A stye, medically Hordeolum, usually takes a harmless course, but is perceived as painful and unpleasant. What are the underlying causes of this glandular infection on the eye and what forms of treatment prove effective?
What is a stye?
A stye on the eye. The skin is red, swollen, and painful. A stye, also known as a hordeolum, is an acute inflammation of the glands of the eyelid caused by bacteria that causes a small thickening to form. If the meibomian glands (sebaceous glands) located on the inner side of the eyelid become inflamed, an internal sty (hordeolum internum) is present. If, on the other hand, the minor glands (sweat glands) or the Zeis glands (sebaceous glands) on the outer side of the eyelid are affected, this is called an external sty (hordeolum externum). Thus, while the inner sty is located on the inner side of the eyelid, as the name suggests, the outer sty occurs either in the area of the eyelashes or on the edge of the eyelid.
Causes
Both internal and external styes are caused by bacteria, particularly staphylococci such as the skin germ Staphylococcus aureus. Infection by streptococci, on the other hand, occurs much less frequently. In general, a weakened immune system increases the risk of bacterial infection. Poor hygiene, for example rubbing the eyes with dirty hands, can also be the cause of a stye. If a stye occurs repeatedly or simultaneously in different places on the eye, it is recommended to have diabetes mellitus clarified by a doctor.
Symptoms, complaints, and signs
The symptoms of a stye sometimes depend on its exact location. It is an acute inflammation of the eyelid. Basically, a stye on the eye is easy to recognize. The affected eyelid is reddened, sensitive to pressure and visibly swollen. Those affected experience severe pain, which can significantly limit them in their daily lives. The stye fills with pus after some time. This is often associated with a strong feeling of tension. The pus can drain off when the stye opens inward or outward on its own. Depending on the exact location of the affected eyelid glands, the sty causes different symptoms. In the case of an internal sty (hordeolum internum), the inflammation is located on the inner side of the eyelid. Sometimes the sty is hardly visible. It can also lead to conjunctivitis. The external sty (hordeolum externum) is usually clearly visible. The affected eyelid glands are located at the outer edge of the eyelid, often at the edge of the eyelid or at the eyelashes. Normally, the symptoms of stye are limited to the eye itself. In rare cases, there is also a general feeling of illness, swelling of the lymph nodes or fever.
Diagnosis and course
Usually, a stye can be diagnosed by visual inspection. If it is an internal stye, so-called ectropionization, i.e., folding the eyelid outward, may be necessary to detect the inflammation. In the case of a stye, local redness is followed over time by painful swelling of the affected area to a small thickening filled with pus. The meibomian glands located on the inner side of the eyelid are larger than the glands located on the outer side, so the inflammation is usually more pronounced compared to the hordeolum externum in an internal stye. Due to the severe swelling of the eyelid, the eyeball itself is often no longer visible in this case. Symptoms such as fever, headache, swollen lymph nodes or a general feeling of illness rarely occur with a stye. However, if these are present, a doctor should be consulted immediately. As a rare complication of a stye, an extension of the infection may occur and lead to orbital phlegmon (inflammation of the orbit) or an extensive eyelid abscess.
Complications
A stye is an inflammation of the conjunctiva that can cause various complications. These should not be taken lightly in any case, otherwise even serious consequential damage can occur. In general, the following applies for this reason: Anyone suffering from a stye should in any case consult a doctor.Only with the help of appropriate treatment can consequential damage be avoided. It is not uncommon for pus to form and for severe pain to occur at night. The eye will also become very red and, especially in the morning hours, will be immensely stuck together by the pus fluid. Under certain circumstances, an abscess can form from such an inflammation in the eye. Such an abscess, if left untreated, will enlarge greatly and build up internal pressure. This internal pressure occurs because the accumulation of pus cannot drain properly. If the bacteria inside get into the bloodstream, then even blood poisoning can occur.
When should you go to the doctor?
In the case of a small stye that does not lead to any other adverse effects, it is not necessary to see a doctor. As soon as it is possible to stop the itching and keep calm, a visit to the doctor can be dispensed with. A doctor should be consulted as soon as a stye develops for the first time. It is particularly advisable for children to see a doctor as soon as possible, as they are often overwhelmed by the situation. If the stye grows abruptly over several days, action is required. If there are disturbances in vision, headaches or a general feeling of indisposition, it is necessary to consult a doctor. If the itching causes open sores or fluid leaks from the affected area, a doctor is needed. If the affected person uses visual aids, there may be problems that should be examined by a medical professional. If there is a feeling of illness, further skin changes, pain or fever, a visit to the doctor is required. If the stye does not slowly regress within a week, a follow-up visit to a physician should be made. If the visual blemish leads to psychological abnormalities, help should be sought. In case of a strong tearful behavior, depressive moods or melancholy, it is advisable to contact a doctor or therapist.
