Stye
Encyclopedia
An external stye or sty (ˈ), also hordeolum (h), is an infection of the sebaceous
glands of Zeis at the base of the eyelash
es, or an infection of the apocrine
sweat glands of Moll
. External styes form on the outside of the lids and can be seen as small red bumps. Internal styes are infections of the meibomian sebaceous glands
lining the inside of the eyelids. They also cause a red bump underneath the lid with only generalized redness and swelling visible on the outside. Styes are similar to chalazia
, but tend to be of smaller size and are more painful and usually produce no lasting damage. Styes are characterized by an acute onset and usually short in duration (7–10 days without treatment) compared to chalazia that are chronic and usually do not resolve without intervention.
bacterial infection, or by the blocking of an oil gland
at the base of the eyelash
. Although they are particularly common in infant
s, styes are experienced by people of all ages. Styes can be triggered by poor nutrition, sleep deprivation
, lack of hygiene or rubbing of the eyes. Sharing of washcloths or face towels should be curtailed to avoid spreading the infection between individuals. Styes can last from one to two weeks without treatment, or as little as four days if treated properly.
Medical professionals will sometimes lance a particularly persistent or irritating stye with a needle to accelerate its draining. A stye's expansion can also be fought with erythromycin
ophthalmic ointment. Medical professionals may also treat styes with other antibiotics, such as chloramphenicol
or amoxicillin
. 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. Erythromycin ointment enjoys widespread use, and may add to comfort and aid in preventing secondary infections. However, it is poorly absorbed when used topically, and usually requires oral dosing to reach the infection with therapeutic levels inside of a stye. Azasite, a topical eye drop form of azithromycin, does appear to penetrate eyelid tissues fairly well, and may be a topical treatment for styes used in the future.
If a stye bursts, care must be taken to cleanse the wound to prevent reinfection.
expands in the area.
Other stye symptoms may include:
As a part of self-care at home, patients 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.
Patients are highly advised to not lance the stye, as serious infection can occur as a result. The infection could spread to the surrounding tissues and areas.
Eye stye sufferers should avoid eye makeup (e.g., eyeliner), lotions and wearing contact lenses, since these can aggravate and spread the infection (sometimes to the cornea).
Medical treatment can also be provided by a doctor and it is aimed on relieving the symptoms. Pain relievers such as acetaminophen may be prescribed and in some cases, antibiotics may be needed. Antibiotics are normally given to patients with multiple styes or with styes that do not seem to heal, and to patients who also suffer from blepharitis
or rosacea
. Commonly, the ophthalmologist prescribes oral or intravenous antibiotics, such as doxycycline
, only when the infection has spread. Topical antibiotic ointments or antibiotic/steroid combination ointments can also be administered in stye treatment.
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 and unnoticeable sutures are used to close the lesion. It is common for the removed stye to be sent for histopathological examination to rule out the possibility of skin cancer.
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
. Styes that are too large 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.
The prognosis is better if one does not attempt to squeeze or puncture the stye, as infection may spread to adjacent tissues. A stye usually will heal within a few days to a week, but if it does not improve or it worsens within two weeks, a doctor's opinion should be sought. Also, patients are recommended to call a doctor if they encounter problems with vision, the eyelid bumps becomes very painful, the stye bleeds or reoccurs or the eyelid or eye becomes red.
can not only reduce the risks of developing styes, but also all 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. Some studies suggest oral flaxseed supplementation to prevent the occurrence of styes.
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 recommended to remove makeup every night before going to sleep and discard old or contaminated eye makeup.
Sebaceous gland
The sebaceous glands are microscopic glands in the skin that secrete an oily/waxy matter, called sebum, to lubricate and waterproof the skin and hair of mammals...
glands of Zeis at the base of the eyelash
Eyelash
An eyelash or simply lash is one of the hairs that grow at the edge of the eyelid. Eyelashes protect the eye from debris and perform some of the same function as whiskers do on a cat or a mouse in the sense that they are sensitive to being touched, thus providing a warning that an object is near...
es, or an infection of the apocrine
Apocrine
Apocrine is a term used to classify exocrine glands in the study of histology. Cells which are classified as apocrine bud their secretions off through the plasma membrane producing membrane-bound vesicles in the lumen. This method is also called decapitation secretion...
sweat glands of Moll
Glands of Moll
Glands of Moll, also known as ciliary glands, are modified apocrine sweat glands that are found on the margin of the eyelid. They are next to the base of the eyelashes, and anterior to the Meibomian glands within the distal eyelid margin. These glands are relatively large and tubular-shaped.Moll's...
. External styes form on the outside of the lids and can be seen as small red bumps. Internal styes are infections of the meibomian sebaceous glands
Meibomian gland
The meibomian glands are a special kind of sebaceous gland at the rim of the eyelids inside the tarsal plate, responsible for the supply of meibum, an oily substance that prevents evaporation of the eye's tear film. They prevent tear spillage onto the cheek, trapping tears between the oiled edge...
lining the inside of the eyelids. They also cause a red bump underneath the lid with only generalized redness and swelling visible on the outside. Styes are similar to chalazia
Chalazion
A chalazion , also known as a meibomian gland lipogranuloma, is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid. Chalazia differ from styes in that they are subacute and usually painless nodules...
