Current pattern treatment of hordeolum by ophthalmologists in Thailand.

OBJECTIVE: To assess the current pattern of treatment among ophthalmologists in Thailand. MATERIAL AND METHOD: A two-page Thai questionnaire was distributed to Thai ophthalmologists' annual meeting. Other questionnaires were sent to the eye institute or conducted by telephone interviews. RESULTS: Five hundred one physicians participated in the present study (49.17%). Warm compression usage was suggested (n = 459; 91.62%). The prescription before I & C was combined topical and oral antibiotics, only oral antibiotics (n = 12; 2.4%), or no oral antibiotics (n = 21; 4.19%). I & C was performed only in cases with flocculated mass in irrespective size (n = 271; 54%), mass size of 4.47 (range 2-10 mm) (n = 124; 24.76%), or requested by patients (n = 13; 2.59%). The prescription after I & C was combined topical and oral antibiotics, no oral antibiotics (n = 74; 14.77%), or no antibiotics at all (n = 14; 2.79%). CONCLUSION: Warm compression was commonly used. I&C was administered if there was flocculated mass. Antibiotics usage before and after I & C was the same. First choice antibiotics were combination of neomycin, polymyxin, and gramicidine eye drop, chloramphenicol eye ointment, and oral dicloxacillin.

[Eye lid reconstruction after bilateral palpebral complete necrosis after an extensive Pseudomonas aeruginosa infection (infected neonatal hordeolum)]. / Reconstructie palpebrala dupa necroza bilaterala completa de pleoape, cu postinfectie locala extensiva cu Pseudomonas aeruginosa (orjelet neona- tal suprainfectat).

In this article we will present a clinical case particularly interesting in terms of diagnosis, treatment and evolution of a infant who presented in our service because very serious evolution of a hordeolum, with infection and then complete necrosis of lower and upper eyelids of both eyes. The substrate counterproductive evolution was identified later, by genetic analysis (X-linked Bruton congenital agammaglobulinemia).

Interventions for acute internal hordeolum.

BACKGROUND: 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. OBJECTIVES: 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. SEARCH STRATEGY: 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) (www.controlled-trials.com), ClinicalTrials.gov (http://clinicaltrials.gov) 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. SELECTION CRITERIA: 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. DATA COLLECTION AND ANALYSIS: 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. MAIN RESULTS: 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. AUTHORS' CONCLUSIONS: 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.

Inadvertent ocular perforation during lid anesthesia for hordeolum removal.

PURPOSE: Ocular perforation during lid anesthesia is rarely reported. We describe here a case of inadvertent corneal perforation and traumatic cataract that occurred during lid anesthesia in a procedure for hordeolum removal. METHODS: A 33-year-old woman presented with a sudden visual loss of her left eye. She had undergone hordeolum removal the day before at a local clinic. On ophthalmologic examination, the cornea was perforated and the lens cortex was extruded into the anterior chamber. After cataract removal and IOL implantation, antibiotics were injected into the vitreous. RESULTS: Her final visual acuity of the left eye was 20/20. Postoperative specular microscopic examination revealed a normal-range endothelial cell count, coefficient of variation, and hexagonality despite the intracameral lidocaine injection. CONCLUSIONS: Anesthetic injection of an infected lid should be done with great caution. Although there are possibilities of corneal endothelial toxicity and endophthalmitis in case of intracameral lidocaine injection through the infected lid, yet proper management may save the patient's vision without complications.

Multiple recurrent hordeola associated with selective IgM deficiency.

An external hordeolum is an acute, suppurative inflammation of the glands of Zeis and sweat glands or hair follicles most commonly caused by staphylococci, usually in the setting of a chronic blepharitis.(1) We report a case of a boy with unilateral multiple recurrent hordeola in association with selective IgM deficiency.

[Anesthetic management of a patient with West syndrome].

A 21-year-old female with West syndrome was scheduled for resection of hordeolum. She had an episode of convulsion at three months of age, and was diagnosed as having West syndrome at one year of age. She had epileptic seizures twice a week in spite of administration of phenytoin, clonazepam and sodium valproate. These drugs had been administered till the morning of the surgery. After premedication with atropine 0.25 mg, anesthesia was induced with propofol (12-->10-->8 mg.kg-1.h-1). The tracheal intubation was performed with vecuronium 0.1 mg.kg-1 and anesthesia was maintained with continuous infusion of propofol 6-8 mg.kg-1.h-1 and local infiltration with 1.0% lidocaine 5 ml. We administered phenytoin to prevent epileptic seizures during the surgery. No epileptic seizures occurred perioperatively. We conclude that propofol may be useful for a patient with West syndrome, and we should be careful not to lower the threshold for convulsion during the perioperative period.

Treatment of styes and meibomian cysts. Practical procedures.

Styes and meibomian cysts are common eye problems presenting to the general practitioner and both can be simply managed in the consulting rooms. Meibomian cysts, however, may present difficulties to the inexperienced and Dr Hudson has outlined a comprehensive plan of assessment and surgical management.