hordeolum

What is a Hordeolum?

A hordeolum, commonly referred to as a stye, is an infection of an oil gland at the edge of the eyelid. This condition results in pain, swelling, and redness in the affected area.

Characteristics of a Hordeolum

• A hordeolum appears as a tender red bump on the edge of the eyelid.
• It's an infection of a gland of the eyelid.
• The infection is most often caused by bacteria [1].
• A hordeolum can be internal or external, affecting different glands in the eyelid [5].

Symptoms

• Pain and swelling in the affected area
• Redness and inflammation around the eye
• A small, tender bump on the edge of the eyelid

Causes

• Bacterial infection of the sebaceous or apocrine eyelid glands [5]
• Blockage of the gland's opening can cause a chalazia, which is similar to a pimple deep in the eyelid [8]

References:

[1] A stye (hordeolum) is a tender red bump on the edge of the eyelid. · It's an infection of a gland of the eyelid. · The infection is most often caused by bacteria ... [2] A hordeolum, commonly called a “stye”, is an infection of an oil gland at the edge of the eyelid and results in pain, swelling and redness. [5] A hordeolum is an acute bacterial infection of the sebaceous or apocrine eyelid glands. An internal hordeolum affects the Meibomian glands while an external ... [8] Chalazia are enlargements of an oil gland (similar to a pimple) deep in the eyelid caused by an obstruction of the gland's opening.

Signs and Symptoms of Hordeolum (Stye)

A hordeolum, also known as a stye, is a common eye problem that can cause discomfort and pain. The signs and symptoms of a hordeolum include:

• A red lump on the eyelid, similar to a boil or pimple [1]
• Eyelid pain and tenderness
• A gritty or scratchy sensation in the eye, as if there is a foreign body present [3]
• Swelling and redness of the eyelid
• Pain or tenderness when touching the affected area
• Excessive tearing
• Crusting or scabbing on the eyelid

In some cases, a hordeolum can also cause a bump inside the eyelid (internal stye) or at the base of an eyelash (external stye). It's essential to note that while a hordeolum is usually not a sign of anything serious, it may be painful and uncomfortable.

References:

[1] A red lump on your eyelid that is similar to a boil or a pimple. Eyelid pain. [3] A gritty, scratchy sensation, as if there is a foreign body in your eye. [5] Swelling, redness, pain or tenderness of the eyelid. Feeling like there is something in your eye. Excessive tearing. Crusting of the eyelid. [7] A stye can cause a small, red, painful lump at the base of your eyelash (external stye) or a bump inside the lid (internal stye).

Diagnostic Tests for Hordeolum

A hordeolum, also known as a stye, can be diagnosed through a combination of clinical examination and patient history.

• Clinical Examination: A thorough eye exam is usually sufficient to diagnose a hordeolum. Your eye doctor will examine the affected area under your eyelid to confirm the presence of a hordeolum.
• Patient History: Taking a detailed medical history from the patient can also help in diagnosing a hordeolum. This includes asking about any symptoms, such as pain or redness, and any previous treatments.

Additional Tests (Rarely Needed)

While not usually necessary for uncomplicated cases of hordeolum, additional tests may be required if there are signs of complications or generalized eyelid cellulitis. These include:

• Blood tests to rule out other conditions
• Imaging studies, such as ultrasound or MRI, to evaluate the extent of the infection

Key Points

• A stye (hordeolum) can usually be diagnosed through a clinical examination and patient history.
• Additional tests are rarely needed but may be required if there are signs of complications.
• Blood tests and imaging studies are not typically necessary for uncomplicated cases.

References:

[9] A stye, also known as a hordeolum, is caused by an acute infectious process involving localized abscess formation at the upper or lower eyelid. [1] Feb 12, 2021 — The diagnosis is based on history and clinical examination, and cultures are not indicated in uncomplicated cases.

Treatment Options for Hordeolum

Hordeolum, also known as a stye, can be treated with various medications to help alleviate symptoms and promote healing.

• Warm Compresses: Applying warm compresses to the affected area can help bring the infection to a head and encourage drainage. This is often the first line of treatment.
• Topical Antibiotics: Erythromycin ophthalmic ointment applied twice a day is usually sufficient treatment for external hordeola. For internal hordeola, topical antibiotics may be ineffective, and oral antibiotics are typically prescribed instead.
• Oral Antibiotics: Amoxicillin or doxycycline may be added if there is a history of multiple or recurrent lesions, or if there is significant and chronic meibomitis. Systemic antibiotics may also be indicated if the hordeolum is complicated by preseptal cellulitis.

Prescription Medications

• Erythromycin: The most commonly prescribed topical antibiotic for stye is erythromycin.
• Amoxicillin: Oral antibiotics like amoxicillin are more effective in treating internal hordeola and may be prescribed if the infection has spread to the eyelid or eye.

Over-the-Counter (OTC) Remedies

• NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can reduce inflammation and help with burning and swelling.
• Saline Solution: Saline solution or lubricating eye drops may be recommended to help ease discomfort.

It's essential to note that treatment for hordeolum should be tailored to the severity and cause of the infection. In some cases, surgery may be necessary if the style becomes severe and needs to be drained.

Differential Diagnoses of Hordeolum

Hordeolum, also known as a stye, can be challenging to diagnose due to its similarity in appearance with other eyelid conditions. Here are some differential diagnoses that should be considered:

• Chalazion: A chalazion is a small bump on the eyelid caused by a blocked oil gland or meibomian gland. It can be difficult to distinguish from a hordeolum, especially in the early stages.
• Pneumo-orbita (rare): This is a rare condition where air enters the orbit and causes swelling and pain.
• Preseptal Cellulitis: A bacterial infection of the eyelid skin that can cause redness, swelling, and pain.
• Sebaceous Gland Carcinoma: A type of cancer that affects the oil glands in the eyelids.
• Squamous Cell Carcinoma (rare): A rare form of skin cancer that can occur on the eyelids.

Key Points to Consider

• The diagnosis of a hordeolum and chalazion requires only a history and physical exam, with no diagnostic tests required or useful in their diagnosis [3].
• During the first 2 days, they may be clinically indistinguishable, making differential diagnoses crucial [4].

References:

[1] - A hordeolum, or stye, is a well-defined, often painful mass at the eyelid margin, commonly caused by bacterial infection of the follicle of the eyelash [2]. [3] - The diagnosis of a stye (hordeolum) and chalazion requires only a history and physical exam. No diagnostic tests are required or useful in their diagnosis. [4] - Diagnosis of chalazion and both kinds of hordeola is clinical; however, during the first 2 days, they may be clinically indistinguishable.

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