What are the other Names for this Condition? (Also known as/Synonyms)

• External Hordeolum
• Internal Hordeolum
• Stye

What is Hordeolum? (Definition/Background Information)

• Hordeolum is a benign condition that appears as a warm, tender bump on or inside the eyelids. It occurs due to an infection of the eyelid glands that produce the oils for the tear film
• Usually, the oil glands inside the eyelids get infected with staphylococcus bacteria, causing a Hordeolum. This may occur in:
  • Individuals who practice poor eyelid hygiene
  • Individuals, who are more prone to having clogged oil glands, due to an insufficient secretion of lipids into the tear film
• There are 2 different types of Hordeolum:
  • Internal Hordeolum: It is a painful lump that occurs inside the eyelid
  • External Hordeolum: It is most commonly referred to as a Stye and is a painful lump that occurs on the eyelid, near the eyelashes. This is the more common subtype of Hordeolum
• There are 3 types of oil glands that contribute to the lipid layer of the tear film. These are the -
  • Meibomian glands
  • Zeis glands
  • Moll glands
• If the meibomian glands are infected, it will cause Internal Hordeolum; if the Zeis or Moll glands are infected, it will cause External Hordeolum
• The signs and symptoms of Hordeolum may include redness of the eye, pain, discharge from the lump, photosensitivity, and general discomfort
• The treatment options may include conservative measures for providing relief from the symptoms and surgery in some cases of recurrence. The prognosis of Hordeolum is generally excellent with suitable treatment, although recurrence of the eyelid lump is possible

Who gets Hordeolum? (Age and Sex Distribution)

• Adults more likely to develop a Hordeolum than children, though the condition is not age-specific. Adults usually produce thicker oils and are more likely to have inflammation of the oil glands from degenerative changes, increasing the likelihood of infection
• It tends to affect men and women equally and is gender non-specific, although wearing eye makeup can increase the likelihood of developing a Hordeolum
• There is no known racial or ethnic predilection, but it may be more common in certain geographical regions where poor eyelid hygiene is practiced 

What are the Risk Factors for Hordeolum? (Predisposing Factors)

The risk factors for Hordeola (plural of Hordeolum) include:

• Poor eyelid hygiene
• Using unclean hands often to rub or wipe the eyes
• Meibomian gland dysfunction
• Blepharitis (inflammation of the eyelid)
• The use of regular eye make-up

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Hordeolum? (Etiology)

The causative factors for Hordeolum include:

• Staphylococcus bacteria present on the eyelids can cause blepharitis, or inflammation of the eyelids
• Eventually, the staphylococcus bacteria can get inside the oil glands of the eyelids, leading to an infection, if poor eyelid hygiene is practiced consistently

What are the Signs and Symptoms of Hordeolum?

The signs and symptoms of Hordeolum that affect the eye include:

• Tender area of swelling, or bump, inside or on the surface of the eyelid
• Pain
• Warmth and redness of the eye
• Mucopurulent discharge (pus leaking from the affected area)
• Increased light sensitivity
• Excessive tear formation
• Presence of foreign body sensation within the eye

How is Hordeolum Diagnosed?

Hordeolum may be diagnosed using the following methods:

• Complete physical examination with study of medical history
• Presence of a tender and painful bump inside or on the surface of the eyelid upon palpation
• Rarely, culture of the infected tissue can help determine the type of bacteria causing the infection. This can help with treatment options

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Hordeolum?

Complications due to a Hordeolum could include:

• Recurrence of the benign lump, even after treatment
• Spread of infection to other areas, such as the nasolacrimal system (in rare cases)
• Dry eye syndrome, if the infection spreads to the lacrimal glands and ducts
• Cosmetic disfigurement due to scarring
• The treatment methods employed may cause a loss of skin coloration around the region, or even corneal deformation
• Complications may arise, during or due to the surgery, such as infection, accidental injury to the neighboring tissue, or bleeding

How is Hordeolum Treated?

The treatment measures for Hordeolum may include:

• Warm compresses to the affected area several times per day
• Digital massage to the affected area several times per day
• Oral antibiotics to treat Internal Hordeolum and topical antibiotics to treat External Hordeolum
• If the lump is painful, then over-the-counter medications may be prescribed to relieve pain
• In recurrent cases, a surgery may be performed to drain the fluid

How can Hordeolum be Prevented?

Preventive methods for Hordeolum could include the following measures:

• Keep your hands clean by washing them regularly, which will help prevent an eye infection and the its spread from the eye
• Do not pull or squeeze the eye lump; it can cause the infection to spread and the eyelids to scar
• Do not use old make-up for eyelashes, since this can be a source of infection
• Do not cover the Hordeolum with make-up, for it might make the condition worse. Also, remove make-up before going to bed
• Using baby soap to gently wash the affected area may prevent recurrence
• Daily digital eyelid massages after warm compresses or in a hot shower can improve secretion of oils (which can help prevent clogging)
• Use of daily over-the-counter eyelid scrubs

What is the Prognosis of Hordeolum? (Outcomes/Resolutions)

• The prognosis of Hordeolum is excellent with appropriate treatment
• With several warm compresses and/or eyelid massages per day, Hordeolum will typically begin to drain in about a week
• The use of antibiotics can resolve the condition in about a week, if warm compresses do not resolve it
• The condition can also resolve with no treatment intervention, but it may take several weeks

Additional and Relevant Useful Information for Hordeolum:

• A Hordeolum is not to be confused with chalazion, for Hordeola are infections and present as tender, painful lesions
• A chalazion is a clogged meibomian gland (non-infectious) that is present as a painless lesion
• If you believe you may have a Hordeolum or a Stye, it is always best to obtain an official diagnosis by an eye doctor to rule out more serious and rarer conditions