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Hordeolum (stye) :

DESCRIPTION: | SIGNS AND SYMPTOMS: | CAUSES: | DIFFERENTIAL DIAGNOSIS: | LABORATORY: | PATHOLOGICAL FINDINGS: | IMAGING: | TREATMENT | DRUG(S) OF CHOICE | PRECAUTIONS: | ALTERNATIVE DRUGS: | PATIENT MONITORING: | POSSIBLE COMPLICATIONS: | MISCELLANEOUS

BASICS TOP

DESCRIPTION: TOP : The common term "stye" refers to any inflammation or infection of the eyelid margin involving the hair follicles of the eyelashes (external hordeolum), meibomian glands (internal hordeolum), or granulomatous infection of the meibomian glands (chalazion)

System(s) affected: Skin/Exocrine

Genetics: No known genetic pattern

Incidence/Prevalence in USA: Extremely common

Predominant age: None

Predominant sex: Male = Female

SIGNS AND SYMPTOMS: TOP :

* Redness of the margin of the eyelid with scaling, collection of discharge

* Localized inflammation of the eyelashes

* Patients may experience itching or scaling of the eyelids, chronic redness, eye irritation leading to localized tenderness and pain

CAUSES: TOP

* The most common causes of eyelid infections are staphylococcal, although other organisms may also be involved

* Seborrhea can predispose to infections of the eyelid

RISK FACTORS: TOP :

* Predisposing blepharitis (low grade infections of the eyelid margin)

* Poor eyelid hygiene

* Contact lens wearers

* Application of make-up

DIAGNOSIS

DIFFERENTIAL DIAGNOSIS: TOP :

* Blepharitis

* Eyelid neoplasms

LABORATORY: TOP : Culture of the eyelid margins is usually not necessary

Drugs that may alter lab results: None

Disorders that may alter lab results: None

PATHOLOGICAL FINDINGS: TOP : Bacterial contamination and white cells in eyelid discharge

SPECIAL TESTS: None

IMAGING: TOP : None

DIAGNOSTIC PROCEDURES: TOP : History and eye examination

TREATMENT: TOP

APPROPRIATE HEALTH CARE: Outpatient

GENERAL MEASURES: TOP :

* Warm compresses to the area of inflammation can help increase blood supply and potentiate spontaneous drainage

* Good personal hygiene with attention to cleansing the eyelids on a daily basis to prevent recurrent infections

* Application of an antibiotic ointment (such as erythromycin) to the margin of the eyelid after proper cleansing. (Except children under 12, where there is a risk of blurred vision and amblyopia.) Helps reduce bacterial proliferation.

SURGICAL MEASURES: If the infection becomes localized to a single gland, incision, drainage, and curettage is sometimes necessary. This is an in-office procedure with a local anesthetic.

ACTIVITY: No restrictions

DIET: No special diet

PATIENT EDUCATION:

* The patient should be instructed in proper cleansing of the eyelids using a solution of tap water and baby shampoo or a commercially prepared hypoallergenic cleanser

* The stye should not be squeezed

MEDICATIONS

DRUGS OF CHOICE: TOP :

* Erythromycin ophthalmic ointment

* Occasionally use of an aminoglycoside ophthalmic ointment such as gentamicin may be necessary if refractory to simpler treatment

Contraindications: None

PRECAUTIONS: TOP : None

Significant possible interactions: None

ALTERNATIVE DRUGS: TOP : None

FOLLOWUP

PATIENT MONITORING: TOP : The patient should be seen within several weeks to assess the effectiveness of therapy

PREVENTION/AVOIDANCE: Eyelid hygiene

POSSIBLE COMPLICATIONS: TOP : None expected. An internal hordeolum, if untreated, may lead to generalized cellulitis of the lid.

EXPECTED COURSE AND PROGNOSIS: Responds well to treatment, but tends to recur in some patients

MISCELLANEOUS TOP

ASSOCIATED CONDITIONS:

* Acne

* Seborrhea

AGE-RELATED FACTORS:

Pediatric: N/A

Geriatric: N/A

Others: N/A

PREGNANCY: N/A

SYNONYMS:

* Internal hordeolum

* External hordeolum

* Chalazion hordeolum

* Zeisian sty

* Meibomian sty

ICD-9-CM:

373.1 Hordeolum

373.2 Chalazion

373.0 Blepharitis

SEE ALSO: N/A

OTHER NOTES: N/A

ABBREVIATIONS: N/A

REFERENCES: None

Author(s):

Robert M. Kershner, MD, FACS

Copyright - Williams & Wilkins, 1997.

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