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{{SK}} Hordeolum
{{SK}} Hordeolum
==Overview==
==Overview==
A stye (also known as a hordeolum) is an infection of the [[sebaceous gland]]s at the base of the [[eyelash]]es on, inside, or under the eyelid.<ref>[http://www.goodhope.org.uk/Departments/eyedept/lidlumps.htm Eyelid lumps] Retrieved March 19 2007</ref> While they produce no long-term damage, styes can be painful.
A stye (also known as a hordeolum) is a painful infection of the [[sebaceous gland]]s at the base of the [[eyelash]]es on, inside, or under the eyelid.<ref>[http://www.goodhope.org.uk/Departments/eyedept/lidlumps.htm Eyelid lumps] Retrieved March 19 2007</ref>. The infection may be internal or external. In many cases, a hordeolum may resolve without treatment; however, the inflammation may spread to other ocular glands or recur. <ref name="pmid23633345">{{cite journal| author=Lindsley K, Nichols JJ, Dickersin K| title=Interventions for acute internal hordeolum. | journal=Cochrane Database Syst Rev | year= 2013 | volume= 4 | issue=  | pages= CD007742 | pmid=23633345 | doi=10.1002/14651858.CD007742.pub3 | pmc=PMC4261920 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23633345  }} </ref>


==Causes==
==Causes==
Styes are generally caused by a [[Staphylococcus aureus]] [[bacteria]] [[infection]] and are particularly common in infants, though people of any age may experience them. They can be triggered by stress, poor nutrition or lack of sleep.<ref name="urlVisionWeb">{{cite web |url=http://www.visionweb.com/content/consumers/dev_consumerarticles.jsp?RID=34 |title=VisionWeb |format= |work= |accessdate=}}</ref>
A stye is usually caused by ''[[Staphylococcus aureus]]''.<ref name="pmid23601478">{{cite journal| author=Deibel JP, Cowling K| title=Ocular inflammation and infection. | journal=Emerg Med Clin North Am | year= 2013 | volume= 31 | issue= 2 | pages= 387-97 | pmid=23601478 | doi=10.1016/j.emc.2013.01.006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23601478  }} </ref> They can be triggered by stress, poor nutrition or lack of sleep.<ref name="urlVisionWeb">{{cite web |url=http://www.visionweb.com/content/consumers/dev_consumerarticles.jsp?RID=34 |title=VisionWeb |format= |work= |accessdate=}}</ref> A stye may be secondary to [[blepharitis]].


A stye can be secondary, caused by [[blepharitis]]. A blocked oil gland near the eye, a [[chalazion]], is often mistaken for a stye.<ref>[http://www.allaboutvision.com/conditions/styes.htm Styes], AllAboutVision.com. Retrieved August 20, 2006.</ref>
==Differential Diagnosis==
A stye must be differentiated from:<ref>{{Cite web | title = Stye | url =http://eyewiki.aao.org/Stye }}</ref>
*[[Xanthelasma]]
*[[Papilloma]]
*[[Cyst]]
*[[Pyogenic Granuloma]]
*[[Amyloid]] Deposition
 
==Risk Factors==
Common risk factors in the development of hordeola are:<ref>{{Cite web | title = Stye | url =http://eyewiki.aao.org/Stye }}</ref>
*Dry eyes
*Chronic [[blepharitis]]
 
==Epidemiology & Demographics==
Styes are particularly common in infants, though they may occur at any age.<ref name="pmid23601478">{{cite journal| author=Deibel JP, Cowling K| title=Ocular inflammation and infection. | journal=Emerg Med Clin North Am | year= 2013 | volume= 31 | issue= 2 | pages= 387-97 | pmid=23601478 | doi=10.1016/j.emc.2013.01.006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23601478  }} </ref>


==Diagnosis==
==Diagnosis==
===History and Symptoms===
===History and Symptoms===
The first signs are tenderness, pain, and redness in the affected area. Later symptoms that arise include swelling, watering of the eye, sensitivity to light, and discomfort during blinking. A yellowish bump develops in the affected area.
The first signs are tenderness and redness in the affected area. Symptoms of a stye include:
*[[Swelling]]
*Watering of the eye  
*Sensitivity to light  
*Discomfort during blinking  
===Physical examination===
====Eyes====
*A localized and tender area with a pointing eruption may be seen in the affected area.<ref>{{Cite web | title = Stye | url =http://eyewiki.aao.org/Stye }}</ref>
*A yellowish bump may be noted.
====Lymph Nodes====
*Adjacent [[lymph nodes]] may be palpable.<ref>{{Cite web | title = Stye | url =http://eyewiki.aao.org/Stye }}</ref>
====Gallery====
======Head======
<gallery>
Image: Hordeoli_01.png| Hordeolum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=192}}</ref>
Image: Hordeoli_02.png| Hordeolum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=192}}</ref>
</gallery>


==Treatment==
==Treatment==
===Medical Therapy===
Most cases of hordeolum resolve without treatment. Supportive therapy for hordeolum consists of warm compresses.  Antimicrobial ophthalmic ointments may be administered<ref name="pmid23601478">{{cite journal| author=Deibel JP, Cowling K| title=Ocular inflammation and infection. | journal=Emerg Med Clin North Am | year= 2013 | volume= 31 | issue= 2 | pages= 387-97 | pmid=23601478 | doi=10.1016/j.emc.2013.01.006 | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23601478  }} </ref>.


