II. Epidemiology
- More common in children and teenagers
III. Pathophysiology
- Types
- External Hordeolum (stye)
- External zeis (Sweat Gland) infection
- Internal Hordeolum
- Internal meibomian gland (Sebaceous Gland) infection
- External Hordeolum (stye)
- Localized superficial abscess
- Usually caused by Staphylococcus aureus infection of the eyelash follicle
IV. Causes
- Staphylococcus organisms
- Seborrhea
V. Risk Factors
- Blepharitis
- Contact Lens wear
- Make-up or cosmetic application
- Poor Eyelid hygiene
VI. Symptoms
- Painful Eye Foreign Body sensation
- Lacrimation
- Photophobia
VII. Signs
- Onset as erythematous tender indurated lid area
- Later Pustule develops in area of Eyelid Inflammation
- Red, swollen, tender mass within Eyelid, at margin
- Types
- External Hordeolum (stye, external zeis or Sweat Gland)
- Most common presentation
- Points to skin surface
- Internal Hordeolum (internal meibomian or Sebaceous Gland infection)
- Points inward toward palpebral Conjunctiva
- Usually larger than External Hordeolum
- External Hordeolum (stye, external zeis or Sweat Gland)
VIII. Differential Diagnosis
- Chalazion
- Blepharitis
- Eyelid neoplasm
IX. Management
- Warm compresses to eye for 15 minutes qid
- Increases blood supply to area
- Increases spontaneous discharge
- Daily cleansing of Eyelids
- Antibiotic ointment to Eyelid margin
- Erythromycin
- Avoid prolonged use in age under 12 years
- Blurred vision (Amblyopia risk)
- Incision, Drainage and Curettage
- Indications
- Single gland involvement
- Failed improvement after 48 hours
- In-office procedure under local anesthetic
- May be performed by non-ophthalmologist
- Indications
X. Complications
-
Chalazion
- May develop from chronic Hordeolum
-
Generalized lid Cellulitis
- Risk of Cavernous Sinus Thrombosis
- Add systemic coverage early for Staphylococcus aureus
- Recurrent Hordeolum
- Unilateral, chronic Staphylococcal infection
- Consider systemic antibiotics
- Refer to Ophthalmology
XI. References
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| Definition (MSHCZE) | Lat. ječné zrno. Ohraničený hnisavý zánět, často stafylokokového původu, některé ze žlázek víčka (kolem vlasového míšku) provázený otokem, zarudnutím, bolestí a později někdy patrným zhnisáním. H. se může vyprázdnit samovolně, vhodnější je incize s místním podáním antibiotik. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
| Definition (MSH) | Purulent infection of one of the sebaceous glands of Zeis along the eyelid margin (external) or of the meibomian gland on the conjunctival side of the eyelid (internal). |
| Concepts | Disease or Syndrome (T047) |
| MSH | D006726 |
| ICD10 | H00.01 |
| SnomedCT | 74612003, 155172004, 267736000, 193912000, 193913005, 397513003, 1489008 |
| English | Hordeolum, Stye, Styes, Hordeolum NOS, Hordeolum [Disease/Finding], sty, stye, styes, hordeolum externum, Stye/hordeolum, Boil of eyelid, Furuncle of eyelid, Stye (disorder), Hordeolum (disorder), hordeolum, Hordeolum, NOS, Sty |
| Swedish | Vagel |
| Japanese | ﾊﾞｸﾘｭｳｼｭ, 麦粒腫, ものもらい |
| Czech | hordeolum, ječné zrno, Ječné zrno, Hordeolum, zánět Zeissovy žlázy |
| Finnish | Luomirauhasen tulehdus |
| Russian | IACHMEN', ЯЧМЕНЬ |
| Polish | Zapalenie gruczołów tarczkowych powiek, Jęczmyk, Jęczmień-choroba |
| Hungarian | Jégárpa, hordeolum, Árpa |
| Norwegian | Hordeolum, Sti på øyet |
| Spanish | orzuelo (concepto no activo), forúnculo del párpado, orzuelo (trastorno), orzuelo, Orzuelo |
| Dutch | hordeolum, Hordeolum, Strontje |
| French | Orgelet, Compère-loriot, Hordeolum, Hordéole |
| German | Gerstenkorn, Hordeolum |
| Italian | Orzaiolo |
| Portuguese | Hordéolo, Terçol |
Ontology: Hordeolum externum (C0019919)
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 373.11 |
| ICD10 | H00.01 , H00.03 |
| SnomedCT | 1489008, 61523007, 193912000 |
| English | Hordeolum, Stye, furuncles on eyelid (physical finding), furuncles on eyelid, hordeolum externum, stye, hordeolum externum (diagnosis), Eyelid boil, external hordeolum, hordeolum external, externum hordeolum, sty external, Hordeolum, external, Furuncle of eyelid (disorder), External hordeolum, Hordeolum externum (disorder), Hordeolum externum, eyelid; furuncle, furuncle; eyelid, Furuncle of eyelid, Boil of eyelid |
| Italian | Foruncolo della palpebra, Orzaiolo esterno, Orzaiolo superficiale |
| Dutch | hordeolum externum, furunkel; ooglid, ooglid; furunkel, ooglidfurunkel |
| French | Orgelet externe, Furoncle de la paupière |
| German | Hordeolum externum, externes Hordeolum, Furunkel des Augenlids |
| Portuguese | Hordéolo externo, Furúnculo palpebral |
| Spanish | Orzuelo externo, Forúnculo del párpado, forúnculo del párpado, furúnculo del párpado, forúnculo del párpado (concepto no activo), chalazión externo (trastorno), chalazión externo, orzuelo externo (trastorno), orzuelo externo |
| Japanese | 外麦粒腫, 眼瞼せつ, ｶﾞﾝｹﾝｾﾂ, ｶﾞｲﾊﾞｸﾘｭｳｼｭ |
| Czech | Hordeolum externum, Furunkl očního víčka |
| Hungarian | szemhéj kelés, Külső hordeolum, Hordeolum externum |
Ontology: Internal hordeolum (C0085690)
| Concepts | Disease or Syndrome (T047) |
| ICD9 | 373.12 |
| ICD10 | H00.02 |
| SnomedCT | 397514009, 15750009, 95752007, 414521009 |
| Dutch | hordeolum internum |
| French | Orgelet interne |
| German | Hordeolum internum, internes Hordeolum |
| Italian | Orzaiolo interno |
| Portuguese | Hordéolo interno |
| Spanish | Orzuelo interno, orzuelo interno (concepto no activo), orzuelo interno (trastorno), orzuelo interno |
| Japanese | 内麦粒腫, ﾅｲﾊﾞｸﾘｭｳｼｭ |
| English | hordeolum internum, hordeolum internum (diagnosis), internal hordeolum, Hordeolum internum (disorder), Internal hordeolum, Hordeolum internum, Internal hordeolum (disorder) |
| Czech | Hordeolum internum |
| Hungarian | Belső hordeolum, Hordeolum internum |