, but tend to be of smaller size and are more painful and usually produce no lasting damage. Styes are characterized by an acute onset and usually short in duration (7–10 days without treatment) compared to chalazia that are chronic and usually do not resolve without intervention.
Cause
Styes are commonly caused by a Staphylococcus aureusStaphylococcus aureus
Staphylococcus aureus is a facultative anaerobic Gram-positive coccal bacterium. It is frequently found as part of the normal skin flora on the skin and nasal passages. It is estimated that 20% of the human population are long-term carriers of S. aureus. S. aureus is the most common species of...
bacterial infection, or by the blocking of an oil gland
Oil gland
An oil gland is a sebaceous gland that secretes sebaceous matter. Oil glands are part of the body's integumentary system and serve to protect the body against germs. They are mainly situated in the corium or true skin. True oil glands secrete matter through a duct. Many creatures, such as fish,...
at the base of the eyelash
Eyelash
An eyelash or simply lash is one of the hairs that grow at the edge of the eyelid. Eyelashes protect the eye from debris and perform some of the same function as whiskers do on a cat or a mouse in the sense that they are sensitive to being touched, thus providing a warning that an object is near...
. Although they are particularly common in infant
Infant
A newborn or baby is the very young offspring of a human or other mammal. A newborn is an infant who is within hours, days, or up to a few weeks from birth. In medical contexts, newborn or neonate refers to an infant in the first 28 days after birth...
s, styes are experienced by people of all ages. Styes can be triggered by poor nutrition, sleep deprivation
Sleep deprivation
Sleep deprivation is the condition of not having enough sleep; it can be either chronic or acute. A chronic sleep-restricted state can cause fatigue, daytime sleepiness, clumsiness and weight loss or weight gain. It adversely affects the brain and cognitive function. Few studies have compared the...
, lack of hygiene or rubbing of the eyes. Sharing of washcloths or face towels should be curtailed to avoid spreading the infection between individuals. Styes can last from one to two weeks without treatment, or as little as four days if treated properly.
Medical professionals will sometimes lance a particularly persistent or irritating stye with a needle to accelerate its draining. A stye's expansion can also be fought with erythromycin
Erythromycin
Erythromycin is a macrolide antibiotic that has an antimicrobial spectrum similar to or slightly wider than that of penicillin, and is often used for people who have an allergy to penicillins. For respiratory tract infections, it has better coverage of atypical organisms, including mycoplasma and...
ophthalmic ointment. Medical professionals may also treat styes with other antibiotics, such as chloramphenicol
Chloramphenicol
Chloramphenicol is a bacteriostatic antimicrobial that became available in 1949. It is considered a prototypical broad-spectrum antibiotic, alongside the tetracyclines, and as it is both cheap and easy to manufacture it is frequently found as a drug of choice in the third world.Chloramphenicol is...
or amoxicillin
Amoxicillin
Amoxicillin , formerly amoxycillin , and abbreviated amox, is a moderate-spectrum, bacteriolytic, β-lactam antibiotic used to treat bacterial infections caused by susceptible microorganisms. It is usually the drug of choice within the class because it is better absorbed, following oral...
. Chloramphenicol is used successfully in many parts of the world, but contains a black box warning
Black box warning
In the United States, a black box warning is a type of warning that appears on the package insert for prescription drugs that may cause serious adverse effects...
in the United States due to concerns about aplastic anemia
Aplastic anemia
Aplastic anemia is a condition where bone marrow does not produce sufficient new cells to replenish blood cells. The condition, per its name, involves both aplasia and anemia...
, which on rare occasions can be fatal. Erythromycin ointment enjoys widespread use, and may add to comfort and aid in preventing secondary infections. However, it is poorly absorbed when used topically, and usually requires oral dosing to reach the infection with therapeutic levels inside of a stye. Azasite, a topical eye drop form of azithromycin, does appear to penetrate eyelid tissues fairly well, and may be a topical treatment for styes used in the future.
If a stye bursts, care must be taken to cleanse the wound to prevent reinfection.
Signs and symptoms
The first sign of a stye is a small, yellowish spot at the center of the bump that develops as pusPus
Pus is a viscous exudate, typically whitish-yellow, yellow, or yellow-brown, formed at the site of inflammatory during infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection of pus within or beneath the epidermis is known as a pustule or...
expands in the area.
Other stye symptoms may include:
- A lump on the top or bottom eyelidEyelidAn eyelid is a thin fold of skin that covers and protects an eye. With the exception of the prepuce and the labia minora, it has the thinnest skin of the whole body. The levator palpebrae superioris muscle retracts the eyelid to "open" the eye. This can be either voluntarily or involuntarily...
