Internal hordeolum is caused by blockage of which glands?

• A. Lacrimal gland
• B. Glands of Moll
• C. Glands of Krause & Wolfring
• D. Tarsal or Meibomian glands

Answer: (D)

Internal hordeolum occurs when the Meibomian glands, the tarsal glands embedded in the eyelid, become blocked and infected. These glands line the inside of the eyelid and secrete the oily component of the tear film. When a duct is obstructed, secretions stagnate and a localized infection—usually with Staphylococcus aureus—develops, forming a tender, palpable nodule inside the eyelid. The lacrimal gland, as well as the glands of Moll and Zeis, are not the sources of this internal stye; the lacrimal gland makes tears, while Moll and Zeis glands are associated with external styes at the lash margin. Glands of Krause and Wolfring are accessory tear glands and don’t cause hordeolum. Thus, blockage of the Meibomian (tarsal) glands best explains the internal hordeolum.