Treatment and therapy
The doctor will take a closer look at the stye in order to initiate further treatment options. As a rule, a stye is harmless: it breaks open after a few days and releases the pus, allowing the inflammation to heal on its own. This process can be accelerated by dry heat, for example by irradiation with a red light lamp. Antibiotic and antiseptic eye drops or ointments from the doctor can also be helpful. Moist heat, for example in the form of compresses with chamomile, is not advisable because of the risk of spreading the pathogens. Contact lenses should also not be worn in the event of a stye. If the stye does not open by itself and the pressure pain increases, it is advisable to have it opened by an ophthalmologist under local anesthesia by means of a puncture. Under no circumstances should the stye itself be squeezed out with the hands or an object. The so-called chalazion, which resembles the stye externally but is painless, should be differentiated. As in the case of the internal sty, the meibomian glands on the inner side of the eyelid are inflamed. However, this is a chronic inflammation and not an acute inflammation as in the case of the stye.
Outlook and prognosis
The prognosis of a stye is favorable. Normally, it heals on its own within a few days. After one to two weeks, freedom from symptoms occurs. Medical treatment is not always necessary. In many patients, natural healing of the infection takes place. A few days after the onset of the disease, the affected area opens and the fluid inside drains away. Complications can occur if there is friction on the eye or if the stye is in a very awkward position. Very rarely conjunctivitis or swelling of the conjunctiva develops. This worsens the good prognosis and delays the healing process. There is a risk that the inflammation may spread to the orbit. Therefore, if complications occur, medical treatment should be initiated as soon as possible. In particular, patients diagnosed with immunodeficiency should accept the help and support of a physician. Otherwise, there will be a deterioration of their health. In the course of life, the formation of a stye can occur again at any time. The prognosis remains positive in case of repeated infection.Since the risk of infection is very high, sufferers must exercise particular caution. In principle, a stye should never be squeezed. This worsens the favorable prognosis and causes the inflammation to spread.
Prevention
Children are more likely to be affected by a stye than adults. To avoid transferring the pathogen from the inflamed eye to the healthy eye with the hands, it is important to pay attention to regular hand washing. Overall, it is advisable not to share towels and other hygiene items with other family members as a preventive measure. In addition, since a weak immune system increases the likelihood of a stye occurring, exercise and a healthy, balanced diet are recommended preventive measures.
Aftercare
A stye is a bacterial infection that naturally requires appropriate aftercare. In general, the chances of complete healing are very good, provided that appropriate hygiene measures are observed. Only if the affected eye is kept clean and pure can a quick and complete recovery be expected. Subsequent aftercare can accelerate and promote the entire process of healing. However, such follow-up care is not mandatory for a stye, so complete healing is possible even without subsequent follow-up appointments. Such aftercare is not mandatory, since a stye usually heals after a few days. After healing is complete, no further treatment at all is necessary, so that further treatment by the doctor can be dispensed with. The aftercare is different if complications occur during the healing process. In such a case, a doctor should be consulted in order to avoid further complications and complaints. Great importance should also be attached to the subsequent aftercare in order to avoid further complications or permanent damage. The eye is a delicate and at the same time one of the most important organs, so proper treatment is of great importance.
What you can do yourself
In most cases, a stye heals on its own. Heat, such as from red light irradiation or a cherry pit pillow, can speed up this process. At first, however, the region around the hordeolum should be spared and, if possible, not touched with the fingers. Very important: never open the lump yourself. Direct contact can aggravate the infection and delay recovery. It is also important to avoid moist heat in compresses, as this can lead to the spread of bacteria. Fenugreek seed, preferably applied to a linen cloth, on the other hand, is beneficial for healing. So is eyebright or apple cider vinegar, both also for external application to the affected eyelid. In case of itching or pain, it helps to dab the inflamed eyelid with lukewarm fennel or chamomile tea. Since a stye indicates a weakened immune system, vitamin preparations can be taken concomitantly. In the long term, a healthy lifestyle with a balanced diet and regular exercise is recommended. Sufficient fluids should also be drunk – ideally two to three liters of water daily. To be on the safe side, contact lens wearers should use a new lens or have the lens cleaned by an ophthalmologist to prevent re-inflammation.