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Educational draft · awaiting clinical reviewUse Rapid for revision, not patient-care decisions. Check current national and local guidance and the BNF or BNFC before acting.
RapidMLAMSRAGP

Chalazion and hordeolum

Essential points for quick revision.

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Look beyond the lid lump

A focal lid swelling should not explain away reduced vision, painful eye movements, proptosis or significant systemic illness.

Action: Arrange emergency assessment when orbital involvement is possible; obtain prompt clinical review for spreading lid infection and urgent specialist assessment for suspicious recurrent lesions.

Synopsis

Distinguish a blocked meibomian gland from an acute lid infection, offer practical conservative care and recognise spreading infection or an atypical persistent lesion.

  • A chalazion is usually a firm, relatively painless inflammatory nodule from gland blockage.
  • A hordeolum is an acute painful infection of a lid gland or lash follicle.
  • An early inflamed chalazion can be tender, so pain alone is not a complete diagnostic rule.

Key red flags

Reduced acuity, diplopia, painful or restricted eye movements, or proptosis.

Investigation priorities

01
Visual acuity and focused eye assessmentFirst step

Identify effects that are not expected from a small uncomplicated lid lesion.

Management branches

Typical localised lesionStart practical conservative care

A focal chalazion or hordeolum has no visual or systemic warning features.

  1. Explain the likely diagnosis and demonstrate safe warm compresses with gentle lid care.
  2. Avoid eye make-up and contact lenses while the acute lesion is active or draining.
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Sources and review status6 sources · checked 7 Sept 2026 · clinical review pending
Sources

Sources and review status

National guidance is shown before implementation-dependent detail. Typical adult dose examples remain subject to patient factors, contraindications and the live BNF or specialist protocol. Source check completed 7 Sept 2026; clinical approval remains outstanding.

Authoring stateRapid draftClinical stateAwaiting reviewJurisdictionUnited Kingdom