Hordeolum is infection of the glands of the eyelid. When the meibomian glands are involved, a large swelling occurs called internal hordeolum . The smaller and more superficial external hordeolum (stye) is an infection of Zeis's or Moll's glands. Pain, redness, and swelling are the principal symptoms. The intensity of the pain is a function of the amount of lid swelling. An internal hordeolum may point to the skin or to the conjunctival surface. An external hordeolum always points to the skin.
Most hordeola are caused by staphylococcal infections, usually Staphylococcus aureus. Culture is seldom required. Treatment consists of warm compresses three or four times a day for 10–15 minutes. If the process does not begin to resolve within 48 hours, incision and drainage of the purulent material is indicated. A vertical incision should be made on the conjunctival surface to avoid cutting across the meibomian glands. The incision should not be squeezed to express residual pus. If the hordeolum is pointing externally, a horizontal incision should be made on the skin to minimize scar formation.
Antibiotic ointment applied to the conjunctival sac every 3 hours is beneficial. Systemic antibiotics are indicated if cellulitis develops.
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Hordeolum, internal and external curtesy by Vaughan and Asburys General Ophthalmology
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