Let's talk about hordeolum or stye.
Most people know what styes are.
These are painful, typically little
punctate areas of basically pus.
These are associated with eyelid hair follicles.
Okay, so it can be localized at the margin of
the eye because that's where the hair follicles are.
And you can see it both in the diagram on
the right, but also on that poor person on the left.
It is infection, typically, infection involving
the eyelash follicle or the eyelid glands.
And these are those glands of
Zeiss and Moll, whoever named those.
And they are basically sebaceous glands, modified
sweat glands that are keeping the eyelashes supple.
That's what the glands of Zeiss and Moll do.
But they can become blocked.
They can become infected,
and when they do, you get a stye.
OK, so this is just showing you on the left-hand
side a typical pustule associated with a hair follicle.
So wherever there are hair follicles,
there are going to be sebaceous glands.
It's kind of everywhere on your body and
you can have a pimple anywhere on your body
associated with similar
sebaceous glands someplace else.
When it happens on the eyelid, we just
give it the special name of hordeolum or stye.
So it's basically a pimple at the lash line.
Okay, and you're getting the pus
that's there along the hair shaft.
So etiology, it's much more
common in children and young adults,
probably has to do a little bit with eye
hygiene associated with rubbing the eyes.
So if you have your finger and it's not
particularly clean with a little bit of Staph aureus on it
and you rub it and you can get it into
those little glands lining the hair shafts,
they can then take over.
Can happen if there's chronic
inflammation there or in settings like diabetes,
which is going to impact the immune response.
So blepharitis, kind of otherwise
inflammation of the eyelids can lead to this.
And it's going to be mainly a Staphylococcus aureus.
So a normal commensal organism that lives on
the skin and can cause just a world of discomfort.
So there are complications
that happen as a result of styes.
And if you have an inflammation of the glands
of Moll or Zeiss, that can clearly impact the ability
to get the sebaceous secretions
from the Meibomian glands out.
So you can have a secondary chalazion
that happens as a result of that infection
of the kind of the eyelash glands.
Okay, next one is going to
be a trigger so be prepared.
This looks awful, but it's a complication of styes.
You can have infection now that
spreads into the entire eyelid and
even into the other structures of the
eye so an orbital or a preseptal cellulitis.
This can actually be quite serious and you
can even develop abscesses as a result of this.
So what do you do to treat a stye?
So it's usually quite conservative.
We want to give warm
compresses and good eyelid hygiene.
And again, the compresses will bring that
pimple to a head and allow it to have the release
of the infected material and
then you can wash it away.
In severe cases, we may require antibiotics.
And if there's lots and lots of inflammation, we may
actually give steroids to block some of that.
In some cases, it may be required
that we actually do incision and drainage,
that we have to do a surgical treatment to get
rid of the infection if there's a really large abscess.