Hordeolum (Stye) – Diseases of the Eyelids

00:01 Let's talk about hordeolum or stye.

00:04 Most people know what styes are.

00:06 These are painful, typically little punctate areas of basically pus.

00:12 These are associated with eyelid hair follicles.

00:16 Okay, so it can be localized at the margin of the eye because that's where the hair follicles are.

00:22 And you can see it both in the diagram on the right, but also on that poor person on the left.

00:29 It is infection, typically, infection involving the eyelash follicle or the eyelid glands.

00:35 And these are those glands of Zeiss and Moll, whoever named those.

00:39 And they are basically sebaceous glands, modified sweat glands that are keeping the eyelashes supple.

00:45 That's what the glands of Zeiss and Moll do.

00:48 But they can become blocked.

00:49 They can become infected, and when they do, you get a stye.

00:53 OK, so this is just showing you on the left-hand side a typical pustule associated with a hair follicle.

01:01 So wherever there are hair follicles, there are going to be sebaceous glands.

01:04 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.

01:13 When it happens on the eyelid, we just give it the special name of hordeolum or stye.

01:16 So it's basically a pimple at the lash line.

01:21 Okay, and you're getting the pus that's there along the hair shaft.

01:26 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.

01:36 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.

01:50 Can happen if there's chronic inflammation there or in settings like diabetes, which is going to impact the immune response.

01:57 So blepharitis, kind of otherwise inflammation of the eyelids can lead to this.

02:04 And it's going to be mainly a Staphylococcus aureus.

02:07 So a normal commensal organism that lives on the skin and can cause just a world of discomfort.

02:15 So there are complications that happen as a result of styes.

02:18 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.

02:31 So you can have a secondary chalazion that happens as a result of that infection of the kind of the eyelash glands.

02:41 Okay, next one is going to be a trigger so be prepared.

02:44 This looks awful, but it's a complication of styes.

02:48 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.

02:59 This can actually be quite serious and you can even develop abscesses as a result of this.

03:07 So what do you do to treat a stye? So it's usually quite conservative.

03:12 We want to give warm compresses and good eyelid hygiene.

03:16 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.

03:27 In severe cases, we may require antibiotics.

03:30 And if there's lots and lots of inflammation, we may actually give steroids to block some of that.

03:38 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.