Generally presents by 3 to 12 weeks and generally resolves by 6 months. It can be treated by BID massaging of the lacrimal duct area. Occasionally requires probing to open the duct. Mucopurulent discharge, excessive tearing, swell-ing, erythema, and tender swelling of the medial lower lid is seen. Gram stain of the purulent material expressed from punctum should be performed to aid in antibiotic therapy.
Daily examinations are necessary because orbital cellulitis is a possible complication.
Adults may warrant referral for dacryocystorhinostomy. Surgery may be indicated if abscess develops. A hordeolum is an acute infection of the ciliary follicle or accessory glands of the anterior lid margin that is generally caused by staphylococci. An external hordeolum begins at the lid margin, whereas an internal hordeolum begins in a meibomian gland. Exam reveals a painful, tender focal mounding of one eyelid that develops over days, often with pustule formation.