STYE

Background
A hordeolum (ie, stye) is a localized infection or inflammation of the eyelid margin involving hair follicles of the
eyelashes (ie, external hordeolum) or meibomian glands (ie, internal hordeolum). A chalazion is a painless
granuloma of the meibomian glands.

A hordeolum usually is painful, erythematous, and localized. It may produce edema of the entire lid. Purulent
material exudes from the eyelash line in external hordeola, while internal hordeola suppurate on the
conjunctival surface of eyelid.

Pathophysiology
Staphylococcus aureus is the infectious agent in 90-95% of cases of hordeolum.

An external hordeolum arises from a blockage and infection of Zeiss or Moll sebaceous glands. An internal
hordeolum is a secondary infection of meibomian glands in the tarsal plate. Both types can arise as a
secondary complication of blepharitis.

Untreated, the disease may spontaneously resolve or it may progress to chronic granulation with formation of a
painless mass known as a chalazion. Chalazia can be quite large and can cause visual disturbance by
deforming the cornea. Generalized cellulitis of the eyelid may occur if an internal hordeolum is untreated.

Most morbidity is secondary to improper drainage. Proper technique and drainage precautions are described in
Treatment.