Stye

Last updated
Stye
Other namesSty, hordeolum [1]
Stye02.jpg
An external stye on the upper eyelid
Pronunciation
Specialty Ophthalmology, optometry
Symptoms Red tender bump at the edge of the eyelid [1]
Usual onsetAny age [2]
DurationFew days or weeks [3]
Causes bacterial infection by Staphylococcus aureus [3]
Differential diagnosis Chalazion [4]
Treatment Warm compresses, antibiotic eye ointment [5] [6]

A stye, also known as a hordeolum, is a bacterial infection of an oil gland in the eyelid. [4] This results in a red tender bump at the edge of the eyelid. [1] [5] The outside or the inside of the eyelid can be affected. [3]

Contents

The cause of a stye is usually a bacterial infection by Staphylococcus aureus . [3] [6] Internal styes are due to infection of the meibomian gland while external styes are due to an infection of the gland of Zeis. [5] A chalazion on the other hand is a blocked meibomian gland without infection. [4] A chalazion is typically in the middle of the eyelid and not painful. [5]

Often a stye will go away without any specific treatment in a few days or weeks. [3] Recommendations to speed improvement include warm compresses. [5] Occasionally antibiotic eye ointment may be recommended. [6] While these measures are often recommended, there is little evidence for use in internal styes. [3] The frequency at which styes occur is unclear, though they may occur at any age. [2]

Signs and symptoms

Stye of the upper eyelid StyeUpper2017.jpg
Stye of the upper eyelid
8-year-old boy with an external hordeolum of lower lid External hordeolum.jpg
8-year-old boy with an external hordeolum of lower lid

The first sign of a stye is a small, yellowish spot at the center of the bump that develops as pus and expands in the area. [7]

Other stye symptoms may include:

Complications

Internal stye of upper eyelid Internal stye.jpg
Internal stye of upper eyelid

Stye complications occur in very rare cases. However, the most frequent complication of styes is progression to a chalazion that causes cosmetic deformity, corneal irritation, and often requires surgical removal. [10] Complications may also arise from the improper surgical lancing, and mainly consist of disruption of lash growth, lid deformity or lid fistula. Large styes may interfere with one's vision.

Eyelid cellulitis is another potential complication of eye styes, which is a generalized infection of the eyelid. Progression of a stye to a systemic infection (spreading throughout the body) is extremely rare, and only a few instances of such spread have been recorded. [11]

Cause

A stye is caused by a bacterial infection. The bacteria are Staphylococcus aureus in about 95% of cases. [12] The infection leads to the blocking of an oil gland at the base of the eyelash. Styes are experienced by people of all ages. Styes can be triggered by poor nutrition, sleep deprivation, lack of hygiene, lack of water, and rubbing of the eyes. Styes can be secondary to blepharitis or a deficiency in immunoglobulin. [13]

Prevention

Stye prevention is closely related to proper hygiene. Proper hand washing can reduce the risks of developing not only styes, but also many other types of infections.

Upon awakening, application of a warm washcloth to the eyelids for one to two minutes may be beneficial in decreasing the occurrence of styes by liquefying the contents of the oil glands of the eyelid and thereby preventing blockage. [14]

To prevent styes, cosmetics and cosmetic eye tools should not be shared among people. Like with all infections, regular hand washing is essential, and the eyes should not be rubbed or touched with unclean hands. Contaminated eye makeup should be discarded and sharing of washcloths or face towels should be curtailed, to avoid spreading the infection between individuals. [15] [16] Breaking the stye may spread bacteria contained in the pus and should be avoided. [17]

Treatment

Most cases of styes resolve on their own within one to two weeks, without professional care. [3] The primary treatment is application of warm compresses.[ medical citation needed ] As a part of self-care at home, people may cleanse the affected eyelid with tap water or with a mild, nonirritating soap or shampoo (such as baby shampoo) to help clean crusted discharge. Cleansing must be done gently and while the eyes are closed to prevent eye injuries. [18]

People with styes should avoid eye makeup (e.g., eyeliner), lotions, and wearing contact lenses, since these can aggravate and spread the infection (sometimes to the cornea). [19] People are advised not to lance the stye themselves, as serious infection can occur. [19] Pain relievers such as acetaminophen may be used.

