Stye (Hordeolum)

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Introduction

  • Stye could be external or internal
  • External stye is the infection of the lash follicle and its associated gland of Zeis or Moll
  • Internal stye (chalazion) is the infection of the meibomian gland

Clinical features

  • Painful lump growing on the eyelid
  • Red swollen area on the eyelid (like a boil)
  • Pain in the affected area of the eyelid
  • Chalazion: firm, painless lump on the eyelid, usually upper lid

Differential diagnoses

  • Various eyelid cysts and tumours

Complications

  • Pre-septal cellulitis
  • Orbital cellulitis
  • Cavernous sinus thrombosis

Investigations

  • If recurrent, screen for diabetes

Non-drug measures

  • Apply warm wet pads for 15 minutes 4 times daily until the stye drains
  • Incision and curettage (if there is still a chalazion lump) as soon as the infection settles

Drug treatment

  • Antibiotic eye ointment to stop infection
    • Chloramphenicol ointment apply 4 times daily for 2 weeks
  • Systemic antibiotics
    • Amoxicillin 250 - 500 mg orally every 8 hours for 5 - 7 days

Notable adverse drug reactions, contraindications and caution

  • Discourage the use of traditional eye medication

Prevention

  • Clean eyelids regularly and thoroughly
  • For recurrent styes, use baby shampoo to clean the eyelashes regularly