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Stye

A stye, also known as a hordeolum, is an acute, painful infection of the sebaceous glands in the eyelid, presenting as a localized, red, pustular lump resembling a boil or pimple near the eyelid margin. Styes are classified as external, affecting the glands of Zeis or Moll at the base of the eyelashes and typically pointing outward, or internal, involving the meibomian glands within the eyelid and pointing inward.^[1] It typically affects the upper or lower eyelid and is filled with pus due to bacterial proliferation following gland blockage.^[2]^[1] Styes are most commonly caused by bacterial infection, with Staphylococcus aureus accounting for 90-95% of cases and Staphylococcus epidermidis as a secondary pathogen.^[1] The infection arises from obstruction of the meibomian glands, glands of Zeis, or glands of Moll, leading to stasis of secretions, inflammation, and abscess formation.^[1] Risk factors include poor eyelid hygiene, chronic conditions such as blepharitis or rosacea, diabetes, immunosuppression, and behaviors like touching the eyes with unwashed hands or leaving eye makeup on overnight.^[2]^[1] They occur across all age groups but are slightly more prevalent in adults aged 30-50 and in females due to increased use of cosmetics.^[1] Symptoms typically include a tender, erythematous nodule on the eyelid with localized swelling, burning sensation, and possible tearing or photophobia.^[2]^[1] If the stye is internal or large, it may cause eyelid soreness, crusting of the eyelid margins, or blurred vision from corneal involvement.^[2]^[1] Diagnosis is usually made through a simple visual examination by a healthcare provider, potentially aided by magnification to assess the eyelid.^[3] Treatment often involves conservative measures, as most styes resolve spontaneously within 7-10 days; warm compresses applied for 5-10 minutes several times daily promote drainage and relieve pain.^[3]^[1] Persistent cases may require topical antibiotic ointments, oral antibiotics if cellulitis develops, or incision and drainage for large abscesses.^[3] Complications are rare but can include recurrent infections or spread to adjacent tissues if the stye is improperly squeezed.^[3]^[1]

Overview

Definition

A stye, medically known as a hordeolum, is an acute, localized infection or inflammation of the sebaceous glands in the eyelid.^[1] It typically arises on the edge of the upper or lower eyelid, appearing as a tender, erythematous pustule or nodule.^[4] This condition generally resembles a pimple or boil, often filled with pus from bacterial overgrowth in blocked glands.^[5] Unlike chronic eyelid disorders such as chalazia, which form nontender granulomas, a stye is acutely painful and inflammatory.^[6] Styes have long been acknowledged in medical practice as a common eyelid affliction.^[7] They may be classified as external or internal based on the glands affected.^[2]

Types

Styes, or hordeola, are classified into two primary types based on the anatomical location and the specific eyelid glands affected: external hordeolum and internal hordeolum.^[1]^[8] An external hordeolum arises from an acute bacterial infection, typically by Staphylococcus aureus, of the glands of Zeis or glands of Moll, which are sebaceous and modified apocrine sweat glands, respectively, located at the base of the eyelash follicles along the external margin of the eyelid.^[1]^[8] These glands are associated directly with the eyelashes, resulting in a superficial lesion that is often more readily visible on the outer eyelid surface and tends to point externally toward the skin.^[1]^[2] In contrast, an internal hordeolum involves infection of the meibomian glands, which are larger oil-producing sebaceous glands embedded within the tarsal plate of the eyelid.^[1]^[8] These glands open onto the inner conjunctival surface, so the resulting abscess forms deeper within the eyelid and may point internally toward the conjunctiva, making it less apparent from the external view without eyelid eversion.^[1]^[2] Internal hordeola have a notable relationship to chalazia, as an unresolved internal hordeolum can evolve into a chalazion when the acute infection subsides but the obstructed meibomian gland duct leads to persistent chronic granulomatous inflammation due to retained lipid secretions.^[1]^[8] Clinically, the distinction between types influences presentation and potential course: external hordeola are typically more superficial and prone to spontaneous drainage, while internal hordeola, being deeper, are associated with a higher risk of recurrence or progression to complications such as chalazion formation if the underlying glandular dysfunction persists.^[1]^[8]

Epidemiology

Incidence and prevalence

Styes, also known as hordeola, are among the most common benign eyelid disorders encountered in clinical practice, though exact global incidence and prevalence rates remain undocumented due to the high frequency of self-resolving cases that do not seek medical attention.^[9] They account for a notable proportion of eyelid-related consultations in primary care and ophthalmology settings, contributing to frequent outpatient visits despite their typically benign course.^[1] For instance, in a study of school-age children in Brazil, the prevalence of hordeolum was reported as 0.3%, highlighting its occurrence even in pediatric populations.^[10] Healthcare utilization data underscore the public health impact of styes, with estimates suggesting an annual incidence of approximately 1 in 1,000 individuals in some populations, though underreporting likely underestimates the true burden.^[11] Most cases resolve spontaneously within 1-2 weeks with conservative measures like warm compresses, reducing the need for intervention, yet acute presentations still drive a significant volume of eye care encounters worldwide.^[1] However, heightened public awareness of eyelid hygiene following the COVID-19 pandemic has been associated with reported increases in consultations for stye and related conditions, potentially reflecting improved detection rather than true rises in occurrence.^[12] Styes occur globally across diverse populations without pronounced seasonal variations, making them a consistent concern in eye health regardless of geographic or climatic factors.^[9]

