In most cases, hordeolum is caused by Staphylococcus aureus. From its clinical manifestations, the disease should pertain to Zhenyan (needle eye) in traditional Chinese medicine. Its exopathic cause is the invasion of pathogenic wind-heat, and it is internally associated with the heat accumulation in spleen and stomach or with the weak and debilitated physique. The main pathogenesis of the disease is that the pathogenic factor invades the eyelid causing qi and blood to stagnate in the eye.

According to the theory of traditional Chinese medicine, there are some patterns of syndrome that lead to hordeolum.
1. Syndrome of pathogenic wind-heat Invasion of Eyelid
2. Syndrome of Pathogenic Heat Invasion of Eye
3. Syndrome of Latent Pathogenic Heat in Spleen and Stomach
4. Syndrome of Asthenia of Spleen and Stomach