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 BodySensation
- 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
- Bacitracin
- 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