Demographic patterns

Styes, or hordeola, affect individuals across all age groups, though a slightly increased incidence is observed among adults aged 30 to 50 years, potentially due to cumulative exposure to risk factors like eyelid hygiene practices and gland function changes.^[1] Children and adolescents are also susceptible, often from habits such as frequent eye rubbing, while older adults may experience higher vulnerability owing to age-related alterations in meibomian gland secretion.^[1] Regarding sex differences, styes show a slight predominance in females, with this pattern attributed to the common use of eye cosmetics that can block sebaceous glands and promote bacterial growth.^[1] In contrast, multiple clinical reviews indicate no significant sexual predilection in overall case distributions, suggesting the female bias may be context-specific to cosmetic-related exposures.^[9] No strong racial or ethnic predilections have been documented for stye occurrence, with prevalence appearing consistent across diverse populations worldwide.^[1] ^[9] However, higher incidence reports emerge in groups with chronic eyelid disorders, such as blepharitis or dry eye syndrome, where gland obstruction and inflammation create a conducive environment for hordeolum development.^[13]

Pathogenesis

Causes

A stye, medically known as a hordeolum, is primarily caused by a bacterial infection of the eyelid glands, with Staphylococcus aureus responsible for approximately 90-95% of cases.^[14] This pathogen, along with other skin flora such as Staphylococcus epidermidis, invades the sebaceous or sweat glands, leading to localized infection.^[1] The pathophysiological mechanism involves initial obstruction of the eyelid gland ducts, often from hypersecretion of oils or accumulation of cellular debris, which creates stasis within the gland. This environment facilitates bacterial colonization and proliferation, triggering an acute suppurative inflammatory response characterized by neutrophil infiltration, pus formation, and eventual abscess development.^[15]^[9] In external hordeola, the infection typically begins at the base of an eyelash follicle, affecting the adjacent glands of Zeis (sebaceous) or Moll (apocrine sweat glands). Internal hordeola, however, arise deeper within the meibomian glands of the tarsal plate, where ductal blockage and subsequent bacterial entry occur along the inner eyelid surface.^[4] Bacterial pathogens predominate in the vast majority of cases.^[15]

Risk factors

Several ocular conditions predispose individuals to styes by obstructing eyelid glands and promoting bacterial overgrowth. Chronic blepharitis, an inflammation of the eyelid margins, significantly increases the risk by altering gland function and facilitating infection.^[1] Meibomian gland dysfunction, characterized by impaired oil secretion from eyelid glands, further elevates susceptibility, often co-occurring with blepharitis.^[1] Ocular rosacea, a subtype of rosacea affecting the eyes, contributes through chronic inflammation and gland blockage, leading to recurrent styes.^[2] Seborrheic dermatitis, a scaly skin condition affecting the eyelids and scalp, heightens risk by causing flaky debris that clogs follicles.^[16] Systemic factors impair immune responses or alter lipid profiles, making stye development more likely. Diabetes mellitus compromises immune function and healing, increasing incidence among affected individuals.^[1] Immunosuppression, such as from HIV or chemotherapy, weakens defenses against bacterial entry into glands.^[1] Hyperlipidemia, particularly elevated serum cholesterol, is associated with meibomian gland alterations that predispose to obstruction and infection.^[16] Behavioral risks primarily involve habits that introduce or trap bacteria on the eyelids. Poor eyelid hygiene, including infrequent cleaning or touching eyes with unwashed hands, allows bacterial buildup.^[2] Frequent eye rubbing exacerbates this by transferring contaminants directly to the lid margins.^[5] Contact lens wear without proper disinfection heightens exposure to pathogens.^[2] Sharing makeup or towels spreads bacteria, while leaving eye cosmetics on overnight or using expired products blocks glands and fosters infection.^[5] A history of previous styes raises the recurrence risk, often signaling underlying predispositions like blepharitis.^[5] Recent data indicate that increased cosmetic use among adults correlates with higher stye incidence, particularly in those aged 30-50.^[1]

