What differentiates a chalazion from a hordeolum?

• A. Chalazion is usually painful and rapid-growing, while hordeolum is painful and acute.
• B. Chalazion occurs only on the lower eyelid.
• C. Hordeolum is typically non-tender.
• D. Chalazion is usually painless and slow-growing, while hordeolum is painful and acute.

Answer: (D)

The key idea is how the eyelid lesion behaves: chalazion vs hordeolum differ in pain, onset, and the underlying process. A chalazion comes from a blocked meibomian gland and triggers a sterile granulomatous inflammation, so it tends to be a painless, firm, slow-growing lump on the eyelid. A hordeolum, on the other hand, is a bacterial infection of the eyelid glands or lash follicle, producing a red, tender, acutely swollen area with potential discharge. Therefore, describing chalazion as usually painless and slow-growing, while hordeolum is painful and acute, best captures the difference. The other statements don’t fit the typical picture: a chalazion isn’t painful or rapid-growing; it can involve either eyelid, and a hordeolum is usually tender rather than non-tender.