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A hordeolum (i.e. stye) is a localized infection or inflammation of the eyelid margin involving hair follicles of the eyelashes or blockage of Sebaceous glands of Zeiss (external hordeolum) or meibomian glands in tarsal plate(internal hordeolum).

Staphylococcus aureus is the infectious agent in 90-95% of cases.

Hordeola usually are self-limited even without drainage. Most of them hordeola eventually point on the surface and drain by themselves

Rarely, it may progress to chronic granulation with formation of a painless chalazion.

Management of Stye

  • If the lesion points at a lash follicle, removal of that one eyelash hair may promote drainage and healing
  • Carefully inspect the underside of the eyelid to avoid missing an internal hordeolum as a surgical drainage (in form of a vertical nick) of an internal pointed lesion speeds the healing process, though this is tricky to be attempted in an uncooperative child.
  • Applying warm and wet compresses for a period of approximately 5-15 minutes, 3 to 4 times a day.
  • Instructing child not to squeeze or rub the stye
  • Avoid contact lenses & eyemake-up until the infection heals
  • Use Antibiotics when inflammation has spread beyond the immediate area of the hordeolum.
    • Topical antibiotics(Bacitracin, Tobramycin) may be used for recurrent lesions and for those that are actively draininghelp stop the spread of the infection to other parts of the eye.
    • Systemic antibiotics(Cloxacillin, Amoxy-clav, Cefuroxime) are indicated if signs of bacteraemia are present or if the patient has tender preauricular lymph nodes.

External Stye

Internal Stye

(Pictures courtesy emedicine.medscape.com)

Posted On: 22/08/2019

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