Clinical presentation

Signs and symptoms

A stye, also known as a hordeolum, typically presents with an acute onset of localized pain and tenderness to touch on the eyelid, accompanied by swelling and redness that forms a small pustule or nodule, usually 2-5 mm in diameter.^[1]^[5] This lesion is often warm to the touch and confined to the margin of the upper or lower eyelid, with external hordeola appearing more superficial and visible near the lash line.^[1]^[4] Associated features include increased tearing (epiphora), sensitivity to light (photophobia), and a sensation of a foreign body or irritation in the affected eye.^[1]^[5] If the stye ruptures, yellowish pus may discharge, sometimes leading to crusting along the eyelid margin.^[1]^[2] Styes occur more frequently on the upper eyelid than the lower.^[4] The condition usually starts as diffuse swelling, evolving over 1-3 days into a more defined, pointed abscess, while internal hordeola tend to cause broader lid edema without a prominent external point.^[1]^[5] Fever is rare in uncomplicated cases, and systemic signs are typically absent, with the stye remaining self-limiting in most instances.^[1]^[2]

Complications

Untreated or recurrent internal hordeola may evolve into a chalazion, a chronic sterile lipogranuloma resulting from persistent blockage of the meibomian gland despite resolution of the acute infection.^[1] This progression occurs when inflammatory debris accumulates, leading to granulomatous inflammation rather than active suppuration.^[13] Infectious complications from a stye primarily involve localized spread, manifesting as preseptal cellulitis characterized by eyelid swelling, erythema, and tenderness without deeper orbital involvement.^[1] More severe dissemination to orbital cellulitis is rare but can occur, potentially causing proptosis, restricted eye movements, and vision impairment; systemic spread is exceptionally uncommon and typically seen only in immunocompromised individuals.^[13] Additional adverse outcomes include eyelid scarring from repeated episodes or inadequate resolution, which may distort lid architecture and lead to recurrent styes.^[1] Corneal irritation, such as keratitis, can arise from lash misdirection (trichiasis) secondary to scarring, while secondary bacterial conjunctivitis may develop due to contiguous spread of infection.^[13]

Diagnosis

Clinical evaluation

The clinical evaluation of a stye, or hordeolum, begins with a detailed history taking to assess the patient's symptoms and potential contributing factors. Healthcare providers inquire about the onset and duration of symptoms, which are typically acute, developing over days to a week, and include localized pain, tenderness, and swelling on the eyelid.^[1] Questions also cover pain level on a scale, any prior eyelid issues such as recurrent styes or blepharitis, hygiene practices including contact lens use or makeup application, and systemic symptoms like fever that might indicate broader infection.^[6] This history helps confirm typical eyelid-focused symptoms while identifying risk factors for recurrence.^[17] Physical examination follows, relying on visual inspection and palpation for diagnosis, as hordeolum presents with characteristic localized features. The eyelid is examined for erythema, swelling, and a tender nodule at the margin, with external hordeola appearing near the lash line and internal ones requiring lid eversion to visualize deeper within the tarsal plate.^[1] Palpation assesses for fluctuance indicating pus accumulation and distinguishes acute tenderness of a stye from the chronic, harder, nontender nodule of a chalazion.^[17] If available, slit-lamp biomicroscopy provides magnified views of the lesion, conjunctival injection, and gland involvement for precise localization.^[6] Visual acuity is generally unaffected unless significant swelling impairs the visual axis.^[1] Routine laboratory tests are not required for uncomplicated cases, as diagnosis is clinical based on history and examination findings.^[3] However, for recurrent or atypical presentations, a culture swab of any discharge may be performed to identify bacterial pathogens, and blood tests such as glucose or HbA1c could evaluate underlying conditions like diabetes.^[1]

Differential diagnosis

A stye, or hordeolum, must be differentiated from several other eyelid conditions that present with localized swelling or inflammation to avoid misdiagnosis. The primary mimics include chalazia, preseptal cellulitis, and various infectious or neoplastic lesions, distinguished primarily by history, onset, tenderness, and associated systemic signs.^[1] Chalazia are chronic, painless granulomatous lesions resulting from blocked meibomian glands, appearing as firm, nontender nodules without acute erythema or purulent discharge, in contrast to the acute, tender, pustular nature of a stye.^[1] Internal hordeola, which involve meibomian gland infection and point toward the conjunctival surface, are often initially misdiagnosed as chalazia due to similar subconjunctival localization and swelling, though they exhibit more pronounced pain and redness.^[18] Preseptal cellulitis presents with diffuse eyelid erythema and swelling extending beyond a single gland, often accompanied by fever or leukocytosis, lacking the discrete, focal pustule typical of a stye; it requires exclusion of orbital extension.^[1] Orbital cellulitis, a more severe mimic, involves deeper involvement with proptosis, ophthalmoplegia, and vision impairment, necessitating urgent imaging such as CT to confirm intraorbital spread and differentiate from localized hordeolum.^[19] Recent guidelines emphasize CT imaging for any suspicion of orbital involvement in eyelid infections to rule out complications like abscess formation.^[20] Other conditions to consider include herpes zoster ophthalmicus, which features painful, dermatomal vesicular eruptions along the trigeminal distribution rather than a solitary pustule; basal cell carcinoma, a persistent, non-resolving nodule often with telangiectasia or lash loss, requiring biopsy for confirmation; and sebaceous cysts, which are painless, fluctuant masses without inflammatory signs.^[1]^[21] Blepharitis may cause diffuse lid margin scaling and redness without a focal lesion, while molluscum contagiosum appears as umbilicated papules lacking tenderness.^[1] Diagnostic clues favoring a stye include acute onset (within 24-48 hours), localized tenderness, and central purulence on examination, whereas chronicity, lack of pus, or atypical features warrant further investigation such as biopsy for suspicious persistent lesions.^[1]

