Stye (hordeolum): Difference between revisions

Revision as of 01:47, 25 October 2011

Background

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

Clinical Features

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

Treatment

Warm compresses x15min QID
Abx
1. Consider oral abx (w/ staph coverage) if pt has concurrent preorbital cellulitis (rare)
2. Little evidence that topical abx are helpful

Disposition

Refer to ophtho if does not improve within 1-2wk or hardens into a chalazion

Source

Tintinalli

Authors:

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 ==Background==
-*Staphylococcus aureus (90-95%)
+*External - arises from blockage and infection of (sebaceous) Zeis or Moll (sweat glands)
-*external hordeolum arises from a blockage and infection of Zeiss or Moll sebaceous glands
+*Internal - arises from blockage and infection of meibomian glands
-*internal hordeolum is a secondary infection of meibomian glands in the tarsal plate
-==Risk Factors==
+==Clinical Features==
-Hordeola are found more frequently in persons who have the following:
+#Pustule accompanied by pain, edema, and erythema of the eyelid
-# 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.)
 ==Treatment==
-#External
+#Warm compresses x15min QID
-##Hot packs
+#Abx
-#Internal
+##Consider oral abx (w/ staph coverage) if pt has concurrent preorbital cellulitis (rare)
-##MSSA: Oral dicloxacillin + hot packs
+##Little evidence that topical abx are helpful
-##MRSA: TMP/SMX-DS 2tabs PO BID
-##MRSA-HA: Linezolid 600mg BID
-==Complications==
+==Disposition==
-*Untreated, the disease may spontaneously resolve or  may progress to chronic granulation with formation of a painless mass (chalazion)
+*Refer to ophtho if does not improve within 1-2wk or hardens into a chalazion
-*Generalized cellulitis of the eyelid
+==See Also==
+[[Chalazion]]
 ==Source==
-Adapted from Pani
+*Tintinalli
 [[Category:Ophtho]]
 [[Category:ID]]