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Styes (hordeola) (Risk factors (Acne rosacea, Trichiasis, Chronic…
Styes (hordeola)
Risk factors
Acne rosacea
Trichiasis
Chronic blepharitis
Ectropion
Pathophysiology
Agent
Staph infection
Types
External/common: eyelid margin, infected eyelish follicle or associated gland
Internal/meibomian: conjunctival surface, infection of meibomian gland
Mechanism
Blockage and infection of eyelash follicle
(gland of Zeiss) or Meibomian follicle
Complications
Periorbital/orbital cellulitis
(rare)
Meibomian cyst (chalazion)
Conjunctivitis
Management
Conservative
Information and advice
Self care (warm compress 5-10m, several times/day;
do NOT attempt to puncture, avoid contacts and makeup)
Referral if persistent despite conservative treatment
Medical
Topical abx
Indciation: evidence of conjunctivitis
E.g. chloramphenicol eye drops
Surgical
Eyelash epilation
Indication: painful external style
MOA: removal of eyelash allows drainage
I+D
Indication: painful external stye
MOA: fine sterile needle (expert use)
Epidemiology
Common
Common cause of a lid lump
Clinical
presentation
Painful eyelid swelling
Unilateral, acute onset
Watery eye
Epiphora
Diagnosis
Examination
External eye examination
Swelling at eyelid margin around eyelash follicle (external),
Swelling internal eyelid, away from margin (internal),
both types erythematous and tender to palpation
CN examination
Normal acuity, movements, reflexes
History
PMH
Blepharitis, eyelid disorders,
skin disorders (rosacea)
DH
Eye drops, other meds, allergies
PC/HPC
Eye swelling (acute onset, unilateral, painful/watery),
no discharge, discomfort/grittiness, no photophobia,
no visual change, treatments so far, previous episodes
FH
Ocular disorders, skin disorders
SH
Occupation, smoking, alcohol
Prognosis
Self limiting, resolve 5-7d
Recur if underlying blepharitis
Definition
Acute localised infection
of the eyelid margin