Treatment

Conservative management

Conservative management forms the cornerstone of treatment for uncomplicated styes, focusing on promoting natural drainage and resolution without invasive interventions. The primary approach involves applying warm compresses to the affected eyelid, which softens the blocked gland and facilitates the release of trapped sebum and pus. Patients are advised to use a clean, warm (not hot) cloth soaked in water around 40-45°C, applied for 10-15 minutes, 3-4 times daily, while gently massaging the eyelid afterward to encourage drainage without forcing it. This method is effective in accelerating healing, with most styes resolving spontaneously within 1-2 weeks.^[1] Eyelid hygiene plays a crucial role in preventing secondary infection and aiding recovery by removing debris and excess oils from the lid margins. Gentle cleansing should be performed daily using diluted baby shampoo or commercial lid scrubs applied with a clean cotton swab or cloth, followed by rinsing with warm water; it is essential to avoid squeezing, popping, or rubbing the stye to prevent spreading the infection. Over 70% of cases respond well to this combined hygiene and compress regimen, avoiding the need for further intervention.^[1]^[3] Supportive measures further alleviate discomfort and reduce irritation during the healing process. Artificial tears can be used as needed to lubricate the eye and relieve any associated dryness or grittiness. Additionally, patients should refrain from wearing eye makeup, contact lenses, or any ocular cosmetics until the stye has fully resolved to minimize bacterial contamination and promote faster recovery. If symptoms persist beyond 1-2 weeks despite these measures, escalation to pharmacological interventions may be necessary.^[1]^[3]

Pharmacological interventions

Pharmacological interventions are typically reserved for styes (hordeola) that do not respond to conservative measures such as warm compresses and eyelid hygiene, particularly when bacterial infection is confirmed or suspected.^[1]^[3] Topical antibiotics serve as the first-line pharmacological option for localized bacterial involvement. Erythromycin ophthalmic ointment, applied as a 0.5-inch ribbon to the conjunctival sac or lid margin four times daily for 7 to 10 days, is commonly prescribed due to its efficacy against Staphylococcus aureus, the primary pathogen in most styes.^[22]^[23] Bacitracin ointment may be used similarly as an alternative, especially in cases of mild external hordeola, to target gram-positive bacteria while minimizing resistance risks.^[24] These agents promote resolution by reducing bacterial load, though they are most effective when combined with drainage facilitation from prior conservative care.^[23] For severe, recurrent, or systemic cases—such as those involving periorbital cellulitis or multiple lesions—oral antibiotics are indicated to address deeper infection. Cephalexin, a first-generation cephalosporin, is often administered at 250 to 500 mg four times daily for 7 to 10 days, providing broad coverage against staphylococcal and streptococcal species.^[4] Dicloxacillin, an antistaphylococcal penicillin, serves as another option at similar dosing for non-MRSA suspects.^[4] In regions with high methicillin-resistant Staphylococcus aureus (MRSA) prevalence, trimethoprim-sulfamethoxazole (160/800 mg twice daily for 7 to 10 days) is preferred for its targeted coverage, particularly if risk factors like recent hospitalization are present.^[4] Anti-inflammatory agents, such as topical corticosteroids, are used rarely and only under close ophthalmologic supervision to prevent masking underlying infection or exacerbating it. Combination preparations like tobramycin-dexamethasone ointment (applied twice daily for 5 to 7 days post-drainage) may be employed in refractory cases to reduce inflammation once active infection is controlled, but monotherapy with steroids is avoided.^[25]^[24] Reviews indicate that antibiotics are unlikely to improve resolution rates beyond conservative measures and should be reserved for cases with signs of spreading infection, to help combat antimicrobial resistance.^[26]^[27]

