Stye

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Stye
Classification and external resources

ICD-10 ICD-9 DiseasesDB MedlinePlus eMedicine MeSH

A stye on an eyelid H00.0 373.11 12583 001009 emerg/755 D006726

An external stye or sty (/sta/), also hordeolum (/hrdilm/), 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 (710 days without treatment) compared to chalazia that are chronic and usually do not resolve without intervention.

Contents

1 Cause 2 Signs and symptoms 3 Treatment 4 Complications 5 Prognosis 6 Prevention 7 See also

8 References 9 External links

[edit] Cause
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 one to two weeks without treatment, or as little as four days if treated properly.[4] Medical professionals will sometimes lance a particularly persistent or irritating stye with a needle to accelerate its draining.[5] A stye's expansion can also be fought with erythromycin ophthalmic ointment.[6] Medical professionals may also treat styes with other antibiotics, such as chloramphenicol or amoxicillin.[7] Chloramphenicol is used successfully in many parts of the world, but contains a black box warning in the United States due to concerns about aplastic anemia, which on rare occasions can be fatal. Erythromycin ointment enjoys widespread use, 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 in the future may be used as a topical treatment for styes. If a stye bursts, care must be taken to cleanse the wound to prevent reinfection.

[edit] 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 Localized pain 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[9] Light sensitivity Tearing Discomfort during blinking[10] Sensation of a foreign body in the eye

[edit] Treatment
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Stye on lower part of a person's eye The primary mode of treatment for a stye is application of warm compresses. Incision and drainage is performed if resolution does not begin in the next 48 hours after warm compresses are started. 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. Another method is to heat a hard boiled egg, poke hole in the bottom, and use the tip of the egg for a more direct heating source for the stye. Cleansing must be done gently and while the eyes are closed to prevent eye injuries.[11] Patients are highly advised to not lance 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 heal (Helen Wu), and to patients who also suffer from blepharitis or rosacea. Commonly, the ophthalmologist prescribes oral or intravenous antibiotics, such as doxycycline, only when the infection has spread. Topical antibiotic ointments or antibiotic/steroid combination ointments 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, and generally under local anesthesia. The procedure consists of 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 for the removed stye to be sent for histopathological examination to rule out the possibility of skin cancer.

[edit] 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 requires surgical removal.[12] 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.[13]

[edit] Prognosis
Although styes are harmless in most cases and complications are very rare, styes often recur. They do not cause intraocular damage, meaning 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. A stye usually will heal within a 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 or reoccurs or the eyelid or eye becomes red.[14]

[edit] Prevention
Stye prevention is closely related to proper hygiene. Proper hand washing can not only reduce the risks of developing styes, but also 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.[15]

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 practice proper eye hygiene. It is recommended to remove makeup every night before going to sleep and discard old or contaminated eye makeup.

[edit] See also