|An external stye on the upper eyelid|
|Symptoms||Red tender bump at the edge of the eyelid|
|Usual onset||Any age|
|Duration||Few days or weeks|
|Causes||Usually bacterial infection by Staphylococcus aureus|
|Treatment||Warm compresses, antibiotic eye ointment|
A stye, also known as a hordeolum, is a bacterial infection of an oil gland in the eyelid. This results in a red tender bump at the edge of the eyelid. The outside or the inside of the eyelid can be affected.
The cause of a stye is usually a bacterial infection by Staphylococcus aureus. The internal ones are due to infection of the meibomian gland while the external ones are due to an infection of the gland of Zeis. A chalazion on the other hand is a blocked oil gland without infection. They are typically in the middle of the eyelid and non painful.
Often a stye will go away without any specific treatment in a few days or weeks. Recommendations to speed improvement include warm compresses. Occasionally antibiotic eye ointment may be recommended. While these measures are often recommended, evidence to support them is poor. The frequency at which styes occur is unclear. They may happen at any age.
Signs and symptoms
Other stye symptoms may include:
- A lump on the top or bottom eyelid
- Localized swelling of the eyelid
- Localized pain
- Crusting of the eyelid margins
- Burning in the eye
- Droopiness of the eyelid
- Scratchy sensation on the eyeball (itching)
- Blurred vision
- Mucous discharge in the eye
- Irritation of the eye
- Light sensitivity
- Discomfort during blinking
- Sensation of a foreign body in the eye
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. Complications may also arise from the improper surgical lancing, and mainly consist of disruption of lash growth, lid deformity or lid fistula. Large styes 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.
Styes are most commonly caused by the blocking of an oil gland at the base of the eyelash. Styes are experienced by people of all ages. Styes can be triggered by poor nutrition, sleep deprivation, lack of hygiene, lack of water, and rubbing of the eyes. Styes often result from a Staphylococcal infection in the eye, and can be secondary to blepharitis or a deficiency in immunoglobulin. Sharing of washcloths or face towels should be curtailed to avoid spreading the infection between individuals.
Stye prevention is closely related to proper hygiene. Proper hand washing can reduce the risks of developing not only styes, but also many 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.
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 also recommended to remove makeup every night before going to sleep and discard old or contaminated eye makeup.
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Most cases of styes resolve on their own within one to two weeks, without professional care. The primary treatment is application of warm compresses. As a part of self-care at home, people 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. Cleansing must be done gently and while the eyes are closed to prevent eye injuries.
People with styes should avoid eye makeup (e.g., eyeliner), lotions, and wearing contact lenses, since these can aggravate and spread the infection (sometimes to the cornea). People are advised not to lance the stye themselves, as serious infection can occur. Pain relievers such as acetaminophen may be used.
Evidence to support the use of antibiotic eye ointment is poor. Occasionally erythromycin ophthalmic ointment is recommended. Other antibiotics, such as chloramphenicol or amoxicillin may also be used. 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.
Incision and drainage is performed if resolution does not begin in the next 48 hours after warm compresses are started. Medical professionals will sometimes lance a particularly persistent or irritating stye with a needle to accelerate its draining.
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 sutures are used to close the lesion. Sometimes the removed stye is sent for a histopathological examination to investigate possibility of skin cancer.
A 2017 Cochrane review found low-certainty evidence that acupuncture helps in hordeolum compared with antibiotics or warm compresses. There was also low-certainty evidence that acupuncture plus usual treatment may increase the chance of hordeolum getting better, though they could not rule out placebo or observer effect, since the studies reviewed either had no positive control, were not blinded, or both.
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 a few days to a week causing the relief of symptoms, but if it does not improve or it worsens within two weeks, a doctor's opinion should be sought. Few people require surgery as part of stye treatment. With adequate treatment, styes tend to heal quickly and without complications.
The prognosis is better if one does not attempt to squeeze or puncture the stye, as infection may spread to adjacent tissues. Also, patients are recommended to call a doctor if they encounter problems with vision, the eyelid bump becomes very painful, the stye bleeds or reoccurs, or the eyelid or eyes becomes red.
The word sty (first recorded in the 17th century) is probably a back-formation from styany (first recorded in the 15th century), which in turn comes from styan plus eye, the former of which in turn comes from the old English stígend, meaning riser, from the verb stígan, rise (in Old English G is often a Y sound). The older form styan is still used in Ulster Scots today.
The homonym sty found in the combination pigsty has a slightly different origin, namely it comes from the Old English stí-fearh—fearh (farrow) is the Old English word for pig—where stig meant hall (cf. steward), possibly an early Old Norse loanword, which could be cognate with the word stigan above.
The synonym late Latin expression is "Hordeolum" a modulation of the word "Hordeolus " simply related to "Horde" (barley), in a resemblance of the growing plant from the seed, in ancient languages, for example Arabic it has the same meaning as a barley fascicle, while in Czech a sty called Ječné zrno (from Ječmen barley and zrno seed or grain).
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