The common stye
The stye is one of the most common eyelid disorders found among the general population. It is often self-treated by the patient using various home remedies. Consequently, lids or eyes may be damaged from improper care, or the occurrence may continue beyond what would normally be necessary. Understanding the etiology, diagnosis, and treatment of this common disorder provides the school nurse and health educator with an opportunity to inform students of this condition and give them insight into the fundamentals of bacterial infection, the bodies physiological response, and some ocular anatomy.
Etiology. The external hordeolum (common stye) is an inflammatory disease caused by an acute staphylococcal infection of the glands of Zeis and Moll (Table 1) (Figure l) within the margin of the eyelid. (1-4) It is essentially an abscess, since pus forms within the lumen of the affected gland. This inflammation is usually localized, but may be associated with staphyococcal blepharitis. Lesions are often associated with fatigue, poor diet, and stress, and can be recurrent. (5)
Diagnosis. The lesion usually is characterized by a localized area of redness, tenderness, and swelling near the lid margin. The primary symptom is localized pain of recent onset. Intensity of pain is in direct proportion to the amount of lid swelling. Within a few days of onset of redness and tenderness, the localized area will develop a yellow point to the skin side of the lid margin. In most cases the abscess will spontaneously drain within three-four days following pointing.
Treatment. Applying hot compresses for 10-15 minutes several times daily will hasten pointing and drainage. Hot compresses increase both tissue temperature and blood flow. (6) This process increases activity of hydrolytic enzymes, which hastens pointing and drainage. (7) Most external hordeola resolve in one-two weeks. Topically applied antibiotic solutions or ointments several times daily may be used to prevent infection of surrounding lash follicles, but this process will not affect the course of the external hordeolum itself. (8) One method to hasten drainage of the external hordeolum is to epilate (remove a hair and its root) the lash, which effectively creates a drainage channel.
For lesions resistant to this...