hordeolum

A hordeolum, commonly called a stye, is an acute infection of the eyelid margin or its glands, resulting in a painful, red, swollen nodule on the eyelid. The condition is most often caused by Staphylococcus aureus.

There are two forms: external hordeolum, which involves the glands of Zeis or Moll at the lid margin, and internal hordeolum, which involves the Meibomian glands located deeper within the eyelid.

Patients typically present with a tender, localized lump on the lid margin, eyelid swelling, and sometimes purulent discharge, tearing, and mild fever. Visual disturbance is uncommon unless swelling is extensive.

Diagnosis is usually clinical. It is distinguished from chalazion, which is a painless granulomatous swelling, and from preseptal cellulitis when there is spreading redness or fever.

Management centers on warmth and hygiene. Apply warm compresses several times daily and practice lid hygiene. Superficial external hordeola may be treated with topical antibiotic ointment, such as erythromycin or bacitracin. In cases of cellulitis, extensive infection, or persistent abscess, oral antibiotics and possible incision and drainage may be required. Avoid squeezing and discontinue contact lens use until resolution. Analgesia can help with discomfort.

Most hordeola resolve within one to two weeks with appropriate care. Complications are rare but can include preseptal cellulitis or abscess formation. Recurrence is more common in people with blepharitis or poor lid hygiene. Regular lid hygiene and treatment of underlying blepharitis can help prevent recurrence.