User:Fazle.Ratul
Name
Fazle Rabbi Ratul
Location
Dhaka, Bangladesh
Affiliation
President Abdul Hamid Medical College, Kishoreganj, Bangladesh, Dept of Medicine, Dept of Ophthalmology
Ophthalmologist
Yes
Subspecialty
Refractive management
Degree type
MBBS
Chalazion and Stye: A Comparative Overview
By Fazle Rabbi Ratul President Abdul Hamid Medical College, Kishoreganj, Bangladesh
Introduction
Chalazion and stye (hordeolum) are two of the most common eyelid disorders encountered in ophthalmology. Although they share some clinical features and involve the eyelid glands, their pathogenesis, management, and outcomes differ significantly. Understanding these conditions is essential for accurate diagnosis and effective treatment.
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Chalazion
Definition
A chalazion is a chronic, sterile, granulomatous inflammation of the Meibomian gland or gland of Zeis caused by the retention of sebaceous secretions.
Etiology
Blockage of the Meibomian gland duct leads to lipid retention and subsequent inflammation.
May occur spontaneously or following a hordeolum.
Clinical Features
Painless, localized swelling on the eyelid.
Slowly enlarging nodule.
Non-tender and firm to palpation.
No acute signs of inflammation (redness, warmth).
Differential Diagnosis
Sebaceous carcinoma.
Basal cell carcinoma.
Hordeolum.
Preseptal cellulitis.
Diagnosis
Primarily clinical based on history and physical examination. Persistent or atypical lesions should be biopsied to rule out malignancy.
Management
1. Conservative: Warm compresses and lid hygiene for initial cases.
2. Medical: Intralesional corticosteroid injection (e.g., triamcinolone) for persistent lesions.
3. Surgical: Incision and curettage for large or refractory chalazia.
4. Prevention: Management of underlying conditions like blepharitis or rosacea.
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Stye (Hordeolum)
Definition
A stye is an acute, painful, purulent inflammation of the eyelid caused by bacterial infection of the glands of Zeis (external hordeolum) or Meibomian glands (internal hordeolum).
Etiology
Most commonly caused by Staphylococcus aureus infection.
Contributing factors include poor hygiene, seborrheic dermatitis, and immunosuppression.
Clinical Features
Painful, erythematous swelling on the eyelid margin.
May have a central pustule.
Associated with warmth and tenderness.
Differential Diagnosis
Preseptal cellulitis.
Chalazion.
Dacryocystitis.
Diagnosis
Clinical diagnosis based on acute pain, localized swelling, and erythema.
Management
1. Conservative: Warm compresses to promote drainage.
2. Medical:
Topical antibiotics (e.g., erythromycin ointment) for localized infection.
Oral antibiotics for spreading or recurrent cases.
3. Surgical: Incision and drainage for large abscesses.
4. Prevention: Proper eyelid hygiene and treatment of underlying blepharitis.
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Complications
Chalazion: Chronic inflammation, recurrence, or misdiagnosis of malignancy.
Stye: Preseptal cellulitis, abscess formation, or progression to orbital cellulitis.
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Conclusion
Chalazion and stye are distinct eyelid conditions that can often be managed conservatively with proper hygiene and prompt treatment. Recognizing their differences is critical for targeted therapy and prevention of complications.
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References
1. Kanski JJ, Bowling B. Clinical Ophthalmology: A Systematic Approach. 8th ed. Elsevier.
2. Khurana AK. Comprehensive Ophthalmology. 7th ed. New Delhi: Jaypee Brothers.
3. Basak SK. Essentials of Ophthalmology. 4th ed.