Antibiotics

Evidence to support the use of antibiotic eye ointment is poor. [6] Occasionally erythromycin ophthalmic ointment is recommended. [20] Other antibiotics, such as chloramphenicol or amoxicillin may also be used. [21] Chloramphenicol is used successfully in many parts of the world, but contains a black box warning in the United States due to concerns about aplastic anemia, which on rare occasions can be fatal.

Antibiotics are normally given to people with multiple styes or with styes that do not seem to heal, and to people who have blepharitis or rosacea.

Procedures

Incision and drainage is performed if resolution does not begin in the next 48 hours after warm compresses are started. Medical professionals will sometimes lance a particularly persistent or irritating stye with a needle to accelerate its draining. [22]

Surgery is the last resort in stye treatment. Styes that do not respond to any type of therapies are usually surgically removed. Stye surgery is performed by an ophthalmologist, and generally under local anesthesia. The procedure consists of making a small incision on the inner or outer surface of the eyelid, depending if the stye is pointing externally or not. After the incision is made, the pus is drained out of the gland, and very small sutures are used to close the lesion. Sometimes the removed stye is sent for a histopathological examination to investigate possibility of skin cancer.

Alternative medicine

A 2017 Cochrane review found low-certainty evidence that acupuncture helps in hordeolum compared with antibiotics or warm compresses. [23] There was also low-certainty evidence that acupuncture plus usual treatment may increase the chance of hordeolum getting better, though they could not rule out placebo or observer effect, since the studies reviewed either had no positive control, were not blinded, or both. [23]

Prognosis

Although styes are harmless in most cases and complications are very rare, styes often recur. They do not cause intraocular damage, meaning they do not affect the eye. Styes normally heal on their own by rupturing within a few days to a week causing the relief of symptoms, but if one does not improve or it worsens within two weeks, a doctor's opinion should be sought. Few people require surgery as part of stye treatment. With adequate treatment, styes tend to heal quickly and without complications.

The prognosis is better if one does not attempt to squeeze or puncture the stye, as infection may spread to adjacent tissues. Also, patients are recommended to call a doctor if they encounter problems with vision, the eyelid bump becomes very painful, the stye bleeds or reoccurs, or the eyelid or eyes becomes red. [24]

Etymology

The word stye (first recorded in the 17th century) is probably a back-formation from styany (first recorded in the 15th century), [25] which in turn comes from styan plus eye, [26] the former of which in turn comes from the old English stīġend, meaning "riser", from the verb stīgan, "to rise". The older form styan is still used in Ulster Scots today.

The homonym sty found in the combination pigsty has a slightly different origin, namely it comes from the Old English stiġ-fearhfearh (farrow) is the Old English word for "piglet"—where stiġ meant "hall" (cf. steward), possibly an early Old Norse loanword, which could be cognate with the word stīgan above. [27]

The synonymous late Latin expression is hordeolum, a modulation of the word hordeolus, which is related to hordeum ("barley"), after its resemblance to a barleycorn. In Czech, a sty is called ječné zrno (from ječmen "barley" and zrno "seed or grain"); in German, it is called Gerstenkorn (barleycorn). In Hebrew it is called שעורה Seh-oh-Ráh ("barley"). In Polish it is called jęczmień ("barley"). In Hungarian it is called árpa ("barley"). In Turkish it is called arpacık (small barley, barleylet)

See also

Related Research Articles

<span class="mw-page-title-main">Conjunctivitis</span> Inflammation of the eye

Conjunctivitis, also known as pink eye or Madras eye, is inflammation of the outermost layer of the white part of the eye and the inner surface of the eyelid. It makes the eye appear pink or reddish. Pain, burning, scratchiness, or itchiness may occur. The affected eye may have increased tears or be "stuck shut" in the morning. Swelling of the white part of the eye may also occur. Itching is more common in cases due to allergies. Conjunctivitis can affect one or both eyes.

<span class="mw-page-title-main">Impetigo</span> Human disease (bacterial infection)

Impetigo is a contagious bacterial infection that involves the superficial skin. The most common presentation is yellowish crusts on the face, arms, or legs. Less commonly there may be large blisters which affect the groin or armpits. The lesions may be painful or itchy. Fever is uncommon.

<span class="mw-page-title-main">Mastitis</span> Medical condition

Mastitis is inflammation of the breast or udder, usually associated with breastfeeding. Symptoms typically include local pain and redness. There is often an associated fever and general soreness. Onset is typically fairly rapid and usually occurs within the first few months of delivery. Complications can include abscess formation.

