Stye (Hordeolum)
Definition | Aetiology | Pathophysiology | Risk Factors | Signs and Symptoms | Investigations | Management
Definition
Stye (hordeolum) is a localized, painful infection of the eyelid, typically involving the hair follicles or meibomian glands.
Aetiology
- Bacterial infection: commonly caused by Staphylococcus aureus.
- Blocked meibomian gland: leading to internal hordeolum.
- Blocked eyelash follicle: resulting in external hordeolum.
Pathophysiology
- Infection leads to inflammation and pus formation within the gland.
- Localized swelling causes tenderness and erythema of the eyelid.
- In some cases, the infection may resolve spontaneously or progress to an abscess requiring drainage.
Risk Factors
- Poor eyelid hygiene.
- Blepharitis.
- Frequent eye rubbing.
- Use of contaminated eye makeup.
- Diabetes mellitus.
- Immunosuppression.
Signs and Symptoms
- Localized swelling: tender, red bump on the eyelid.
- Pain: discomfort or tenderness around the affected area.
- Pus discharge: may develop in severe cases.
- Crusting of eyelid margins: due to dried discharge.
- Blurred vision: if swelling affects eyelid closure.
Investigations
- Clinical diagnosis: based on characteristic appearance.
- Swab for microbial culture: if recurrent or unresponsive to treatment.
- Blood glucose testing: if underlying diabetes is suspected.
Management
1. Conservative Management:
- Warm compresses: applied several times daily to promote drainage.
- Good eyelid hygiene: gentle cleansing with warm water.
- Avoidance of eye makeup and contact lenses: until resolved.
2. Medical Management:
- Topical antibiotics: chloramphenicol if secondary bacterial infection is suspected.
- Oral antibiotics: flucloxacillin in severe or recurrent cases.
3. Surgical Management:
- Incision and drainage: indicated for large or persistent styes.
4. Referral:
- Ophthalmology: if stye is recurrent, persistent, or associated with preseptal cellulitis.
- Endocrinology: if diabetes mellitus is suspected as an underlying cause.