Stye (hordeolum): Difference between revisions

Latest revision as of 17:39, 24 September 2025

Background

Anterior view of the right eye, with lacramal duct shown medial.

The tarsi and their ligaments. Right eye; anterior view.

External - arises from blockage and infection of Zeis (sebaceous) or Moll (sweat) glands
Internal - arises from blockage and infection of meibomian glands

Clinical Features

External stye

Internal stye

Pustule of eyelid
Usually accompanied by pain, edema, and erythema

Differential Diagnosis

Periorbital swelling

Proptosis

Normal IOP
- Orbital cellulitis
- Orbital pseudotumor
- Orbital tumor
Increased IOP
- Retrobulbar abscess
- Retrobulbar emphysema
- Retrobulbar hemorrhage
- Ocular compartment syndrome
- Orbital tumor

No proptosis

Periorbital cellulitis/erysipelas
Dacryocystitis (lacrimal duct)
Dacryocele/Dacryocystocele
Dacryostenosis
Dacryoadenitis (lacrimal gland)
Allergic reaction
Nephrotic Syndrome (pediatrics)

Lid Complications

Blepharitis (crusts)
Chalazion (meibomian gland)
Stye (hordeolum) (eyelash folicle)

Other

Evaluation

Clinical diagnosis, based on history and physical exam

Management

Discontinue eye makeup and contacts use until resolved
Warm compresses
Antibiotics
- Consider oral antibiotics (with staph coverage) if patient has concurrent periorbital cellulitis (rare)
- Little evidence that topical antibiotics are helpful

Disposition

Discharge
Refer to ophtho if no improvement within 1-2 weeks

External Links

LITFL: An Eyelid Lump

References

Authors:

@@ Line 1: / Line 1: @@
 ==Background==
-*Staphylococcus aureus (90-95%)
+[[File:Gray896.png|thumb|Anterior view of the right eye, with lacramal duct shown medial.]]
-*external hordeolum arises from a blockage and infection of Zeiss or Moll sebaceous glands
+[[File:Gray894.png|thumb|The tarsi and their ligaments. Right eye; anterior view.]]
-*internal hordeolum is a secondary infection of meibomian glands in the tarsal plate
+[[File:eyelid glands.png|thumb]]
+*External - arises from blockage and infection of Zeis (sebaceous) or Moll (sweat) glands
+*Internal - arises from blockage and infection of meibomian glands
-==Risk Factors==
+==Clinical Features==
-Hordeola are found more frequently in persons who have the following:
+[[File:Stye02.jpg|thumb|External stye]]
-# Diabetes
+[[File:2048px-Hordeolum.JPG|thumb|Internal stye]]
-# Other debilitating illness
+*Pustule of eyelid
-# Chronic blepharitis
+*Usually accompanied by pain, edema, and erythema
-# 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.)
-==Treatment==
+==Differential Diagnosis==
-#External
+{{Periorbital swelling DDX}}
-##Hot packs
-#Internal
-##MSSA: Oral dicloxacillin + hot packs
-##MRSA: TMP/SMX-DS 2tabs PO BID
-##MRSA-HA: Linezolid 600mg BID
-==Complications==
+==Evaluation==
-*Untreated, the disease may spontaneously resolve or  may progress to chronic granulation with formation of a painless mass (chalazion)
+*Clinical diagnosis, based on history and physical exam
-*Generalized cellulitis of the eyelid
-==Source==
+==Management==
-Adapted from Pani
+*Discontinue eye makeup and contacts use until resolved
+*Warm compresses
+*[[Antibiotics]]
+**Consider oral antibiotics (with [[staph]] coverage) if patient has concurrent [[periorbital cellulitis]] (rare)
+**Little evidence that topical antibiotics are helpful
-[[Category:Ophtho]]
+==Disposition==
+*Discharge
+*Refer to ophtho if no improvement within 1-2 weeks
+==See Also==
+*[[Chalazion]]
+*[[Periorbital swelling]]
+==External Links==
+*[https://litfl.com/an-eyelid-lump/ LITFL: An Eyelid Lump]
+==References==
+<References/>
+[[Category:Ophthalmology]]
+[[Category:ID]]