<span class="mw-page-title-main">Blepharitis</span> Inflammation of the eyelid

Blepharitis, sometimes known as granulated eyelids, is one of the most common ocular conditions characterized by inflammation, scaling, reddening, and crusting of the eyelid. This condition may also cause swelling, burning, itching, or a grainy sensation when introducing foreign objects or substances to the eye. Although blepharitis by itself is not sight-threatening, it can lead to permanent alterations of the eyelid margin. The primary cause is bacteria and inflammation from congested meibomian oil glands at the base of each eyelash. Other conditions may give rise to blepharitis, whether they be infectious or noninfectious, including, but not limited to, bacterial infections or allergies.

<span class="mw-page-title-main">Eyelid</span> Thin fold of skin that covers and protects the eye

An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. "Palpebral" means relating to the eyelids. Its key function is to regularly spread the tears and other secretions on the eye surface to keep it moist, since the cornea must be continuously moist. They keep the eyes from drying out when asleep. Moreover, the blink reflex protects the eye from foreign bodies. A set of specialized hairs known as lashes grow from the upper and lower eyelid margins to further protect the eye from dust and debris.

<span class="mw-page-title-main">Dry eye syndrome</span> Medical condition of dry eyes

Dry eye syndrome, also known as keratoconjunctivitis sicca, is the condition of having dry eyes. Symptoms include dryness in the eye, irritation, redness, discharge, blurred vision, and easily fatigued eyes. Symptoms range from mild and occasional to severe and continuous. Dry eye syndrome can lead to blurred vision, instability of the tear film, increased risk of damage to the ocular surface such as scarring of the cornea, and changes in the eye including the neurosensory system.

<span class="mw-page-title-main">Cherry eye</span> Prolapse of the tear gland of the third eyelid in animals

Cherry eye is a disorder of the nictitating membrane (NM), also called the third eyelid, present in the eyes of dogs and cats. Cherry eye is most often seen in young dogs under the age of two. Common misnomers include adenitis, hyperplasia, adenoma of the gland of the third eyelid; however, cherry eye is not caused by hyperplasia, neoplasia, or primary inflammation. In many species, the third eyelid plays an essential role in vision by supplying oxygen and nutrients to the eye via tear production. Normally, the gland can turn inside-out without detachment. Cherry eye results from a defect in the retinaculum which is responsible for anchoring the gland to the periorbita. This defect causes the gland to prolapse and protrude from the eye as a red fleshy mass. Problems arise as sensitive tissue dries out and is subjected to external trauma Exposure of the tissue often results in secondary inflammation, swelling, or infection. If left untreated, this condition can lead to dry eye syndrome and other complications.

<span class="mw-page-title-main">Chalazion</span> Inflammatory swelling of the eyelid due to meibomian gland blockage

A chalazion or meibomian cyst is not a cyst but a granuloma in the eyelid that results from a blocked meibomian gland. It typically occurs in the middle of the eyelid, red, and not painful. They tend to come on gradually over a few weeks.

<span class="mw-page-title-main">Boil</span> Medical condition (infection)

A boil, also called a furuncle, is a deep folliculitis, which is an infection of the hair follicle. It is most commonly caused by infection by the bacterium Staphylococcus aureus, resulting in a painful swollen area on the skin caused by an accumulation of pus and dead tissue. Boils are therefore basically pus-filled nodules. Individual boils clustered together are called carbuncles. Most human infections are caused by coagulase-positive S. aureus strains, notable for the bacteria's ability to produce coagulase, an enzyme that can clot blood. Almost any organ system can be infected by S. aureus.

<span class="mw-page-title-main">Trachoma</span> Infectious disease that causes a roughening of the inner surface of the eyelids

Trachoma is an infectious disease caused by bacterium Chlamydia trachomatis. The infection causes a roughening of the inner surface of the eyelids. This roughening can lead to pain in the eyes, breakdown of the outer surface or cornea of the eyes, and eventual blindness. Untreated, repeated trachoma infections can result in a form of permanent blindness when the eyelids turn inward.

<span class="mw-page-title-main">Ear pain</span> Pain in the ear

Ear pain, also known as earache or otalgia, is pain in the ear. Primary ear pain is pain that originates from the ear. Secondary ear pain is a type of referred pain, meaning that the source of the pain differs from the location where the pain is felt.

<span class="mw-page-title-main">Cradle cap</span> Crusting or scaling of a babys scalp

Cradle cap is crusty or oily scaly patches on a baby's scalp. The condition is not painful or itchy, but it can cause thick white or yellow scales that are not easy to remove. Cradle cap most commonly begins sometime in the first three months but can occur in later years. Similar symptoms in older children are more likely to be dandruff than cradle cap. The rash is often prominent around the ear, the eyebrows or the eyelids. It may appear in other locations as well, where it is called infantile seborrhoeic dermatitis. Cradle cap is just a special—and more benign—case of this condition. The exact cause of cradle cap is not known. Cradle cap is not spread from person to person. It is also not caused by poor hygiene. It is not an allergy, and it is not dangerous. Cradle cap often lasts a few months. In some children, the condition can last until age 2 or 3.

<span class="mw-page-title-main">Meibomian gland</span> Sebaceous glands along the rims of the eyelid

Meibomian glands are sebaceous glands along the rims of the eyelid inside the tarsal plate. They produce meibum, an oily substance that prevents evaporation of the eye's tear film. Meibum prevents tears from spilling onto the cheek, traps them between the oiled edge and the eyeball, and makes the closed lids airtight. There are about 25 such glands on the upper eyelid, and 20 on the lower eyelid.

<span class="mw-page-title-main">Corneal abrasion</span> Scratch to the surface of the cornea of the eye

Corneal abrasion is a scratch to the surface of the cornea of the eye. Symptoms include pain, redness, light sensitivity, and a feeling like a foreign body is in the eye. Most people recover completely within three days.

<span class="mw-page-title-main">Neonatal conjunctivitis</span> Medical condition

Neonatal conjunctivitis is a form of conjunctivitis which affects newborn babies following birth. It is typically due to neonatal bacterial infection, although it can also be non-infectious. Infectious neonatal conjunctivitis is typically contracted during vaginal delivery from exposure to bacteria from the birth canal, most commonly Neisseria gonorrhoeae or Chlamydia trachomatis.

<span class="mw-page-title-main">Clobetasone</span> Chemical compound

Clobetasone (INN) is a corticosteroid used in dermatology, for treating such skin inflammation as seen in eczema, psoriasis and other forms of dermatitis, and ophthalmology. Topical clobetasone butyrate has shown minimal suppression of the hypothalamic–pituitary–adrenal axis.

<span class="mw-page-title-main">Dental abscess</span> Collection of pus in or around a tooth

A dental abscess is a localized collection of pus associated with a tooth. The most common type of dental abscess is a periapical abscess, and the second most common is a periodontal abscess. In a periapical abscess, usually the origin is a bacterial infection that has accumulated in the soft, often dead, pulp of the tooth. This can be caused by tooth decay, broken teeth or extensive periodontal disease. A failed root canal treatment may also create a similar abscess.

<span class="mw-page-title-main">Acute haemorrhagic conjunctivitis in Ghana</span> Aspect of public health in Ghana

Acute Haemmorrhagic Conjunctivitis is the inflammation of the conjunctiva of sudden onset. It presents as a reddening of the eye due to the infection of the conjunctiva. The conjunctiva is the thin transparent tissue that covers the eye from the Corneal limbus to the lid margin. Many conditions can lead to the inflammation of the conjunctiva. They include allergies, bacterial infection, viral infection etc. A common form of the condition that occurs every rainy season is the seasonal conjunctivitis popularly referred to as "Apollo" by West Africans because the reports of its first epidemic in Accra coincided with the Apollo 11 Moon landing. Every year prior to the rainy season in the country, various health warnings are given to remind citizens of the condition.

<span class="mw-page-title-main">Meibomian gland dysfunction</span> Disease of the meibomian glands of the eyelid

Meibomian gland dysfunction is a chronic disease of the meibomian glands, which is commonly characterized by obstruction of the end of the duct that delivers the secretion produced by the glands to the eye surface, which prevents the glandular secretion from reaching the ocular surface. The dysfunction could be that the amount of secretion produced may be abnormal. Dysfunction could also be related to the quality of the meibum produced. MGD may result in evaporative dry eye, blepharitis, chalazion, unsealed lid during sleep, and meibomian gland atrophy.

<span class="mw-page-title-main">Warm compress</span> Method of applying heat to the body

A warm compress is a method of applying heat to the body. Heating sources can include warm water, microwaveable pads, wheat packs and electrical or chemical pads. Some unorthodox methods can include warmed potatoes, uncooked rice, and hard-boiled eggs. The most common warm compress is a warm, wet washcloth.

References

  1. 1 2 3 "Hordeolum (Stye)". PubMed Health. Archived from the original on 8 September 2017. Retrieved 14 October 2016.
  2. 1 2 Ferri, Fred F. (2016). Ferri's Clinical Advisor 2017: 5 Books in 1. Elsevier Health Sciences. p. 1219. ISBN   9780323448383. Archived from the original on 2016-10-18.
  3. 1 2 3 4 5 6 7 Lindsley K, Nichols JJ, Dickersin K (2017). "Non-surgical interventions for acute internal hordeolum". Cochrane Database Syst Rev. 1 (1): CD007742. doi:10.1002/14651858.CD007742.pub4. PMC   5370090 . PMID   28068454.
  4. 1 2 3 "Eyelid Disorders Chalazion & Stye". NEI. 4 May 2010. Archived from the original on 18 October 2016. Retrieved 14 October 2016.
  5. 1 2 3 4 5 Carlisle, RT; Digiovanni, J (15 July 2015). "Differential Diagnosis of the Swollen Red Eyelid". American Family Physician. 92 (2): 106–12. PMID   26176369.
  6. 1 2 3 4 Deibel, JP; Cowling, K (May 2013). "Ocular inflammation and infection". Emergency Medicine Clinics of North America. 31 (2): 387–97. doi:10.1016/j.emc.2013.01.006. PMID   23601478.
  7. "What are the signs and symptoms of a sty?". Medicinenet. Archived from the original on 2010-04-07. Retrieved 2010-04-06.
  8. "Stye Symptoms". Archived from the original on 2010-04-06. Retrieved 2010-04-06.
  9. "Symptoms". Archived from the original on 2010-03-07. Retrieved 2010-04-06.
  10. "Hordeolum and Stye: Follow-up". Archived from the original on 2010-04-09. Retrieved 2010-04-06.
  11. "What is the prognosis (outcome) of a sty?". Archived from the original on 2010-04-12. Retrieved 2010-04-06.
  12. Willmann, D.; Guier, C. P.; Patel, B. C.; Melanson, S. W. (2021). "Stye". NIH - StatPearls - Stye. StatPearls. PMID   29083787.
  13. Tamparo, Carol; Lewis, Marcia (2011). Diseases of the Human Body. Philadelphia, PA: F.A Davis Company. p. 504. ISBN   978-0-8036-2505-1.
  14. "Prevention". Archived from the original on 2010-04-10. Retrieved 2010-04-06.
  15. "VisionWeb". Archived from the original on September 9, 2017.
  16. "BBC - Health - Ask the doctor - Styes". Archived from the original on February 1, 2010.
  17. "Merck Manual - Treat Your Sty". Archived from the original on 2020-07-19. Retrieved 2020-07-19.
  18. "Medical Treatment". Archived from the original on 2010-04-11. Retrieved 2010-04-06.
  19. 1 2 "Merck Manual - Chalazion and Stye (Hordeolum)".
  20. "Medscape: Medscape Access". Emedicine.com. 2018-11-19. Archived from the original on 2008-08-04.
  21. eMedicine - Periorbital Infections : Article by R Gentry Wilkerson, MD. Archived 2007-04-03 at the Wayback Machine
  22. Sty (Stye, Hordeolum) Causes, Infection Symptoms and Treatment by MedicineNet.com Archived 2007-05-20 at the Wayback Machine
  23. 1 2 Cheng K, Law A, Guo M, Wieldand LS, Shen X, Lao L (2017). "Acupuncture for acute hordeolum". Cochrane Database Syst Rev. 2 (9): CD011075. doi:10.1002/14651858.CD011075.pub2. PMC   5378315 . PMID   28181687.
  24. "Eyelid bump". Archived from the original on 2010-04-10. Retrieved 2010-04-06.
  25. sty, n.4: "sty" . Oxford English Dictionary (Online ed.). Oxford University Press.(Subscription or participating institution membership required.)
  26. "styan" . Oxford English Dictionary (Online ed.). Oxford University Press.(Subscription or participating institution membership required.)
  27. sty, n.3: "sty" . Oxford English Dictionary (Online ed.). Oxford University Press.(Subscription or participating institution membership required.)