Surgical procedures

Surgical procedures are reserved for styes, also known as hordeola, that fail to respond to conservative or pharmacological treatments, particularly when they form fluctuant abscesses or persist beyond 1 to 2 weeks.^[1] These interventions are indicated in cases of recurrent styes, progression to chalazia, or associated complications such as cellulitis, where drainage is necessary to alleviate symptoms and prevent further spread of infection.^[23] Incision and drainage (I&D) remains the primary surgical approach, typically performed as an outpatient procedure under local anesthesia by an ophthalmologist.^[1] The I&D procedure begins with the administration of local anesthetic to numb the eyelid. For external hordeola affecting the skin surface, a small incision is made through the skin and underlying orbicularis muscle to access the abscess, allowing pus to be released; for internal hordeola involving the conjunctival side, the incision is made internally via the conjunctiva to minimize visible scarring.^[23] Following drainage, curettage is performed using a curette to remove residual granulomatous material and debris from the cavity, promoting complete resolution.^[28] The procedure usually takes 15 to 30 minutes and is conducted in an office setting.^[29] Postoperatively, patients are advised to apply warm compresses several times daily to aid healing and reduce swelling, along with topical antibiotic and steroid drops or ointments to prevent infection and inflammation.^[29] Recovery typically occurs within one week, with instructions to avoid eye makeup or contact lenses during this period.^[30] I&D for styes carries a low complication rate, estimated at less than 5%, with potential risks including minor bleeding, infection, or recurrence, though success rates exceed 79% in resolving lesions.^[31] In select cases, particularly for recurrent or cosmetically sensitive chalazia evolving from styes, CO2 laser ablation can be used for precise incision and vaporization of tissue, offering reduced bleeding and faster healing compared to traditional methods.^[31]

Prognosis and prevention

Prognosis

The prognosis for a stye (hordeolum) is generally excellent, with most cases resolving spontaneously without long-term sequelae. Uncomplicated styes typically resolve within 1 to 2 weeks, even without intervention, though application of warm compresses and eyelid hygiene can accelerate drainage and reduce discomfort during this period.^[1] In mild cases, symptoms such as pain and swelling often subside within 3 to 7 days, while full resolution, including any residual swelling, occurs by 10 to 14 days in the majority of patients.^[5] Persistent styes beyond 2 weeks are uncommon and may indicate the need for further evaluation to rule out progression to a chalazion or underlying issues.^[32] Recurrence rates vary but are elevated in individuals with predisposing factors, such as chronic blepharitis or meibomian gland dysfunction, where repeated episodes can occur if these conditions remain unmanaged. Adherence to eyelid hygiene practices significantly lowers the likelihood of recurrence by addressing bacterial buildup and gland obstruction. Studies on recurrent hordeola highlight associations with Demodex mite infestation, particularly in adults, further emphasizing the role of targeted management in preventing cycles of infection.^[33] Long-term effects are rare and typically limited to cosmetic concerns like mild scarring or chalazion formation in unresolved or recurrent cases, with no impact on vision unless complications such as orbital cellulitis develop. Early intervention ensures an excellent overall outcome, minimizing any risk of chronic eyelid changes.^[1]

Prevention

Preventing styes involves maintaining good eyelid hygiene to reduce bacterial buildup and oil gland blockage. Daily scrubbing of the eyelids with a diluted solution of baby shampoo and warm water, using a clean cloth or cotton swab, helps remove debris and excess oils that can contribute to stye formation.^[34] Alternatively, over-the-counter hypochlorous acid sprays or lid scrubs can be applied to the closed eyelids to decrease bacterial load and support overall eyelid health, particularly for those prone to recurrent infections.^[35]^[27] Removing all eye makeup nightly is essential, as leftover residue can clog meibomian glands and promote bacterial growth.^[2] Adopting behaviors that minimize bacterial transmission and irritation further lowers risk. Individuals should avoid sharing personal items such as towels, pillows, washcloths, or cosmetics, as these can harbor Staphylococcus bacteria responsible for most styes.^[5]^[36] For contact lens wearers, thorough handwashing before handling lenses and proper disinfection using recommended solutions prevent introduction of pathogens to the eye area.^[37]^[2] Refraining from touching or rubbing the eyes with unwashed hands also reduces the chance of transferring bacteria from the skin or environment.^[34] Addressing underlying conditions is crucial for those at higher risk. Managing blepharitis through consistent eyelid hygiene and prescribed treatments, such as topical antibiotics if needed, can significantly decrease stye recurrence, as blepharitis often predisposes individuals to gland blockages.^[2]^[38] Similarly, controlling rosacea with dermatological care helps mitigate associated eyelid inflammation that may lead to styes.^[27] For people with diabetes, maintaining stable blood sugar levels through medical management reduces susceptibility, given the condition's link to impaired immune response and higher infection rates.^[39] Limiting heavy or prolonged use of eye makeup, especially oil-based products, avoids excessive gland occlusion.^[40]

Etymology

Word origin

The English term "stye," also commonly spelled "sty," originates from the Old English noun stīgend, meaning "rising" or "that which rises," which alluded to the swelling that protrudes on the eyelid. This form derives from the verb stīgan, "to rise" or "to go up," stemming from Proto-Germanic *stīganą and ultimately Proto-Indo-European *steigh-, connoting "to stride, step, or rise," evoking the idea of a pimple-like elevation.^[41] By the Middle English period, the term evolved into styanye around 1440, as recorded in the Promptorium Parvulorum, a late medieval English-Latin dictionary that cataloged medical vocabulary and described the condition as an eyelid pustule or boil in folk healing contexts.^[42] The modern spelling "stye" emerged in the early 17th century as a back-formation from styanye, through a folk etymology that reinterpreted it as "sty on eye," resulting in the alternative "sty" that persists in older texts despite no etymological link to the pig enclosure homonym.^[43] This linguistic development underscores its roots in everyday descriptions of ocular swellings within 15th-century English medical literature.^[44]

