Conditions of the eye

Subtopic:

Stye (Hordeolum)

Stye

A stye represents a localized infection impacting the hair follicles or sebaceous glands located within the eyelids. This signifies that the infection is confined to a particular region of the eyelid.

OR

A stye is characterized as a small, pus-containing bump (abscess), frequently resulting from infection by staphylococcal bacteria. These bumps can arise along either the outer or inner border of the eyelid.

Cause

The primary culprit behind stye development is typically the bacterium Staphylococcus aureus. This bacterium is a common agent in various skin infections.

Types of stye

Generally, styes are categorized into three main types based on their location and underlying cause:

  • External stye: This type manifests as swelling along the external edge of the eyelid. It commonly progresses into a painful, yellowish lesion filled with pus and exhibits tenderness to touch.

  • Internal stye: This form of swelling occurs on the inner lining of the eyelid. It is generally perceived as less painful compared to an external stye due to its location within the eyelid tissues.

  • Chalazion: This presents as a swollen nodule on the eyelid. It develops when an oil-producing gland within the eyelid becomes obstructed. A chalazion can sometimes originate from an internal stye (hordeolum).

External styes

A stye on the outer surface of the eyelid

A stye appearing on the outer eyelid’s surface can arise from an infection within one of these structures:

  • Eyelash follicle: These are essentially tiny sacs within the skin from which individual eyelashes grow. When an eyelash follicle becomes infected, it can trigger a stye to form at the base of the eyelash itself.

  • Sebaceous gland: Connected to each eyelash follicle is a sebaceous gland. These glands produce sebum, an oily substance that plays a vital role in keeping the eyelash lubricated and preventing it from becoming overly dry or fragile. Infection of this sebaceous gland can result in the development of a stye.

  • Apocrine (Moll) gland: This is a specialized type of sweat gland that releases its secretions into the eyelash follicle. The apocrine gland contributes to the tear film, aiding in preventing the eye from becoming dry and maintaining moisture. Infection within an apocrine gland can also be a cause of an external stye.

Internal styes

Internal styes develop when the meibomian glands become infected. These specialized glands are located within the eyelids and are crucial for producing an oily secretion. This oily substance is a vital component of the tear film, which coats and protects the surface of your eye.

When these meibomian glands become blocked, it can lead to the formation of a cyst. This cyst can subsequently become infected, resulting in an internal stye.

Chalazion

A chalazion can develop and you might not see any symptoms. When there are symptoms, they can include:
a bump on the eyelid, sometimes becoming red and swollen. Occasionally it can be tender.
rarely, an entirely swollen eyelid
blurry vision, if the chalazion is large enough to press on the eyeball

Clinical Features

The telltale signs and symptoms of a stye commonly include:

  • Reddened skin in the affected area: The skin surrounding the stye will exhibit inflammation and appear flushed.

  • Pain sensation: The stye location is typically painful, particularly upon physical contact.

  • Sensitivity to touch: The eyelid affected will be tender when pressure is applied.

  • Itchy feeling: An itching sensation might be felt, mainly during the initial stages of development.

  • Light sensitivity (Photophobia): An elevated sensitivity to bright light may manifest in the affected eye.

  • Pus accumulation: A key characteristic of a stye is the formation of pus within the infected zone.

  • Yellowish swelling appearance: Roughly three days prior to the stye opening naturally, a yellowish swelling could become visible.

  • Spontaneous rupture possible: Styes frequently burst open on their own, discharging the pus.

  • Early stage itching: The sensation of itchiness can be an initial symptom experienced.

  • Presence of a lump on either the upper or lower eyelid.

  • Swelling, discomfort, and tenderness of the eyelid.

  • Pus development is a primary indicator of a stye.

  • Increased tear production (Watering eye): More tears may be produced by the affected eye.

  • Eye sensitivity to light: The eye may exhibit increased sensitivity to light.

  • Localized eyelid swelling, though in some instances, the entire eyelid can become swollen.

  • Appearance of a tiny yellowish spot at the center of the swollen area, indicating pus accumulation.

  • Discomfort during blinking due to the swelling and pain.

  • Feeling of a foreign object lodged in the eye.

  • Mucous discharge from the eye.

  • Temporary blurred vision may occur in certain cases.

  • Crusting along the eyelid edges.

  • Burning sensation in the affected eye.

Management of a Stye

In numerous cases, a stye will resolve without needing specific medical treatment.

  • Styes generally heal independently: Most styes will disappear on their own over a period of time.

  • Avoid eye rubbing: Refrain from touching or rubbing the eye as this could facilitate the spread of infection to other areas.

  • Apply warm compresses: Use a warm, moist compress to the affected eye for approximately 10 minutes several times a day. This aids in promoting drainage and easing discomfort.

  • Topical antibiotic ointment: Apply a 1% tetracycline eye ointment 2-4 times daily. Continue this treatment for two days after symptoms have completely subsided to ensure the infection is fully cleared.

  • Gentle eyelash removal: If an eyelash close to the stye is loose, it can be carefully removed to prevent further irritation or blockage.

  • Internal Hordeolum: When a stye develops within one of the deeper glands of the eyelid, it is termed an internal hordeolum.

  • More pronounced symptoms: Pain and other symptoms are typically more intense with internal hordeola compared to external styes.

  • Medical drainage may be required: Because internal hordeola rarely rupture spontaneously, medical intervention to open and drain the pus may be necessary.

Note

  • Recurrence of Internal styes: Individuals who have experienced an internal stye have a tendency to develop them again in the future.

Surgery

  • Incision and Drainage: If improvement is not observed within 48 hours after starting warm compresses, surgical incision and drainage might be considered.

  • Surgical Procedure: This involves making a small incision, either on the inner or outer eyelid surface, to allow for pus drainage from the gland. Very fine sutures might be used to close the small incision site.

Prevention

Adopting effective hygiene practices can significantly lower the likelihood of stye development.

  • Maintain good personal hygiene: Focus on overall cleanliness to minimize bacteria exposure.

  • Frequent hand washing: Wash your hands thoroughly and often, especially before touching your face or eyes.

  • Regular facial cleansing: Wash your face regularly to remove dirt, oil, and bacteria buildup.

  • Remove loose eyelashes: Gently eliminate any loose eyelashes to prevent gland blockage.

  • Avoid sharing cosmetics: It is advisable to never share makeup or eye makeup applicators with others to prevent bacterial transfer.

  • Makeup removal and replacement: Always remove makeup each night before sleeping and replace old or potentially contaminated eye makeup regularly to minimize bacterial contamination.