===Medical Therapy===
* '''Hordeolum'''<ref>{{ Cite web | title =  Managing Eye Infections in Older Adults. | url = http://journals.lww.com/infectdis/Citation/1998/12000/Managing_Eye_Infections_in_Older_Adults_.5.aspx }}</ref>
* '''Hordeolum'''<ref>{{ Cite web | title =  Managing Eye Infections in Older Adults. | url = http://journals.lww.com/infectdis/Citation/1998/12000/Managing_Eye_Infections_in_Older_Adults_.5.aspx }}</ref>
:* 1. '''External hordeolum, for a  single lesion'''
:* 1. '''External hordeolum, for a  single lesion'''
::* Supportive therapy: application of warm compresses 4-6 times/day.
::* Preferred regimen: Supportive therapy is sufficient. Application of warm compresses 4-6 times/day.
::* Note: Antibiotic therapy is questionable value for a single lesion and often not indicated.
::* Note: Antibiotic therapy is questionable value for a single lesion and often not indicated.
:* 2. '''External hordeolum, for multiple/recurrent lesions'''
:* 2. '''External hordeolum, for multiple/recurrent lesions'''
::* Preferred regimen (1): antistaphylococcal antibiotic therapy [[Bacitracin]] topical qd-tid
::* Preferred regimen (1): [[Bacitracin]] ophthalmic q8-24h
::* Preferred regimen (2): [[Erythromycin]] topical ointment up to 6 times/day, along with lid hygiene.
::* Preferred regimen (2): [[Erythromycin]] topical q4-6h
:* 3. '''Internal hordeolum'''
:* 3. '''Internal hordeolum'''
::* Supportive therapy: warm compressess in conjugation with systemic antistaphylococcal antibiotics
::* Preferred regimen: Warm compresses 4-6 times/day in conjugation with systemic antistaphylococcal antibiotics
::* Note (1): If the lesion do not respond to this regimen, incision and drainage are indicated.
::* Note: If the lesion do not respond to this regimen, incision and drainage are indicated.
::* Note (2): Chalazion effectively treated with lid hygiene and warm compression in most circumstances.
 
==Physical examination==
 
===Gallery===
 
====Head====
 
<gallery>
 
Image: Hordeoli_01.png| Hordeolum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=192>
 
Image: Hordeoli_02.png| Hordeolum. <SMALL><SMALL>''[http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=12  With permission from Dermatology Atlas.]''<ref name="www.atlasdermatologico.com.br">{{Cite web | title = Dermatology Atlas | url = http://www.atlasdermatologico.com.br/disease.jsf?diseaseId=192>
 
</gallery>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 19:43, 28 September 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Jesus Rosario Hernandez, M.D. [2]; Faizan Sheraz, M.D. [3]

Synonyms and keywords: Hordeolum

Overview

A stye (also known as a hordeolum) is a painful infection of the sebaceous glands at the base of the eyelashes on, inside, or under the eyelid.[1]. The infection may be internal or external. In many cases, a hordeolum may resolve without treatment; however, the inflammation may spread to other ocular glands or recur. [2]

Causes

A stye is usually caused by Staphylococcus aureus.[3] They can be triggered by stress, poor nutrition or lack of sleep.[4] A stye may be secondary to blepharitis.

Differential Diagnosis

A stye must be differentiated from:[5]

Risk Factors

Common risk factors in the development of hordeola are:[6]

Epidemiology & Demographics

Styes are particularly common in infants, though they may occur at any age.[3]

Diagnosis

History and Symptoms

The first signs are tenderness and redness in the affected area. Symptoms of a stye include:

  • Swelling
  • Watering of the eye
  • Sensitivity to light
  • Discomfort during blinking

Physical examination

Eyes

  • A localized and tender area with a pointing eruption may be seen in the affected area.[7]
  • A yellowish bump may be noted.

Lymph Nodes

Gallery

Head

Treatment

Medical Therapy

Most cases of hordeolum resolve without treatment. Supportive therapy for hordeolum consists of warm compresses. Antimicrobial ophthalmic ointments may be administered[3].

  • 1. External hordeolum, for a single lesion
  • Preferred regimen: Supportive therapy is sufficient. Application of warm compresses 4-6 times/day.
  • Note: Antibiotic therapy is questionable value for a single lesion and often not indicated.
  • 2. External hordeolum, for multiple/recurrent lesions
  • 3. Internal hordeolum
  • Preferred regimen: Warm compresses 4-6 times/day in conjugation with systemic antistaphylococcal antibiotics
  • Note: If the lesion do not respond to this regimen, incision and drainage are indicated.

References

  1. ↑ Eyelid lumps Retrieved March 19 2007
  2. ↑ Lindsley K, Nichols JJ, Dickersin K (2013). "Interventions for acute internal hordeolum". Cochrane Database Syst Rev. 4: CD007742. doi:10.1002/14651858.CD007742.pub3. PMC 4261920. PMID 23633345.
  3. ↑ 3.0 3.1 3.2 Deibel JP, Cowling K (2013). "Ocular inflammation and infection". Emerg Med Clin North Am. 31 (2): 387–97. doi:10.1016/j.emc.2013.01.006. PMID 23601478.
  4. ↑ "VisionWeb".
  5. ↑ "Stye".
  6. ↑ "Stye".
  7. ↑ "Stye".
  8. ↑ "Stye".
  9. ↑ 9.0 9.1 "Dermatology Atlas".
  10. ↑ "Managing Eye Infections in Older Adults".
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