Symptoms
A barleycorn (Hordeolum, from Latin , barley) manifests as an inflammatory and painful swelling of an eyelid margin gland on the edge of the eyelid or on the inner side of the eyelid with redness and pus formation. Other possible symptoms include an uncomfortable foreign body sensation, lidoedema, eye tearing, irritation, and conjunctivitis. Styes may rarely affect multiple glands and may be recurrent. Other complications include spread of the infection to the surrounding skin (cellulitis) and the development of a hailstone.
Causes
Underlying cause is an acute bacterial infection of the eyelid margins with . Rarely, other bacteria are involved. An infection of the sebaceous glands (Zeis glands) and Moll glands (sweat glands) at the edge of the eyelid is referred to as an external stye. An infection of the meibomian glands on the inner side of the eyelid is called an inner sty. The pathogens are transmitted, for example, as a smear infection. Hordeola often occurs in association with inflammation of the eyelid margin.
Diagnosis
Diagnosis is usually made in medical treatment on the basis of the clinical picture and, in some cases, with a bacterial culture. A painless lump below the edge of the eyelid suggests a hailstone. Other possible differential diagnoses include lid margin inflammation, conjunctivitis, foreign bodies, and xanthoma.
Nonpharmacologic treatment
A stye usually resolves on its own within 1-2 weeks. After maturing, it deflates and heals.
- Heat (red light irradiation) or with a small stitch incision can facilitate the breakthrough of the pus under medical treatment.
- In self-medication, warm compresses are used, which are applied several times a day.
- A good eyelid margin hygiene (eg Systane) and massage the eyelid margin is also recommended.
- Squeezing and additional irritation by cosmetics or contact lenses should be avoided.
- Wash hands regularly with soap.
Drug treatment
Antibiotic eye drops or ointments are used to treat the infection and inhibit further spread. Agents approved for this indication in many countries include gentamicin (Ophtagram), framycetin (Soframycin), polymyxin B, and neomycin (Spersapolymyxin); other agents are mentioned in the literature. Oral antibiotics are used in a severe or complicated course. Hexamidine (Desomedin) is approved for self-medication in this indication. Irgamid eye ointment is no longer commercially available. In alternative medicine, eyebright ophthalmics, for example, are used. They are available without a doctor’s prescription.
