Local Injections of Fluorouracil for Eyelid Hordeolum

Summary:

Hordeolum is usually self-limited, but a subset of patients develop persistent, symptomatic induration or prefer to avoid incision and curettage in the cosmetically sensitive eyelid. Currently, treatment methods for hordeolum mainly include local warm compresses, local or systemic antibiotic therapy, and abscess incision and drainage. We describe a small case series of 4 female patients with eyelid inflammatory nodules within the hordeolum–chalazion spectrum treated with local injection of 6-fold diluted 5-fluorouracil. Clinical response and adverse events were recorded. Two patients achieved complete clinical resolution within 3 to 7 days after a single injection. One bilateral case improved rapidly after the initial injection; the right-sided lesion resolved by day 7, whereas a left-sided induration persisted despite a second injection and remained essentially unchanged at follow-up. One long-standing post–incision-and-drainage case showed marked reduction by day 2 and further improvement by day 7 but did not completely resolve. No treatment-related adverse events were observed, and no recurrence was noted in cases with complete resolution during follow-up. Local injection of 6-fold diluted 5-fluorouracil may represent a potential minimally invasive option for selected patients with persistent eyelid inflammatory nodules. Responses were variable in this small uncontrolled series; further controlled studies are warranted to clarify efficacy, optimal dosing, and safety.