Which eyelid condition generally requires antibiotics due to infectious etiology?

• A. Blepharitis
• B. Chalazion
• C. Conjunctivitis
• D. Hordeolum

Answer: (D)

An acute eyelid infection of the eyelid glands is a hordeolum, usually caused by Staphylococcus species. Because it represents a localized bacterial infection of the eyelid tissues, it typically requires antibiotics to clear the infection and prevent spread, in addition to measures like warm compresses to promote drainage. Hordeolum presents as a tender, red, swollen lump on the eyelid margin, sometimes with purulent discharge.

By contrast, a chalazion is not infectious but a chronic blockage and granulomatous inflammation of a Meibomian gland, so it is treated with warm compresses and sometimes incision or drainage rather than antibiotics. Blepharitis is lid-margin inflammation that can be inflammatory or associated with chronic bacterial colonization; antibiotics may be used for secondary infection but the condition is not an acute infectious gland abscess. Conjunctivitis involves the conjunctiva rather than the eyelid glands, and while it may be bacterial and require antibiotics, it’s not primarily an eyelid-gland infection.