Hordeolum

Definition

A hordeolum is a small infection of the glands in the eye, located in the eyelids. The infection causes a red bump on the eyelid that may look like a pimple. This type of infection, also known as a stye, is usually quite painful. There are two types of hordeola:

  • External—occurs when the infection is external to the lash line
  • Internal—occurs when the infection is inside of the lash line

Hordeola are often easily diagnosed and prompt treatment often prevents progression of the infection. Contact your doctor if you think you may have a hordeolum.

Hordeolum (Stye)
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Causes

A hordeolum is caused by a blockage in the small glands located along the eyelid margin. These glands produce oil and the blockage prevents normal drainage of the gland. If bacteria are trapped in the gland, an infection can develop, and the development of fluid and pus cause the area to become red and inflamed. In 90%-95% of cases, the resulting infection is caused by the bacteria called Staphylococcus aureus (sometimes known as “staph”). It is possible to have more than one hordeolum at a time, and it is common for them to reoccur.

Risk Factors

Hordeolum is a common condition, although the exact incidence in the US is not known. Some conditions may increase the risk of developing a hordeolum, these include:

  • Poor eyelid hygiene
  • Chronic illness
  • Previous hordeolum (hordeola often recur in the same eyelid)

Symptoms

A hordeolum usually begins as a red and swollen area on or in the eyelid. Often, the area is very tender and painful. In addition to the red, painful bump, some other symptoms of hordeola include:

  • Tearing of the eye
  • Blurred vision
  • A sensation of a foreign body or scratchiness in the eye
  • Sometimes, there is a point or yellowish spot on the swollen area. This is where the discharge of pus will occur when the hordeolum drains.

Internal hordeola are usually more painful and are less likely to come to a point without the assistance of a doctor. If you experience redness and painful swelling in the eye, or any change in vision, it is important to contact your eye doctor immediately. These symptoms may be caused by other health conditions as well.

Diagnosis

In most cases, a simple eye exam is all that is necessary to confirm the diagnosis of a hordeolum. Other than looking at your eye, special tests are not usually necessary for diagnosis.

Treatment

Often hordeola resolve spontaneously on their own. In these cases, only hot compresses to assist the drainage are needed. Warm compresses can be applied four to six times a day for several minutes a session. However, if they do not drain on their own, hordeola often respond very quickly to simple treatment from your doctor. It is important to get treatment as soon as possible. If untreated, the infection may continue to grow or lead to other conditions, including cellulitis. Chalazia occur when the gland is blocked, but no infection is present. Cellulitis occurs when the infection spreads to the tissue of the eyelid or beyond. This can become a true emergency!

Drainage

Drainage of the lesion is the first step in treating the hordeolum. If the hordeolum does not drain on its own, your doctor may assist drainage of the infection by lancing the hordeolum. The pus and contents of the swollen area can then be drained. It is important never to try to lance the hordeolum without the assistance of a doctor; permanent damage to the eye or eyelid can occur.

Antibiotics

In some cases, antibiotics are also given to ensure that the entire infection is eliminated. Antibiotics may be given in oral form, or as eye drops/eye ointment. In many cases, antibiotics alone are ineffective.

If you are diagnosed with a hordeolum, follow your doctor's instructions.

Prevention

The best prevention against developing a hordeolum is to keep the area around the eye as clean as possible. Always wash your hands thoroughly before touching your eyes, and refrain from rubbing your eyes.

Although it may not be possible to prevent the development of every hordeolum, obtaining prompt treatment when one occurs is the best way to prevent future recurrences. It is important that you do not attempt to drain the hordeolum yourself. Any squeezing or poking at the hordeolum may cause more damage. The infection may be spread inadvertently, or damage to the eye could result.

Be sure to call your doctor immediately if:

  • You have vision problems
  • There is a blister or crusting on the eyelid
  • The white of the eye becomes red
  • The hordeolum bleeds
  • You have pain

Revision Information

  • Reviewer: Eric Berman, MD
  • Review Date: 06/2014 -
  • Update Date: 07/17/2014 -
  • The American Academy of Ophthalmology

    http://www.aao.org

  • The American Optometric Association

    http://www.aoa.org

  • Canadian Association of Optometrists

    http://www.opto.ca

  • Canadian Ophthalmological Society

    http://www.eyesite.ca

  • Hordeolum. The Merck Manual website. Available at: http://www.merckmanuals.com/professional/eye%5Fdisorders/eyelid%5Fand%5Flacrimal%5Fdisorders/chalazion%5Fand%5Fhordeolum%5Fstye.html. Accessed August 25, 2005.

  • Hordeolum (stye)/chalazion. John Hopkins website. Available at: http://prod.hopkins-abxguide.org/diagnosis/heent/hordeolum%5F%5Fstye%5F%5Fchalazion.html?contentInstanceId=255294. Accessed July 21, 2009.

  • Pasternak A, Irish B. Ophthalmologic infections in primary care. Clinics in Family Practice. 2004;6:19-633.

  • Skorin L. Hordeolum and chalazion treatment, the full gamut. Optometry Today website. Available at: http://www.optometry.co.uk/clinical/details?aid=247. Accessed August 25, 2005.

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