What are the treatment options for a hordeolum?

• A. Observation with no treatment.
• B. Immediate surgical drainage.
• C. Warm compresses; may require topical or oral antibiotics if abscess or cellulitis develops.
• D. Steroid injection into the eyelid.

Answer: (C)

In hordeolum, the goal is to promote drainage and control infection without unnecessary procedures. Warm compresses applied several times daily help loosen the blockage of the eyelid gland, encourage drainage, and relieve pain, with lid hygiene to limit bacterial load. If an abscess forms or there is spreading infection (cellulitis), adding topical antibiotics and, if needed, oral antibiotics is appropriate. Observation alone isn’t ideal because the infection can worsen, and immediate surgical drainage isn’t first-line unless there’s a persistent or enlarging abscess despite conservative care. Steroid injections aren’t used since they can worsen infection. So the best approach is warm compresses with topical or oral antibiotics if abscess or cellulitis develops.