Efficacy of Care and Antibiotic Use for Chalazia and Hordeola

Abstract

Objectives: To evaluate whether use of an antibiotic improves the efficacy of care for a chalazion or hordeolum. Methods: A cross-sectional retrospective review was performed. All patients treated for a newly diagnosed chalazion or hordeolum at the University of California, San Francisco from 2012 to 2018 were identified. Patients were excluded when clinical notes were inaccessible or there was inadequate documentation of treatment modality or outcome. Patient demographics, setting of initial presentation, treatment modalities, antibiotic use, and outcomes were analyzed. Results: A total of 2,712 patients met inclusion criteria. Management with an antibiotic was observed in 36.5% of patients. An antibiotic was 1.53 times (95% confidence interval [CI], 1.06-2.22, P¼0.025) more likely to be prescribed in emergency or acute care setting for a chalazion. Older age was associated with a higher risk of receiving an antibiotic for a hordeolum (adjusted RR 1.07 per decade, 95% CI, 1.05-1.11, P,0.001). The addition of an antibiotic to conservative measures for a chalazion (adjusted RR, 0.97, 95% CI, 0.89-1.04, P¼0.393) or hordeolum (adjusted RR, 0.99, 95% CI, 0.96-1.02, P¼0.489) was not associated with an increased likelihood of treatment success. Conclusion: Although frequently prescribed, an antibiotic is unlikely to improve the resolution of a chalazion or hordeolum.

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“…This is consistent with Mansour et al mention that upper eyelid infections are more common than lower eyelid infections, with (20) (27) samples from the upper eyelid (Mansour et al, 2006). It also agrees with Alsoudi et al study, which found a 53.2% incidence of infection in the upper eyelids (Alsoudi et al, 2022). The reason for this is that the upper eyelid has more sebaceous glands than the lower eyelid, with 25-40 and 20-30, respectively.…”

“…The study found that oily skin has a role in chalazion infection, with females with oily skin having a higher frequency of infection 50.9% than males 34.6%, Table 7. This is congruent with the findings of Alsoudi et al, who discovered that females were impacted at a higher rate than males 58% (Alsoudi et al, 2022). According to Petricek et al, sex hormones, particularly androgens, are vital in controlling the lacrimal, meibomian, and sebaceous glands, the imbalance of which is related to dry eye illness.…”

Benchmarking Current Practice Standards for Chalazion Treatment Among Oculoplastic Surgeons

“…This aligns with a recent retrospective chart review in which conservative measures were used in 97.7% of presenting chalazia. 3 In our study for chronic chalazia, I&C was the most likely treatment to be suggested followed by intralesional steroid injection. Wu et al’s 2 randomized clinical trial comparing different conservative chalazion treatments found more chronic lesions (>2 months) were less likely to respond to more conservative treatment.…”

Randomized Prospective Evaluation of Microblepharoexfoliation BlephEx as Adjunctive Therapy in the Treatment of Chalazia

“… 2 , 4 Other treatments for chalazia include oral doxycycline, antibiotic–steroid ointments, and meibomian gland expression. 5 , 6 …”

“…2,4 Other treatments for chalazia include oral doxycycline, antibiotic-steroid ointments, and meibomian gland expression. 5,6 One suspected cause of chalazia is the Demodex mite, the most common human skin ectoparasite. 7 Although chalazia are most often due to ocular rosacea or generalized lid inflammation, Demodex has been characterized as a possible risk factor for recurrent chalazia in adults.…”