Internal Hordeolum is the inflammation of the meibomian gland associated with blockage of the duct.
1. Predisposing factors are similar to hordeolum externum ( See details on External Hordeolum)
2. Causative mechanism
Hordeolum internum may occur as:
- Primary Staphylococcal infection of the meibomian gland.
- Secondary infection in a chalazion (infected chalazion).
Clinical features of hordeolum internum
- Acute pain
- Swelling of the lid
- Mild watering
- Note: The symptoms are similar to external hordeolum except that pain is more intense, due to the swelling being embedded deeply in the dense fibrous tissue.
- A localized, firm, red, tender swelling of the lid associated with marked oedema.
- On examination, hordeolum internum can be differentiated from hordeolum externum by the fact that in it, the point of maximum tenderness and swelling is away from the lid margin and that pus usually points on the tarsal conjunctiva (seen as yellowish area on everting the lid) and not on the root of cilia.
Treatment of internal hordeolum
It is similar to hordeolum externum (see details on External Hordeolum ) except that, when pus is formed, it should be drained by a vertical incision from the tarsal conjunctiva.