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.


OBJECTIVE
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.


METHODS
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.


METHODS
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.


METHODS
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.


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.


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.
Lindsley
Kristina
K
Center for Clinical Trials, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe Street, W5010, Baltimore, Maryland, USA, 21205.
Nichols
Jason J
JJ
Dickersin
Kay
K
D000208:Acute Disease; D006726:Hordeolum / Q000473:pathology / Q000601:surgery*; D006801:Humans
Med Clin North Am. 1983 Jan;67(1):131-52
6338305
Emerg Med Clin North Am. 2008 Feb;26(1):57-72, vi
18249257
Acta Ophthalmol (Copenh). 1983 Oct;61(5):933-7
6659900
Nurs Mirror. 1979 Sep 13;149(11):18-9
257560
JAMA. 1967 Feb 6;199(6):427-8
6071231
Practitioner. 1956 Mar;176(1053):318-21
13310413
Lancet. 1958 Oct 4;2(7049):728-9
13588988
Ophthalmic Surg. 1986 Jun;17(6):351-3
3737106
Br J Ophthalmol. 1984 Nov;68(11):836-7
6498138
Jpn J Antibiot. 1974 Aug;27(4):451-5
4548096
Aust Fam Physician. 1981 Sep;10(9):714-5, 717
7305749
J Med Libr Assoc. 2006 Apr;94(2):130-6
16636704
Jpn J Antibiot. 1973 Dec;26(6):535-9
4544498
Emerg Med Clin North Am. 1995 Aug;13(3):631-48
7635086
J Med Assoc Thai. 2005 May;88(5):647-50
16149682
Practitioner. 1982 May;226(1367):901-23
6980409
Indian Pract. 1966 Oct;19(10):689-90
5923490
J Am Optom Assoc. 1990 Dec;61(12):904-6
2081834
Indian J Ophthalmol. 1987 Jul-Aug;35(4):183-5
3506927
J Sch Health. 1991 Feb;61(2):95-7
2016867
Br Med J. 1954 Dec 4;2(4900):1322-5
13209110
Postgrad Med. 1950 Feb;7(2):133
15404349
Int Ophthalmol Clin. 1984 Summer;24(2):65-77
6233233
Infect Dis Clin North Am. 2007 Jun;21(2):393-408, vi
17561075
J Altern Complement Med. 2008 Jun;14(5):461-4
18564951
Cesk Oftalmol. 1987 Sep;43(5):374-6
3664694
Jpn J Antibiot. 1969 Dec;22(6):522-5
5309771
DICP. 1991 Apr;25(4):359-60
1926904
Immunol Allergy Clin North Am. 2008 Feb;28(1):137-68, vii
18282550
Pediatr Rev. 1999 Aug;20(8):283-4
10429150
Ann Ophthalmol. 1987 Oct;19(10):376-9
3318623
Am Fam Physician. 1971 Apr;3(4):104-9
4251550
Postgrad Med. 1986 Aug;80(2):271-2
3737498
Aust Fam Physician. 1987 Jun;16(6):828, 830
3675335
Jpn J Antibiot. 1971 Apr;24(2):51-8
4996452
Ann Ophthalmol. 1988 May;20(5):196-8
3408086
Br J Ophthalmol. 1984 Nov;68(11):833-5
6498137
Surv Ophthalmol. 1996 Mar-Apr;40(5):343-67
8779082