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Hordeolum (Stye) – Diseases of the Eyelids

by Richard Mitchell, MD

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    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.


    About the Lecture

    The lecture Hordeolum (Stye) – Diseases of the Eyelids by Richard Mitchell, MD is from the course External Eye Diseases.


    Included Quiz Questions

    1. The margin of the eyelid
    2. Upper eyelid
    3. Medial canthus
    4. Lateral canthus
    5. Lacrimal caruncle
    1. Sebum
    2. Meibum
    3. Mucus
    4. Keratin
    5. Tears
    1. Diabetes
    2. Tuberculosis
    3. Leprosy
    4. Hypertension
    5. Anemia
    1. Chalazion and eyelid abscess
    2. Chalazion and blepharitis
    3. Chalazion and conjunctivitis
    4. Chalazion and iritis
    5. Chalazion and stye

    Author of lecture Hordeolum (Stye) – Diseases of the Eyelids

     Richard Mitchell, MD

    Richard Mitchell, MD


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