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Cochrane Database Syst Rev. 2010 Sep 8;(9):CD007742. doi: 10.1002/14651858.CD007742.pub2.

Interventions for acute internal hordeolum.

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  • 1Center for Clinical Trials, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, W5010, Baltimore, Maryland, USA, 21205.

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Hordeolum is a common, painful, inflammation of the eyelid margin that is usually caused by bacterial infection. The infection affects oil glands of the eyelid and can be internal or external. In many cases, the lesion drains spontaneously and resolves untreated; however, the inflammation can spread to other ocular glands or tissues and recurrences are common. If unresolved, acute internal hordeolum can become chronic or develop into a chalazion. External hordeola, also known as styes, were not included in the scope of this review.


The objective of this review was to investigate the effectiveness and safety of non-surgical treatments for acute internal hordeolum compared to observation or placebo.


We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2010, Issue 6), MEDLINE (January 1950 to June 2010), EMBASE (January 1980 to June 2010), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to June 2010), the metaRegister of Controlled Trials (mRCT) (, ( and the WHO International Clinical Trials Registry Platform (ICTRP). There were no language or date restrictions in the search for trials. The electronic databases were last searched on 21 June 2010.


The selection criteria for this review included randomized or quasi-randomized clinical trials of patients diagnosed with acute internal hordeolum. Studies of patients with external hordeolum (stye), chronic hordeolum or chalazion were excluded. Non-surgical interventions of interest included the use of hot or warm compresses, lid scrubs, antibiotics, or steroids compared to observation, placebo, or other active interventions.


Two review authors independently assessed the references identified by the electronic searches for inclusion in this review. No relevant studies were found. The reasons for exclusion were documented.


There were no trials identified for inclusion in this review. The majority of the references identified from our search reported on external hordeola or chronic internal hordeola. The few references specific to acute internal hordeolum reported mostly recommendations for treatment or were reports of interventional case series, case studies, or other types of observational study designs and were published over 20 years ago.


We did not find any evidence for or against the effectiveness of non-surgical interventions for the treatment of hordeolum. Controlled clinical trials would be useful in determining which interventions are effective for the treatment of acute internal hordeolum.

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