Stye

👁️‍🗨️ Stye (Hordeolum)

🔍 Definition

A stye is a localized, painful, red bump on the eyelid caused by acute infection of the eyelid glands, typically Staphylococcus aureus.

💥 Think of it as a pimple on the eyelid — red, tender, and usually filled with pus.

 

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📚 Types of Stye (Hordeolum)

Type	Gland Involved	Location	Appearance & Features
External Hordeolum	Gland of Zeis or Moll (sebaceous/sweat glands)	At eyelid margin, near eyelashes	Red, tender lump at lash line, may point outward
Internal Hordeolum	Meibomian gland (inside tarsal plate)	Inner eyelid (palpebral conjunctiva)	Deeper, painful, swelling toward conjunctiva

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🦠 Causes / Risk Factors

• Staphylococcus aureus (most common cause)

• Poor eyelid hygiene

• Blepharitis

• Meibomian gland dysfunction

• Touching/rubbing eyes with unclean hands

• Stress or fatigue

• Use of expired or shared eye makeup

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👀 Symptoms

• Painful, red swelling on or inside eyelid

• Localized tenderness

• Tearing or mild discharge

• Foreign body sensation

• Eyelid heaviness or discomfort

• Sometimes associated with low-grade fever or preseptal cellulitis (if severe)

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🔬 Signs on Examination

• Localized, red, tender nodule

• Pointing pustule may be visible (esp. in external stye)

• Surrounding eyelid edema

• Tenderness to touch

• In internal stye → swelling may push against the globe

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🧪 Diagnosis

• Clinical — based on history and exam.

• No special testing needed unless recurrent or severe.

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💊 Management

🔹 Conservative (Mainstay Treatment)

Step	Description
Warm compresses	10–15 mins, 3–4x/day to promote drainage
Gentle lid massage	Helps express pus after warm compress
Avoid squeezing	Can worsen infection or cause spread
Maintain lid hygiene	Prevents recurrence

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🔹 Medical Therapy (If Needed)

Medication	When to Use
Topical antibiotic ointment (e.g. erythromycin, bacitracin)	For external stye, especially if draining
Oral antibiotics (e.g. amoxicillin-clavulanate, doxycycline)	If cellulitis or multiple styes present
Pain relievers (e.g. paracetamol, ibuprofen)	For discomfort

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🔹 Surgical Intervention (Rare Cases)

• Incision and drainage (I&D) — if stye persists > 1–2 weeks, is very large, or becomes a chalazion

• Performed under local anesthesia

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🔁 Complications

• Chalazion: Chronic, painless lump if infection resolves but gland remains blocked

• Preseptal cellulitis: If infection spreads to eyelid tissue

• Recurrent styes may suggest underlying blepharitis, MGD, or rosacea

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🧠 Mnemonic: “STYE”

• S: Staph infection

• T: Tender red lump

• Y: You need warm compresses

• E: External or internal gland involved

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🛡️ Prevention Tips

• Wash hands before touching eyes

• Remove makeup before bed

• Don’t share towels or cosmetics

• Keep eyelids clean (especially if prone to blepharitis)

• Replace old or expired eye makeup

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🧾 Quick Summary Table

Feature	External Stye	Internal Stye
Gland involved	Zeis or Moll (lash line)	Meibomian gland (deep lid)
Location	Lid margin	Inner eyelid (conjunctival side)
Appearance	Red bump with a yellow head	Diffuse lid swelling
Treatment	Warm compress, topical ointment	Warm compress, oral antibiotics if severe

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Would you like:

• A visual comparing stye vs chalazion?

• A patient education handout version?

• Or a case-based quiz to test understanding?