Terminology

The primary medical term for a stye is hordeolum, derived from the Latin hordeum meaning "barley," due to the swelling's resemblance to a grain on the eyelid margin.^[7] This Latin term is preferred in professional medical literature for its specificity in denoting the acute infection of eyelid sebaceous glands.^[1] In everyday usage, the condition is commonly called a "stye" in American English or "sty" in British English, with subtypes specified as hordeolum externum for infections of the external glands (e.g., glands of Zeis or Moll) and hordeolum internum for those affecting internal meibomian glands.^[4] These distinctions aid in precise clinical communication and guide targeted management. A hordeolum must be differentiated from a chalazion, the latter term originating from the Greek khalazion, a diminutive of khalaza meaning "small lump" or "hailstone," reflecting its firm, nodule-like appearance.^[45] Both represent eyelid inflammations, but a hordeolum is characteristically acute and infectious, often staphylococcal, whereas a chalazion is a chronic, sterile granuloma from gland blockage.^[1] Under the 2025 ICD-11 classification by the World Health Organization, hordeolum is standardized with code 9A01.2, encompassing hordeolum externum (9A01.20), hordeolum internum (9A01.21), and unspecified cases (9A01.2Z), facilitating consistent international reporting and epidemiology.^[46]

References

[1]
Stye (sty) - Symptoms & causes - Mayo Clinic
A stye is a painful lump near the edge of the eyelid that may look like a boil or a pimple. Styes are often caused by bacterial infections and may be filled ...
[2]
Hordeolum (Stye) - StatPearls - NCBI Bookshelf - NIH
A stye, or hordeolum, is an acute, painful ocular infection involving the sebaceous glands of the upper or lower eyelid.
[3]
Stye (sty) - Diagnosis & treatment - Mayo Clinic
Sep 20, 2025 · In most cases, a stye doesn't require specific treatment, but using warm compresses can hasten the healing. A stye typically goes away on its own.Missing: definition | Show results with:definition
[4]
Chalazion and Hordeolum (Stye) - Eye Disorders - Merck Manuals
A hordeolum (stye) is an acute, localized swelling of the eyelid that may be external or internal and usually is a pyogenic (typically staphylococcal) infection ...
[5]
Stye (Sty): What It Is, Causes, Symptoms & Treatment
A stye is a painful red bump on the edge of your eyelid. Similar to an acne pimple, a stye forms when a tiny oil gland near your eyelashes becomes blocked and ...
[6]
Hordeolum (stye) | AOA - American Optometric Association
A hordeolum, commonly called a “stye”, is an infection of an oil gland at the edge of the eyelid and results in pain, swelling and redness.
[7]
What is a stye and how do you treat it? - Moran CORE
So, stigan + eie = sty + eye = stye! Stye was first recorded in the 17th Century. Etymology of “Hordeolum”: derived from hordeum, which is Latin for “barley” ...
[8]
What are the differences between a stye, a chalazion, an internal ...
A stye or external hordeolum is an infection of the gland of Zeis which opens into the eyelash follicle. There will be erythema around the eyelash follicle ...Missing: medical | Show results with:medical
[9]
Hordeolum: Background, Pathophysiology, Epidemiology
Dec 30, 2024 · A hordeolum, commonly known as a stye, is an acute infection of the eyelid, typically caused by staphylococcal bacteria.Background · Pathophysiology · Epidemiology
[10]
Hordeolum and Chalazion | The Color Atlas of Pediatrics
In one study of school-age children in Brazil, the prevalence of chalazion was found to be 0.2 percent and that of hordeolum was 0.3 percent.
[11]
Causes, symptoms and details of Stye - Pulse Reference
While exact prevalence figures vary, styes are estimated to affect approximately 1 in 1,000 individuals each year. Although they can occur at any age, styes are ...Missing: incidence | Show results with:incidence
[12]
Impact of COVID-19 in the present of ophthalmology focusing on ...
The participants agreed that the frequency of patients with dry eye disease (75%), stye/chalazion (62%) and blepharitis (60%) has increased. According to 28%, ...Missing: post- hygiene<|control11|><|separator|>
[13]
Stye - EyeWiki
Oct 28, 2025 · External hordeolum (or stye) of the left upper eyelid. Fluorescein dye from the ocular examination is seen on the lower eyelid.
[14]
Hordeolum (Stye) - MD Searchlight
In about 90% to 95% of cases, this infection is caused by a bacteria known as Staphylococcus aureus, with another kind of staph bacteria, Staphylococcus ...Missing: percentage | Show results with:percentage
[15]
Hordeolum (Stye) | Concise Medical Knowledge - Lecturio
