Daily Bolus of LR: Hordeolum

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March 10, 2011 by dailybolusoflr



A hordeolum, more commonly known as a stye in layman’s terms, is a localized but acute inflammatory process involving the sebaceous glands or hair follicles of the eye.


·         Upwards of 90% of these are caused by Staphylococcus species.

·         Internal hordeola may drain onto the conjunctival surface, while external hordeola may drain from a focal point at the lash line.


These patients typically have focal redness, swelling and pain at the site of the hordeolum, although diffuse lid edema may also be present.


Conservative management involves:

·         Warm compress for 10-15 minutes at least 4 times a day.

·         Topical antibiotics such as erythromycin (although this is unproven in the literature to help)


If conservative management does not initiate drainage (rare cases) consideration can be made to a stab incision with an 18G needle or an 11-blade scalpel.  If incision is performed, all attempts should be made to sty on the internal surface and as far away from the actual pointed surface.  This will decrease the chance of an internal to external fistula formation. 


Click on the following link to see a picture.






Linda Regan, MD FACEP

Program Director, Emergency Medicine Residency

Johns Hopkins Medical Institutions


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