Definition
of a Stye: A stye is the common
name for a hordeolum. A stye
is an infection (abcess/boil) of one of the tiny oil producing glands inside
the eyelid usually caused by staphylococcus aureus bacteria. There are
two types of styes, officially called internal hordeolum
and external hordeolum.
An internal hordeolum (stye) is a
bacterial infection of the meibomian glands inside the eyelids. Internal
styes tend to be more severe and occur a little less often than an external
hordeolum.
An external hordeolum (stye) is a
bacterial infection of the Glands of Zeis and/or Glands of Moll inside the
eyelids. This type of stye is more superficial and tends to heal quicker.
A stye can occur on either the upper
or lower eyelid.
Causes
of a Stye: A stye is usually caused by staphylococcus aureus bacteria which infect
the internal sebaceous glands within the eyelids. Styes are common in
infants and children but affect people of all ages.
If the pores of the oil glands become blocked by
debris or otherwise they tend to develop an infection. The bacteria
multiply in the root (follicle) of an eyelash.
A stye may be related to blepharitis, which should be treated
regularly to avoid styes.
Signs
and symptoms:
The first
sign of a stye is a small, yellowish spot at the center of the bump that
develops as pus
expands in the area.
Other stye symptoms may include:
- A lump on the top
or bottom eyelid
- Localized swelling
of the eyelid
- Localized pain
- Redness
- Tenderness
- Crusting of the
eyelid margins
- Burning in the eye
- Droopiness of the
eyelid
- Scratchy sensation on the eyeball (itching)
- Mucous discharge
in the eye
- Irritation of the
eye
- Light
sensitivity
- Tearing
- Discomfort during
blinking
- Sensation of a foreign body in the eye
Treatment of a Stye:
Most styes can be treated without
medical intervention by applying hot compresses for 10-15 minutes at a time for
four times per day. There is some controversy that a warm compress may
worsen the swelling and shouldn’t be used for several days. However, the
purpose of the warm compress is not to decrease swelling, but rather to open
the pores of the tiny oil glands to allow proper drainage so the eye can heal
itself. Therefore, we only recommend warm/hot compresses.
Removing an
eyelash or two in the center of the bump may help to stimulate drainage of the
infection.
Clean the eyelid
margin and the entire eyelid with an over the counter eyelid scrub (e.g.
SteriLid Eyelid Cleanser or Ocusoft eyelid scrubs) that can be purchased
at any pharmacy.
Most styes
will heal within 10-14 days.
If
the stye does not get better within 3-5 days treatment by an eye doctor is
recommended. The doctor may prescribe oral antibiotics such as:
Keflex
(cephalexin) 500mg twice per day for seven days for patients
who are not allergic to penicillin or cephalosporins.
Option
(also if no penicillin allergy) Augmentin (Amoxicillin +
Clavulanic acid):
Dose if mild infection -generic Augmentin 500 mg. twice a day for one week
Dose
if more severe –generic 875mg Augmentin twice a day for one week
Most severe - 1000mg Augmentin twice a day for one week (not generic)
When the
patient has a penicillin or cephalosporin allergy:
Zithromax
(azithromycin) in a Z-pak (500mg on day one, followed by 250mg for the
next four days) is a good alternative.
OR, if the
patient also has allergies to macrolides, we recommend:
Oral fluoroquinolone
Levaquin (levofloxacin) at 500mg once daily for 7 days.
Or Cipro
(ciprofloxacin) 500-1000 mg once daily for 7 days
Topical eye
medicines in most cases offer very little healing since they do not penetrate
into the glands. There is some evidence that topical Azithromycin (Azasite)
has some penetrating ability. However, it is an expensive medicine and
most patients are not happy if it doesn’t heal the hordeolum. The tested
and proven treatment would be to use an oral antibiotic, many of which are
available generically at a greatly reduced cost.
Complications: Use of the above
medicines on a timely basis will also prevent an eyelid cellulitis or
preseptal cellulitis which is a serious complication of a hordeolum.
If the above medicines are not
effective at treating the hordeolum it has probably become a chalazion.
Chalazion may resolve without treatment but many require a minor surgery to
remove.
Prognosis: Although styes
are usually harmless and complications are rare, styes often recur. Styes
normally heal using the treatment described above with no vision complications.
Preventing: Preventing a
stye is primarily a function of improved hygiene around the eyelid
area. Regular use of eyelid scrubs (e.g. SteriLid Eyelid Cleanser or
Ocusoft Lid Scrubs) will greatly reduce the incidence of stye formation.
There is some evidence that flaxseed
oil or fish oil may assist in keeping the oil flowing freely from the glands in
the eyelids so they don’t become clogged and susceptible to bacterial
infection.
Women should never share cosmetics
with others. Women should remove makeup every night before going to sleep and
discard old or contaminated eye makeup.
মন্তব্যসমূহ
একটি মন্তব্য পোস্ট করুন