Aug 4, 2025 · Stasis of the gland secretions predisposes the glands to bacterial infection. Staphylococcus aureus is the most common pathogen.<|control11|><|separator|>
[16]
Dermoscopic detection of unusual eyelash Trichophyton ...
Dear Editor, A 4‐year‐old girl presented with an acute, painful raised mass on the left upper eyelid mimicking hordeolum (stye) (a). Dermoscopy revealed ...
[17]
Stye and chalazion - Symptoms, diagnosis and treatment
Risk factors. age 30-50 years; blepharitis and ocular rosacea; seborrheic dermatitis; elevated serum cholesterol; diabetes mellitus; poor eyelid hygiene; ethnic ...
[18]
Unmet needs for patients with seborrheic dermatitis - ScienceDirect
Among Black women, for whom SD is more common than in other groups in the United States, the condition is exacerbated by increased use of pomade hair styling ...Missing: stye | Show results with:stye<|separator|>
[19]
How to treat an eye infection due to MRSA - MedicalNewsToday
May 29, 2025 · How can MRSA infect the eye and what treatment options are available? Read on to learn more about MRSA eye infections.
[20]
Eyelid Disorders: Diagnosis and Management - AAFP
Jun 1, 1998 · A hordeolum, also known as a stye, is an acutely presenting, erythematous, tender lump within the eyelid (Figure 5). An internal hordeolum ...
[21]
Hordeolum and chalazion - JAAPA
Internal hordeolum involves a meibomian gland abscess that usually points onto the conjunctival surface of the lid and can be mistaken for a chalazion. A ...
[22]
Clinical Practice Guidelines : Periorbital and orbital cellulitis
Orbital cellulitis is an emergency with serious complications including intracranial infection, cavernous sinus thrombosis and vision loss · Urgent imaging and ...
[23]
Between the Septal Divide: Managing Preseptal and Orbital Cellulitis
Nov 15, 2024 · Symptoms include localized redness (erythema), swelling (edema) and discomfort or pain in the affected area.
[24]
Differential Diagnosis of the Swollen Red Eyelid - AAFP
Jul 15, 2015 · A hordeolum, or stye, is a well-defined, often painful mass at the eyelid margin, commonly caused by bacterial infection of the follicle of the ...
[25]
Hordeolum (Stye)/Chalazion | Johns Hopkins ABX Guide
Jan 17, 2023 · Comment: Conservative therapy with lid hygiene was approximately 80% effective in treating chalazia. Warm water and table salt solution were ...Missing: management | Show results with:management
[26]
What are the best antibiotics for treating a stye (hordeolum)?
Aug 18, 2025 · For styes (hordeola), warm compresses and topical antibiotics such as erythromycin or bacitracin ointment are the first-line treatment, ...
[27]
Hordeolum Treatment & Management: Medical Care, Surgical Care
Dec 30, 2024 · Medical therapy for hordeola includes eyelid hygiene (lid scrubs), warm compresses of the lesions for 10 minutes 4 times per day, and topical antibiotic ...
[28]
What antibiotics treat a stye (hordeolum)? - Dr.Oracle
Oct 10, 2025 · Oral Antibiotic Options · Clindamycin (300-450 mg four times daily) · Cephalexin (250-500 mg four times daily) · Doxycycline (100 mg twice daily) ...
[29]
Chalazion Medication: Antibiotics, Corticosteroids
Aug 18, 2024 · Topical steroids can be helpful in minimizing inflammation and in reducing edema, thereby facilitating any drainage that may take place.
[30]
Stye Medicine: Prescription and OTC Eye Drops and Ointments
In severe cases, a doctor may prescribe a steroid after draining a hordeolum with surgery. Once the infection has been drained, a steroid can ease swelling.
[31]
https://www.tandfonline.com/doi/full/10.1080/02713683.2023.2279014
[32]
Efficacy of Care and Antibiotic Use for Chalazia and Hordeola - NIH
A total of 2,712 patients met inclusion criteria. Management with an antibiotic was observed in 36.5% of patients. An antibiotic was 1.53 times (95% CI, 1.06– ...<|control11|><|separator|>
[33]
Hordeolum: Causes, Symptoms, Treatments, Recovery
Nov 29, 2022 · Hordeolum, Stye, or Sty is caused by bacterial infection of the sebaceous (Zeis) glands, sweat (Moll) glands or meibomian glands of the eyelid.Missing: definition | Show results with:definition
[34]
Stye Treatment, Surgery · Top Rated Eye Doctor - NYC
Risks of Stye Surgery. There are potential side effects and complications associated with chalazion or stye surgical removal that include: Infection ...
[35]
Stye (Chalazion) Treatment London | Private Eye Specialist
Jun 9, 2025 · After a chalazion drainage procedure, it's best to wait 1 to 2 weeks before applying makeup to the eyelid. This gives the incision site time ...How Common Are Styes And... · Treatment Options · Frequently Asked Questions<|separator|>
[36]
