A stye, also known as a hordeolum, is a bacterial infection of an oil gland in the

eyelid An eyelid is a thin fold of skin that covers and protects an eye. The levator palpebrae superioris muscle retracts the eyelid, exposing the cornea to the outside, giving vision. This can be either voluntarily or involuntarily. The human eyel ...

. This results in a red tender bump at the edge of the eyelid. The outside or the inside of the eyelid can be affected. The cause of a stye is usually a

bacterial infection Pathogenic bacteria are bacteria that can cause disease. This article focuses on the bacteria that are pathogenic to humans. Most species of bacteria are harmless and are often beneficial but others can cause infectious diseases. The number of ...

by ''

Staphylococcus aureus ''Staphylococcus aureus'' is a Gram-positive spherically shaped bacterium, a member of the Bacillota, and is a usual member of the microbiota of the body, frequently found in the upper respiratory tract and on the skin. It is often positive ...

''. The internal ones are due to infection of the

meibomian gland Meibomian glands (also called tarsal glands, palpebral glands, and tarsoconjunctival glands) are sebaceous glands along the rims of the eyelid inside the tarsal plate. They produce meibum, an oily substance that prevents evaporation of the eye' ...

while the external ones are due to an infection of the

gland of Zeis Glands of Zeis are unilobar sebaceous glands located on the margin of the eyelid. The glands of Zeis service the eyelash. These glands produce an oily substance that is issued through the excretory ducts of the sebaceous lobule into the middle por ...

. A

chalazion A chalazion (; plural chalazia or chalazions) or meibomian cyst is a cyst in the eyelid usually due to a blocked meibomian gland, typically in the middle of the eyelid, red, and not painful. They tend to come on gradually over a few weeks. A ...

on the other hand is a blocked oil gland without infection. A chalazion is typically in the middle of the eyelid and not painful. Often a stye will go away without any specific treatment in a few days or weeks. Recommendations to speed improvement include

warm compresses A warm compress is a method of applying heat to the body. Heating sources can include warm water, microwaveable pads, wheat packs and electrical or chemical pads. Some unorthodox methods can include warmed potatoes, uncooked rice, and hard-boiled ...

. Occasionally

antibiotic An antibiotic is a type of antimicrobial substance active against bacteria. It is the most important type of antibacterial agent for fighting bacterial infections, and antibiotic medications are widely used in the treatment and prevention of ...

eye ointment may be recommended. While these measures are often recommended, there is little evidence for use in internal styes. The frequency at which styes occur is unclear, though they may occur at any age.

Signs and symptoms

The first sign of a stye is a small, yellowish spot at the center of the bump that develops as

pus Pus is an exudate, typically white-yellow, yellow, or yellow-brown, formed at the site of inflammation during bacterial or fungal infection. An accumulation of pus in an enclosed tissue space is known as an abscess, whereas a visible collection ...

and expands in the area. Other stye symptoms may include: * A lump on the top or bottom

* Localized swelling of the eyelid * Localized

pain Pain is a distressing feeling often caused by intense or damaging stimuli. The International Association for the Study of Pain defines pain as "an unpleasant sensory and emotional experience associated with, or resembling that associated with, ...

* Redness * Tenderness * Crusting of the eyelid margins * Burning in the eye * Droopiness of the eyelid * Scratchy sensation on the

eyeball Eyes are organs of the visual system. They provide living organisms with vision, the ability to receive and process visual detail, as well as enabling several photo response functions that are independent of vision. Eyes detect light and conve ...

(itching) *

Blurred vision Blurred vision is an ocular symptom where vision becomes less precise and there is added difficulty to resolve fine details. Temporary blurred vision may involve dry eyes, eye infections, alcohol poisoning, hypoglycemia, or low blood pressure. ...

* Mucous discharge in the eye * Irritation of the eye * Light sensitivity * Tearing * Discomfort during blinking * Sensation of a foreign body in the eye

Complications

Stye complications occur in very rare cases. However, the most frequent complication of styes is progression to a

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 A fistula (plural: fistulas or fistulae ; from Latin ''fistula'', "tube, pipe") in anatomy is an abnormal connection between two hollow spaces (technically, two epithelialized surfaces), such as blood vessels, intestines, or other hollow or ...

. Large styes may interfere with one's vision. Eyelid

cellulitis Cellulitis is usually a bacterial infection involving the inner layers of the skin. It specifically affects the dermis and subcutaneous fat. Signs and symptoms include an area of redness which increases in size over a few days. The borders of t ...

