VOL. 7, No. 1/2, December 2011

Z. Onaran, et al. [2011] Med. Hypotheses Res. 7: 49−52.

Systemic Isotretinoin for the Management of Refractory
and Recurrent Hordeolum in Blepharitis

Zafer Onaran*, Ayşe Anıl Karabulut, Pelin Yılmazbaş and
Kemal Örnek

Department of Ophthalmology (ZO, PY, KÖ), and Department of Dermatology (AAK),
Kırıkkale University School of Medicine, Kırıkkale, Turkey

Abstract. Internal hordeolum is purulent eyelid infection arising from meibomian gland
secondary to occlusion of the gland orifice by sebum or ductal hyperkeratinization.
Recurrent and relapsing hordeolum cases in spite of current treatment modalities born out an
idea of a new therapeutic agent focusing on the pathogenesis of hordeolum. Isotretinoin may
be this agent with proven effects of inhibiting sebum production and ductal keratinization in
pilosebaceous unit. The common developmental origin of the meibomian gland and
pilosebaceous unit is the basis of our hypothesis that isotretinoin could inhibit the hordeolum
formation. We suggest that similar act of mechanism of isotretinoin on acne vulgaris — the
inflammatory disorder of the pilosebaceous unit — could be applied on meibomian glands
and prevent hordeolum formation.

* Correspondence: Dr. Zafer Onaran, Kırıkkale University School of Medicine, Department
of Ophthalmology, Fabrikalar Mah, Saglik Cad, 71100 Kırıkkale, Turkey. TEL: 0090-533-359-
3075. FAX: 0090-312-425-7421. E-MAIL: