A stye, also known as hordeolum, is an inflammation on the eyelid

associated with a small collection of pus (abscess). In most cases, the

infection is caused by the Staphylococcus bacteria.

A hordeolum (ie, stye) is a localized infection or inflammation of the eyelid margin

involving hair follicles of the eyelashes (ie, external hordeolum) or meibomian
glands (ie, internal hordeolum).

Symptoms of a stye

Most commonly, styes only affect one eye at a time.

The patient will have a painful red swelling on his/her eyelid which can make the eye tear and
become red. Sometimes styes can look like a pimple.

Styes very rarely affect both eyes simultaneously; an individual will generally have one stye in
one eye. However, it is possible to have more than one stye in the same eye, or one in each eye.

Symptoms of a stye can include:

A lump on the eyelid

Swelling of the eyelid

Pain

Redness

Tenderness

Crusting of the margins of the eyelids

 Burning sensation

Droopiness of the eyelid

Itching of the eye

Blurry vision

Discharge of mucus from the eye

Light sensitivity

Tearing

Discomfort when blinking

The feeling that there is an object in the eye

External hordeolum
External styes emerge along the outer edge of the eyelid. They can become yellow, filled with
pus, and painful when touched. They can be caused by an infection of the:

Eyelash follicle - the small holes in the skin from which eyelashes grow.

Sebaceous (Zeis) gland - this gland is attached to the eyelash follicle and
produces sebum. Sebum helps lubricate the eyelash and stop it from drying
out.

Apocrine (Moll) gland - this gland also helps prevent eyelashes from drying
out. It is a sweat gland that empties into the eyelash follicle.

Internal hordeolum
In Internal Stye, the swelling develops inside the eyelid. It is more painful than an external one.
They are most commonly due to an infection in the meibomian gland. These glands are
responsible for producing a secretion which makes up part of the film that covers the eye.

Patients may also experience a burning sensation in the eye, crusting of the eyelid margins,
droopiness of the eyelids, itchiness on the eyeball, sensitivity to light, tearing, a feeling that
something is stuck to the eye, and discomfort when blinking.

Risk factors for styes

The following can increase the risk of developing a stye:

Using cosmetics after their use-by dates

 Not removing eye makeup before going to bed

Not disinfecting contact lenses before putting them in

Changing contact lenses without washing hands thoroughly

Adolescents tend to have styes more commonly, but people of any age can
develop them

Poor nutrition

Sleep deprivation

If a member of the household has a stye, the other residents should not share wash cloths or face
towels to minimize cross infection.

Treatment options for a stye

A warm compress can be helpful in some cases of stye.

Most styes go away on their own without the need for any treatment. As soon as they rupture,
symptoms tend to improve rapidly.

Doctors say you should not try to burst a stye yourself.

A warm compress held gently against the eye may help ease symptoms. The water should not be
too hot; special care should be taken when applying it to somebody else, such as a child.

The compress should be held against the eye for 5-10 minutes, three or four times each day.

Not only does the compress ease the discomfort, but it may also encourage the pus to drain away.
Once the pus has drained away, symptoms normally improve rapidly.

Pain relievers such as ibuprofen or acetaminophen (Tylenol, paracetamol) may be helpful if the
stye is particularly sore.

If an external stye is extremely painful, the doctor may remove the eyelash nearest to it, and
drain the pus away by lancing it with a thin needle. This procedure should only be carried out by
a professional. If things do not improve, the patient may be referred to a specialist, for example,
an ophthalmologist.

If the stye persists, the doctor may prescribe a topical antibiotic cream or antibiotic eye drops. If
the infection spreads beyond the eyelid, oral antibiotics might be prescribed.

It is best not to apply eye makeup, lotions, or wear contact lenses until the stye has completely
gone.

Possible complications of a stye

Complications, although extremely rare, may sometimes occur; these can include:

Meibomian cyst - this is a cyst of the small glands (Meibomian glands) located in the eyelid. The
glands discharge a lubricant, called sebum in the edge of the eyelid. A persistent stye on the
inside of the eyelid can eventually develop into a Meibomian cyst (chalazions), especially if the
gland is obstructed. This type of cyst is easily and effectively treatable.

Preseptal cellulitis (periorbital cellulitis ) - this may develop if the infection spreads to tissue
around the eye. The layers of skin around the eye become inflamed and red, making the eyelids
go red and swollen. This is treated with antibiotics.

Although the complications can occur, as mentioned previously, most cases of stye will clear
with minimal intervention.

Pathophysiology

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

in rare cases, recurrent styes may indicate an immunologic defect

An external hordeolum arises from a blockage and infection of Zeiss or Moll

sebaceous glands. An internal hordeolum is a secondary infection of meibomian
glands in the tarsal plate. Both types can arise as a secondary complication of
blepharitis.
Untreated, the disease may spontaneously resolve or it may progress to chronic
granulation with formation of a painless mass known as a chalazion. Chalazia can be
quite large and can cause visual disturbance by deforming the cornea. Generalized
cellulitis of the eyelid may occur if an internal hordeolum is untreated.

Pathophysiology

Types
External Hordeolum (stye)
External zeis (Sweat Gland) infection
Internal Hordeolum
Internal meibomian gland (Sebaceous Gland) infection
Localized superficial abscess
Usually caused by Staphylococcus aureus infection of the eyelash follicle
A hordeolum (stye) is an acute, localized swelling of the eyelid that may be external
or internal and usually is a pyogenic (typically staphylococcal) infection or abscess.
Most hordeola are external and result from obstruction and infection of an eyelash
follicle and adjacent glands of Zeis or Moll glands. Follicle obstruction may be
associated withblepharitis. An internal hordeolum, which is very rare, results from
infection of a meibomian gland. Sometimescellulitis accompanies hordeola.

Staphylococcus aureus (~9095% of all cases) or by Staphylococcus epidermidis

infection of a ciliary follicle within the eyelid margin -> spread of infection to the
glands of Zeis or Moll -> abscess formation -> external hordeolum or stye -> small,
superficial swelling which points to the lid margin
infection may be acute or subacute
Staph. aureus is the usual cause
an internal hordeolum refers to the formation of an abscess involving the
meibomian glands and results in lesions that are larger and point through the skin
or conjunctival surface
in rare cases, recurrent styes may indicate an immunologic defect
-------------------------------------------------------------------------------------------------------

Most morbidity is secondary to improper drainage. Proper technique and drainage

precautions are described in Treatment.

Causes

Staphylococcal organisms are the most common causes of eyelid infections, but
other organisms may be involved.

Hordeola are found more frequently in persons who have the following:

Diabetes
Other debilitating illness
Chronic blepharitis
Seborrhea
High serum lipids (High lipid levels increase the blockage rate of sebaceous
glands, but lowering of serum lipid levels in these patients has not decreased
frequency of recurrence.)

1. Basics

2.

3. In-Depth

4. Multimedia

5. Resources
 1. Definition

2. Symptoms

3. Causes

4. Risk factors

5. Preparing for your appointment

6. Tests and diagnosis

7. Treatments and drugs

8. Lifestyle and home remedies

9. Prevention

Products and services

Free E-newsletter
Subscribe to Housecall

Our general interest e-newsletter keeps you up to date on a wide variety of health topics.

Sign up now

Lifestyle and home remedies

By Mayo Clinic Staff
Until your sty goes away on its own, try to:

Leave the sty alone. Don't try to pop the sty or squeeze the pus from a sty. Doing so can
cause the infection to spread.

Clean your eyelid. Gently wash the affected eyelid with mild soap and water.

Place a warm washcloth over your closed eye. To relieve pain, run warm water over a
clean washcloth. Wring out the washcloth and place it over your closed eye. Re-wet the
washcloth when it loses heat. Continue this for 5 to 10 minutes. Then gently massage the
eyelid. Repeating this two to three times a day may encourage the sty to drain on its own.

Keep your eye clean. Don't wear eye makeup until the sty has healed.

Go without contacts lenses. Contact lenses can be contaminated with bacteria associated
with a sty. If you wear contacts, try to go without them until your sty goes away.

Prevention
By Mayo Clinic Staff

To prevent eye infections:

Wash your hands. Wash your hands with soap and warm water or use an alcohol-based
hand sanitizer several times each day. Keep your hands away from your eyes.

Take care with cosmetics. Reduce your risk of recurrent eye infections by throwing
away old cosmetics. Don't share your cosmetics with others. Don't wear eye makeup
overnight.

Make sure your contact lenses are clean. If you wear contact lenses, wash your hands
thoroughly before handling your contacts and follow your doctor's advice on disinfecting
them.

Apply warm compresses. If you've had a sty before, using a compress regularly may
help prevent it from coming back.

Manage blepharitis. If you have blepharitis, follow your doctor's instructions for caring
for your eyes.
Antibiotics
Class Summary

Topical antibiotics are useful for control of staphylococcal infections in eyelids and
nares.
Bacitracin ophthalmic ointment (AK-Tracin)

View full drug information

Prevents transfer of mucopeptides into growing cell wall; inhibits bacterial cell wall
synthesis.
Tobramycin ophthalmic solution or ointment (Tobrex, AKTob)

View full drug information

Interferes with bacterial protein synthesis by binding to 30S and 50S ribosomal
subunits, which results in a defective bacterial cell membrane; available as solution,
ointment, and lotion
Erythromycin (EES, E-Mycin, Ery-Tab)

View full drug information

First-choice treatment when systemic therapy is indicated; also indicated for

treatment of infections caused by susceptible strains of microorganisms, including S
aureus.

Tetracycline (Sumycin)

View full drug information

Treats susceptible bacterial infections of both gram-positive and gram-negative
organisms as well as infections caused by mycoplasmal, chlamydial, and rickettsial
organisms; inhibits bacterial protein synthesis by binding with 30S and possibly 50S
ribosomal subunit(s) of susceptible bacteria
Cloxacillin (Cloxapen, Tegopen)

For treatment of infections caused by penicillinase-producing staphylococci. May be

used to initiate therapy when a staphylococcal infection is suspected.

Complications

The most frequent complication of hordeolum is progression to a chalazion that

causes cosmetic deformity, corneal irritation, or the need for surgical removal.

Complications of improper drainage are disruption of lash growth, lid deformity, or

lid fistula.

Generalized eyelid cellulitis may develop if an internal hordeolum is untreated.

Follow Up
In most cases, styes don't require medical care. Call your health care provider if:

The stye doesn't heal in a week or 10 days.

The stye becomes more painful or swollen after several days of home
treatment.

The person also has fever or chills.

 The person develops vision problems.

The person has recurring styes.

The entire eyelid or eye itself is red or swollen.

Redness spreads to around the eye or the cheek.

The person has an abnormal immune system (for example, people with
diabetes or HIV, patients receiving treatment for cancer, organ transplant
recipients).

Incision and drainage of external Hordeola may be performed at the slit lamp using
topical anesthesia and an 18-gauge or 20-gauge needle.

Incision and drainage of internal Hordeola requires a local anesthetic delivered by

injection to the involved eyelid. It is customary to employ a stab incision with a #11
blade, ideally using a transconjunctival approach, to avoid potential scarring of the
external lid. A topical antibiotic should be applied to the incision site for 24 hours
following the procedure.
Fast facts on styes
Staphylococcus aureus is the infectious agent in 90-95% of cases of
Hordeolum.

Styes can be painful but often heal without medical intervention.

If a Stye persists for more than a week or affects vision, medical attention
should be sought.

Home remedies for styes include a warm compress and OTC pain medication

Most morbidity is secondary to improper drainage.

In rare cases, recurrent styes may indicate an immunologic defect.

Styes can be external or internal.