Stye

Stye
Classification and external resources
A regular stye on a person's eye
ICD-9	373.11
DiseasesDB	12583
MedlinePlus	001009
eMedicine	emerg/755
MeSH	D006726

An external stye (pronounced /ˈstaɪ/) or hordeolum (/hɔrˈdiːələm/) is an infection of the sebaceous glands of Zeis at the base of the eyelashes, or an infection of the apocrine sweat glands of Moll.^[1] External styes form on the outside of the lids and can be seen as small red bumps. Internal styes are infections of the meibomian sebaceous glands lining the inside of the eyelids. They also cause a red bump underneath the lid with only generalized redness and swelling visible on the outside. Styes are similar to chalazia, but tend to be of smaller size and are more painful and usually produce no lasting damage. Styes are characterized by an acute onset and usually short in duration (7-10 days without treatment) compared to chalazia that are chronic and usually do not resolve without intervention.

Causes

Styes are commonly caused by a Staphylococcus aureus bacterial infection, or by the blocking of an oil gland at the base of the eyelash. Although they are particularly common in infants, styes are experienced by people of all ages. Styes can be triggered by poor nutrition, sleep deprivation, lack of hygiene or rubbing of the eyes. Sharing of washcloths or face towels should be curtailed to avoid spreading the infection between individuals.^[2][3] Styes can last from 1 to 2 weeks without treatment, or as little as 4 days if treated properly.^[4]

Medical professionals will sometimes lance a particularly persistent or irritating stye with a needle in order to accelerate its draining.^[5] A stye's expansion can also be fought with erythromycin ophthalmic ointment.^[6] Medical professionals may also treat stye with other antibiotics such as chloramphenicol or Amoxicillin.^[7] Chloramphenicol is used successfully in many parts of the world but contains a box warning in the United States due to concerns about aplastic anemia, which on rare occasions can be fatal. Erythromycin ointment enjoys widespread usage and may add to comfort and aid in preventing secondary infections. However, it is poorly absorbed when used topically and usually requires oral dosing to reach the infection with therapeutic levels inside of a stye. Azasite, a topical eye drop form of Azithromycin, does appear to penetrate eyelid tissues fairly well and may be a topical treatment for styes used in the future.

If a stye bursts, care must be taken to cleanse the wound to prevent reinfection.

Signs and Symptoms

The first sign of a stye is a small, yellowish spot at the center of the bump that develops as pus expands in the area.^[8]

Other stye symptoms may include:

• A lump on the top or bottom eyelid
• Localized swelling of the eyelid
• Pain which becomes more intense if the pus ruptures ^[9]
• Redness
• Tenderness to touch
• Crusting of the eyelid margins
• Burning in the eye
• Droopiness of the eyelid
• Scratchy sensation on the eyeball
• Blurred vision
• Mucous discharge in the eye
• Irritation of the eye ^[10]
• Light sensitivity
• Tearing
• Discomfort during blinking ^[11]
• Sensation of a foreign body in the eye.

Treatment

As styes usually go away within a week, most patients do not require medical treatment. The first steps in treating styes include applying warm compresses on the affected eye, four to six times a day, for approximately 15 minutes. This helps the drainage and hastens the curing process.

Stye on lower part of a person's eye

As a part of self-care at home, patients 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.^[12]

Patients are highly advised to not squeeze or puncture the stye as serious infection can occur as a result. The infection could spread to the surrounding tissues and areas.

Eye stye sufferers should avoid eye makeup (e.g., eyeliner), lotions and wearing contact lenses since these can aggravate and spread the infection (sometimes to the cornea).

Medical treatment can also be provided by a doctor and it is aimed on relieving the symptoms. Pain relievers such as acetaminophen may be prescribed and in some cases, antibiotics may be needed. Antibiotics are normally given to patients with multiple styes or with styes that do not seem to cure and to patients who also suffer from blepharitis or rosacea. Commonly, the ophthalmologist prescribes oral or IV antibiotics only when the infection has spread. Antibiotics that are usually given include Vibramycin, Oracea, Atridox and Adoxa. Topical antibiotic ointments or antibiotic/steroid ointment combination can also be administered in stye treatment.

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 in his office, and generally under local anesthesia. The procedure consists in 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 and unnoticeable sutures are used to close the lesion. It is common that the removed stye is biopsied to rule out the possibility of skin cancer.

Complications

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 require surgical removal.^[13] Complications may also arise from the improper surgical lancing and mainly consist of disruption of lash growth, lid deformity or lid fistula. Styes that are too large 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.^[14]

Prognosis

Although styes are harmless in most cases and complications are very rare, styes often recur. They do not cause intraocular damage, meaning that they do not affect the eye. Styes normally heal on their own by rupturing within few days to a week, causing the relief of symptoms. Few people require surgery as part of stye treatment.With adequate treatment, styes tend to heal quickly and without arising any type of complications.

The prognosis is better if one does not attempt to squeeze or puncture the stye as infection may spread to adjacent tissues. Styes usually heal within few days to a week, but if it does not improve or it worsens within two weeks, a doctor's opinion should be sought. Also, patients are recommended to call a doctor if they encounter problems with vision, the eyelid bumps becomes very painful, the stye bleeds, recurrent styes or the eyelid or eye becomes red.^[15]

Prevention

Stye prevention is closely related to proper hygiene. Proper hand washing can not only reduce the risks of developing styes, but all 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. Some studies suggest oral flaxseed supplementation to prevent the occurrence of styes.^[16]

In order to prevent developing styes it is recommended to never share cosmetics or cosmetic eye tools with other people. People should also keep their eye tools clean and generally having proper eye hygiene. Women are recommended to remove makeup every night before going to sleep and discard old or contaminated eye makeup.

See also

• Blepharitis
• Chalazion

References

External links

• 409665546 at GPnotebook
• 20-228f. at Merck Manual of Diagnosis and Therapy Home Edition