DESCRIPTION: | SIGNS AND SYMPTOMS: | CAUSES: | DIFFERENTIAL DIAGNOSIS: | LABORATORY: | PATHOLOGICAL FINDINGS: | IMAGING: | TREATMENT | DRUG(S) OF CHOICE | PRECAUTIONS: | ALTERNATIVE DRUGS: | PATIENT MONITORING: | POSSIBLE COMPLICATIONS: | MISCELLANEOUS
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
* 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
* The most common causes of eyelid infections are staphylococcal, although other organisms may also be involved
* Seborrhea can predispose to infections of the eyelid
* Predisposing blepharitis (low grade infections of the eyelid margin)
* Poor eyelid hygiene
* Contact lens wearers
* Application of make-up
DIAGNOSIS
* 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
DIAGNOSTIC PROCEDURES: TOP : History and eye examination
APPROPRIATE HEALTH CARE: Outpatient
* 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
* 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
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.