Full article: Chalazion Treatment: A Concise Review of Clinical Trials
The surgical treatment performed better with higher rate of resolution, 90% vs 70% in the small, 88% vs 50% in the medium and 100% vs 0% in the large chalazia ...
[37]
A pilot study on the efficacy of 10600 nm carbon dioxide laser ...
Sep 16, 2024 · The overall findings of our study demonstrated that CO2 ablative lasers can be used safely for treating benign eyelid margin lesions with a ...
[38]
Laser Chalazion Removal - ResearchGate
May 28, 2025 · CO2 laser excision of chalazion can be done successfully in the office with minimal to no bleeding and with complete extirpation of the ...
[39]
How long does a stye last? Duration and treatment
Feb 28, 2020 · They usually clear up on their own within 1–2 weeks and may not require medical treatment. Applying a warm compress may help speed up healing.
[40]
Clinical characteristics of Demodex-associated recurrent hordeola
Nov 1, 2021 · In the recurrent hordeolum group, Demodex mites were found in 74 (68.5%) and 17 (37.8%) of the adult and pediatric patients (p < 0.001), ...
[41]
Blepharitis vs Stye: What's the Difference and How are They Treated?
May 1, 2025 · Both styes and blepharitis can be painful and annoying. However, the right treatment can help you find relief from the itchy and inflammatory ...
[42]
Understanding Stye -- Prevention - WebMD
Also, don't put expired makeup, used towels, or dirty hands on your eyelids. A tender spot near your eyelashes can be an early warning sign of a stye. Apply a ...Missing: hygiene | Show results with:hygiene
[43]
[PDF] Blepharitis Preferred Practice Pattern®
Sep 22, 2023 · Reduction in bacterial load using hypochlorous acid hygiene solution on ocular skin. Clin Ophthalmol. 2017;11:707-714. Page 35. Blepharitis ...<|control11|><|separator|>
[44]
Stye - EyeWiki
Oct 28, 2025 · Primary Prevention Daily eyelid hygiene with a mild soap and warm water is necessary to reduce the incidence of styes. Eyelid and face make-up ...
[45]
Stye: Causes, Symptoms, & Treatment | John A. Moran Eye Center
Styes frequently recur. Your ophthalmologist may recommend a small biopsy (tissue sample) of the stye to rule out underlying medical conditions. How Do You ...Missing: rate | Show results with:rate
[46]
Stye Causes, Treatment, and Prevention - Healthline
Jul 18, 2022 · A stye is a lump on your eyelid caused by a bacterial infection. Improperly sanitized contact lens, eye makeup, and conditions like diabetes ...Overview · Treatment · PreventionMissing: definition | Show results with:definition
[47]
What Is the Difference Between a Stye and a Chalazion?
Mar 24, 2025 · Blepharitis increases the risk of developing a chalazion or stye. Anyone can get a stye or chalazion. But you are even more likely to get ...
[48]
Internal Stye: Symptoms, Causes & Treatment - Cleveland Clinic
Nov 28, 2022 · An internal stye (hordeolum) is an inflamed and infected oil gland on the inner edge of your eyelid. Symptoms include eyelid pain, tenderness and swelling.Missing: follicle | Show results with:follicle
[49]
How To Use Cosmetics Safely Around Your Eyes
Aug 20, 2024 · Always apply makeup outside the lash line, away from the eye, to avoid blocking the oil glands of the upper or lower eyelid. These glands ...Missing: hygiene | Show results with:hygiene
[50]
Sty - Etymology, Origin & Meaning
"Sty" originates from Old English and Proto-Germanic roots; it means a pig pen, an inflamed eyelid swelling, or to go up/ascend, reflecting its varied ...
[51]
styany, n. meanings, etymology and more | Oxford English Dictionary
The earliest known use of the noun styany is in the Middle English period (1150—1500). OED's earliest evidence for styany is from around 1440, in Promptorium ...Missing: styanye | Show results with:styanye
[52]
STYE Definition & Meaning - Dictionary.com
Word History and Origins. Origin of stye. C15 styanye (mistakenly taken as sty on eye ), from Old English stīgend rising, hence swelling, stye + ye eye.Missing: etymology | Show results with:etymology
[53]
STY Definition & Meaning - styes - Merriam-Webster
Sep 21, 2025 · ... Old English stig pen; pigpen; akin to Old Norse svīnsti pigpen. Noun (2). short for obsolete English styan, from Middle English styanye eye ...
[54]
What is a chalazion and how do you treat it? The many faces of ...
Dec 19, 2021 · Etymology: The Greek word “khalaza” means a “small knot”. The diminutive of “khalaza” is “khalazion”. Singular: “Chalazion”; Plural: “Chalazia” ...
[55]
Hordeolum - ICD-11 MMS - Find-A-Code
sections/codes in this section (9A01.2-9A01.2) · Hordeolum externum (9A01.20) · Hordeolum internum (9A01.21) · Hordeolum, unspecified (9A01.2Z).