- Localized swelling of the eyelid
- Localized painPainPain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
- Redness
- Tenderness to touch
- Crusting of the eyelid margins
- Burning in the eye
- Droopiness of the eyelid
- Scratchy sensation on the eyeball
- Blurred visionBlurred vision-Causes:There are many causes of blurred vision:* Use of atropine or other anticholinergics* Presbyopia -- Difficulty focusing on objects that are close. The elderly are common victims....
- Mucous discharge in the eye
- Irritation of the eye
- Light sensitivity
- Tearing
- Discomfort during blinking
- Sensation of a foreign body in the eye
Treatment
The primary mode of treatment for a stye is application of warm compresses. Incision and drainage is performed if resolution does not begin in the next 48 hours after warm compresses are started.As a part of self-care at home, patients may cleanse the affected eyelid with tap water or with a mild, nonirritating soap
Soap
In chemistry, soap is a salt of a fatty acid.IUPAC. "" Compendium of Chemical Terminology, 2nd ed. . Compiled by A. D. McNaught and A. Wilkinson. Blackwell Scientific Publications, Oxford . XML on-line corrected version: created by M. Nic, J. Jirat, B. Kosata; updates compiled by A. Jenkins. ISBN...
or
shampoo
Shampoo
Shampoo is a hair care product used for the removal of oils, dirt, skin particles, dandruff, environmental pollutants and other contaminant particles that gradually build up in hair...
(such as baby shampoo) to help clean crusted discharge. Cleansing must be done gently and while the eyes are closed to prevent eye injuries.
Patients are highly advised to not lance the stye, as serious infection can occur as a result. The infection could spread to the surrounding tissues and areas.
Eye stye sufferers should avoid eye makeup (e.g., eyeliner), lotions and wearing contact lenses, since these can aggravate and spread the infection (sometimes to the cornea).
Medical treatment can also be provided by a doctor and it is aimed on relieving the symptoms. Pain relievers such as acetaminophen may be prescribed and in some cases, antibiotics may be needed. Antibiotics are normally given to patients with multiple styes or with styes that do not seem to heal, and to patients who also suffer from blepharitis
Blepharitis
Blepharitis is an ocular condition characterized by chronic inflammation of the eyelid, the severity and time course of which can vary. Onset can be acute, resolving without treatment within 2–4 weeks , but more generally is a long standing inflammation varying in severity...
or rosacea
Rosacea
Rosacea is a chronic condition characterized by facial erythema . Pimples are sometimes included as part of the definition. Unless it affects the eyes, it is typically a harmless cosmetic condition...
. Commonly, the ophthalmologist prescribes oral or intravenous antibiotics, such as doxycycline
Doxycycline
Doxycycline INN is a member of the tetracycline antibiotics group, and is commonly used to treat a variety of infections. Doxycycline is a semisynthetic tetracycline invented and clinically developed in the early 1960s by Pfizer Inc. and marketed under the brand name Vibramycin. Vibramycin...
, only when the infection has spread. Topical antibiotic ointments or antibiotic/steroid combination ointments can also be administered in stye treatment.
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 and unnoticeable sutures are used to close the lesion. It is common for the removed stye to be sent for histopathological examination to rule out the possibility of skin cancer.
Complications
Stye complications occur in very rare cases. However, the most frequent complication of styes is progression to a chalazionChalazion
A chalazion , also known as a meibomian gland lipogranuloma, is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid. Chalazia differ from styes in that they are subacute and usually painless nodules...
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
Fistula
In medicine, a fistula is an abnormal connection or passageway between two epithelium-lined organs or vessels that normally do not connect. It is generally a disease condition, but a fistula may be surgically created for therapeutic reasons.-Locations:Fistulas can develop in various parts of the...
. Styes that are too large may interfere with one's vision.
Eyelid cellulitis
Cellulitis
Cellulitis is a diffuse inflammation of connective tissue with severe inflammation of dermal and subcutaneous layers of the skin. Cellulitis can be caused by normal skin flora or by exogenous bacteria, and often occurs where the skin has previously been broken: cracks in the skin, cuts, blisters,...
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.
Prognosis
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 few days to a week, causing the relief of symptoms. Few people require surgery as part of stye treatment. With adequate treatment, styes tend to heal quickly and without arising any type of complications.The prognosis is better if one does not attempt to squeeze or puncture the stye, as infection may spread to adjacent tissues. A stye usually will heal within a few days to a week, but if it does not improve or it worsens within two weeks, a doctor's opinion should be sought. Also, patients are recommended to call a doctor if they encounter problems with vision, the eyelid bumps becomes very painful, the stye bleeds or reoccurs or the eyelid or eye becomes red.
Prevention
Stye prevention is closely related to proper hygiene. Proper hand washingHand washing
Hand washing for hand hygiene is the act of cleaning the hands with or without the use of water or another liquid, or with the use of soap, for the purpose of removing soil, dirt, and/or microorganisms....
can not only reduce the risks of developing styes, but also all 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. Some studies suggest oral flaxseed supplementation to prevent the occurrence of styes.
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 recommended to remove makeup every night before going to sleep and discard old or contaminated eye makeup.