Progression to chalazion Periorbital Cellulitis (infection of the eyelid or skin around the eye)

 

People often confuse blepharitis, hordeolum, and chalazion as the same conditions. Blepharitis, a condition characterised by the inflammation of the eye, has similar symptoms as chalazion and hordeolum. The symptoms of blepharitis include redness, itching, burning, and irritation. In addition to these symptoms, blepharitis causes dandruff-like flakes near the base of the eyelashes. 

The primary difference between blepharitis vs hordeolum vs chalazion is their appearance. While a chalazion and hordeolum cause a lump on the eyelid,  blepharitis causes inflammation all around the eyelid. However, blepharitis can increase the risk of having a chalazion or hordeolum. Sometimes, blepharitis can result from similar causes as external hordeolum vs chalazion, i.e., bacteria or clogging of the oil glands.   

Once you develop a chalazion or hordeolum, there is a high chance that you may develop them again in the future. Some tips to help prevent chalazion or hordeolum include:

1. Try not to rub your eyes as it can spread bacteria and cause irritation.
2. Always wash your hands before touching your eyes or putting in contacts.
3. Do not share your makeup with others.
4. Replace eye makeup every six months or less. 
5. Wash your face every night and remove all makeup before bed. 
6. Protect your eyes from dust and pollution. 
7. If you develop chalazion frequently, scrub your eyelid regularly with baby shampoo. 

Usually, chalazion and hordeolum resolve on their own. However, if these lumps on the eyelid cause much pain or discomfort, you may want to consult a doctor. Call your healthcare professional if: 

1. Home treatment does not reduce inflammation.
2. The lump does not go away even after a month.
3. The size of the lump does not reduce with warm compresses or eye massage.
4. The lump is painful or irritates your eyeball or cornea.
5. Chalazion or hordeolum makes it hard for you to see.
6. You suspect an infection.

Chalazion vs hordeolum are inflammatory lesions of the eyelid with different causes and symptoms. A chalazion is caused by blocked oil glands, while a hordeolum is caused by bacteria. Both conditions may cause swelling and redness, but a hordeolum is often more painful. The diagnosis and treatment for these conditions are similar, focusing on warm compresses, eyelid massage, and eye hygiene. 

If an appearance of a chalazion or hordeolum bothers you, consult a specialist at HexaHealth. Our team will be happy to resolve your queries regarding hordeolum and chalazion differences and help you diagnose your eyelid lesion. If recommended home treatments and antibiotics do not work, we will connect you with the best surgeons for surgical drainage.