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.

Cause

A stye is caused by a bacterial infection. The bacteria are

in about 95% of cases. The infection leads to the blocking of an oil gland at the base of the

eyelash An eyelash (also called lash) (Latin: ''Cilia'') is one of the hairs that grows at the edge of the eyelids. It grows in one layer on the edge of the upper and lower eyelids. Eyelashes protect the eye from debris, dust, and small particles and p ...

. Styes are experienced by people of all ages. Styes can be triggered by poor nutrition, sleep deprivation, lack of hygiene, lack of water, and rubbing of the eyes. Styes can be secondary to blepharitis or a deficiency in immunoglobulin.

Prevention

Stye prevention is closely related to proper hygiene. Proper hand washing can reduce the risks of developing not only styes, but also many 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. To prevent styes, cosmetics and cosmetic eye tools should not be shared among people. Like with all infections, regular hand washing is essential, and the eyes should not be rubbed or touched with unclean hands. Contaminated eye makeup should be discarded and sharing of washcloths or face towels should be curtailed, to avoid spreading the infection between individuals. Breaking the stye may spread bacteria contained in the pus and should be avoided.

Treatment

Most cases of styes resolve on their own within one to two weeks, without professional care. The primary treatment is application of warm compresses. As a part of self-care at home, people 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. People with styes should avoid eye makeup (e.g., eyeliner), lotions, and wearing contact lenses, since these can aggravate and spread the infection (sometimes to the cornea). People are advised not to lance the stye themselves, as serious infection can occur. Pain relievers such as acetaminophen may be used.

Antibiotics

Evidence to support the use of

eye ointment is poor. Occasionally erythromycin ophthalmic ointment is recommended. Other antibiotics, such as chloramphenicol or amoxicillin may also be used. 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. Antibiotics are normally given to people with multiple styes or with styes that do not seem to heal, and to people who have blepharitis or rosacea.

Procedures

Incision and drainage is performed if resolution does not begin in the next 48 hours after warm compresses are started. Medical professionals will sometimes lance a particularly persistent or irritating stye with a needle to accelerate its draining. 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 Surgical suture, sutures are used to close the lesion. Sometimes the removed stye is sent for a Histopathology, histopathological examination to investigate possibility of skin cancer.

Alternative medicine

A 2017 Cochrane review found low-certainty evidence that acupuncture helps in hordeolum compared with antibiotics or warm compresses. There was also low-certainty evidence that acupuncture plus usual treatment may increase the chance of hordeolum getting better, though they could not rule out placebo or observer effect, since the studies reviewed either had no positive control, were not blinded, or both.

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 a few days to a week causing the relief of symptoms, but if it does not improve or it worsens within two weeks, a doctor's opinion should be sought. Few people require surgery as part of stye treatment. With adequate treatment, styes tend to heal quickly and without complications. The prognosis is better if one does not attempt to squeeze or puncture the stye, as infection may spread to adjacent tissues. Also, patients are recommended to call a doctor if they encounter problems with vision, the eyelid bump becomes very painful, the stye bleeds or reoccurs, or the eyelid or eyes becomes red.

Etymology

The word ''stye'' (first recorded in the 17th century) is probably a back-formation from ''styany'' (first recorded in the 15th century), which in turn comes from ''styan'' plus ''eye'', the former of which in turn comes from the old English ''stīġend'', meaning "riser", from the verb ''stīgan'', "to rise". The older form ''styan'' is still used in Ulster Scots today. The homonym ''sty'' found in the combination ''pigsty'' has a slightly different origin, namely it comes from the Old English ''stiġ-fearh''—''fearh'' (farrow) is the Old English word for "piglet"—where ''stiġ'' meant "hall" (cf. ''steward''), possibly an early Old Norse loanword, which could be cognate with the word ''stīgan'' above.sty, n.3: The synonymous late Latin expression is ''hordeolum'' a modulation of the word ''hordeolus'' simply related to ''hordeum'' ("barley"), after its resemblance to a barleycorn. In Czech, a sty is called ''ječné zrno'' (from ''ječmen'' "barley" and ''zrno'' "seed or grain"); in German, it is called ''Gerstenkorn'' (barleycorn). In Hebrew it is called "שעורה" Seh-oh-Ráh (Barley)

References

External links

Merck Manual
* {{Eye pathology Disorders of eyelid, lacrimal system and orbit Eye Wikipedia medicine articles ready to translate Wikipedia neurology articles ready to translate