An obstructed meibomian gland that becomes acutely inflamed is called an internal hordeolum. It is typically the result of infectious inflammation and the organism most commonly involved is Staphylococcus.
Antibiotic therapy is thus the typical first step along with relief of the obstruction which can be achieved by using warm compresses. Manual gland expression with expression forceps and controlled heating using MiboFlow can also work well.
At FishmanVision we are always striving for minimalist options, and as such, we have been using Intense Pulsed Light (IPL) as a newer treatment option. Stay tuned for this becoming a first line therapy.
However, if these measures fail, incising the gland to relieve the obstruction is quite successful. Shown in this video snippet is a simple 2 – stab incision of the obstructed gland.
If left untreated or conservative measures fail to resolve it, the hordeolum becomes a chalazion which is the result of a chronic localized lipogranulomatous inflammation.