Hordeolum and Chalazion

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Overview

Hordeolum (stye) and chalazion are problems that can occur at the level of a small sebaceous glands of the upper or lower eyelid. The stye (or the external hordeolum) is a small infection of sebaceous glands in the eyelid, which surrounds the base of an eyelash. Initially, it appears as a small, soft, red swelling, which reaches a maximum in 3 days. The stye then breaks, drains and heals in about a week. The internal hordeolum, as the stye is an infection. This instead affects the sebaceous gland deeper inside the eyelid. They are usually bigger and stay longer than the stye.
A chalazion is an inflammation of the deep sebaceous glands of the eyelids. It is not an infection. A typical chalazion develops slowly over a period of 2-3 weeks, usually without eye pain.
 
Article Content:
Overview
Causes
Symptoms
Investigation
Treatment
Prophylaxis
Home Treatment


Causes

The cause of the stye is often unknown, but it may occur because of:
- the rubbing of the eyelid, thus irritating the sebaceous glands. The bacteria on the hands can cause infection
- the use of mascara, eyeliner and other cosmetics that can irritate the eye. If these products are contaminated with bacteria, an infection may develop.
A chalazion may develop from an internal hordeolum that does not drain and does not heal. When the pores of the sebaceous glands are blocked, both an internal hordeolum and a chalazion can occur. Thus, the pores no longer drain and get inflamed. Another problem that can be added or with which the stye can be confused is an infection or inflammation of the eyelid called blepharitis.


Symptoms

The internal hordeolum, though deeper into the eyelid, has the same symptoms as the stye. A chalazion tends to grow slower and deeper into the eyelid than the stye, generally not causing pain and persisting for several months. A chalazion can form a cyst under the skin, especially when the pores of the glands are blocked and the substanes are formed within the gland. The inflammation and swelling can spread to surrounding eye area, for example to the eyebrows. It can expand enough in order to interfere with the eyesight.


Investigation

It is often difficult to differentiate between stye and chalazion, which are mild eyelid diseases. Both are diagnosed through a careful visual examination of the eyelid. If there is a hard swelling inside the eyelid, this is frequently diagnosed as a chalazion.
If the stye does not heal with home treatment, the fluid from inside can be examined in order to determine the exact bacteria that caused the infection and the proper treatment. The stye starts as a red, sensitive spot at surface of the eyelid along the eyelash line. This transforms itself in a small, soft blister, like acne. The eye may tear and the eyelid may be painful. Typically, the stye develops a head (white or yellow fluid is collected) which breaks in about 3 days. After the opening of the stye, this heals and disappears.


Treatment

Home treatment is enough for most styes and internal hordeolums, minor problems of the eyelid. If home treatment is unsuccessful, you may need a prescription ointments or eye drops. It is necessary to consult a specialist if:
- A stye becomes very painful, grows very quickly and continues to drain (particularly if it drains pus)
- Redness and swelling exceed the outside of the eyelid, its inside or it is in the eye
- There are eyesight problems
- The stye does not get better after three days of home treatment or does not heal after a week of treatment.
 
If the infection spreads to the eyelid or eyebrow, treatment with oral antibiotics may be needed. If a very big stye does not heal with home treatment or a chalazion is bulky enough in order to interfere with the eyesight – it must be incised by a specialist so that it drains and heals then. After this procedure, an antibiotic with ointment or eye drops will be used.
The specialist may recommend washing the eyelid or along the eyelash line with fine soap or gentle shampoo (one for children for example) to reduce the chance of infection if the a history of recurrent stye or signs of blepharitis do exist. You can make a fine soap at home mixing non-irritating soap like baby shampoo, with an equal amount of warm water. Usually 30 ml of each is enough. A clean towel or cotton wool soaked in the prepared solution will be used for the gentle cleaning of the eyelid.


Prophylaxis

In order to prevent the stye, the internal hordeolum and a chalazion:
- Do not rub eyes, which can irritate them and spread infection
- Protect the eyes from dust and pollutants from the air by wearing protection eyeglasses, especially when trimming or raking the lawn
- Avoid heavily polluted and dusty areas
- Replace cosmetics, especially mascara at least every six months. Bacteria can grow inside them.
- Promptly treat any inflammation or infection of the eyelids (blepharitis). Otherwise the infection can spread to the sebaceous glands of the eyelid and cause stye.


Home Treatment

Although most styes and chalazions are not contagious:
- Avoid sharing towels, bath sponges or cosmetics
- Wash hands frequently and do not rub eyes, especially if you are caring for someone with stye or any type of infection
- Wash hands frequently if you have an infection in the body and do not introduce them in the eyes.
Home treatment for stye and chalazion is normally sufficient. These measures reduce the discomfort and promote healing:
- Do not use cosmetics or contact lenses until the complete healing of the stye or chalazion
- Apply warm, wet compresses. Warm, wet compresses applied 3-6 times a day leads to a faster healing. A warm compress may also help to open the blocked pores of a gland so that it can drain and begin to heal. Before using it, wash your hands. Use a soft gauze or cloth soaked in warm water. Do not use hot water and do not warm the moist gauze in the microwave
- the compress may become too hot and burn the eyelid. The compress is kept on your eyelid until it cools (usually 5-10 minutes). You can also use saline or rose water instead of tap water to speed the healing process.
- Let the stye or chalazion break alone, without raising or opening it
- If you use treatment without prescription make sure that it is for the eye (ophthalmic), not for the ears (otic). The available treatments without prescription in order to treat the stye are ointments and ophthalmic solutions. If the stye or chalazion does not heal with home treatment, it is necessary to consult a specialist, sometimes requiring ointments with antibiotics or eye drops.
Before applying eye ointment or eyedrops, wash your hands. Do not touch the tip of the applicator with your hand. The applicator should be clean and should not touch the eye or the eyelid when applying it. Ointments or drops are applied by looking at well lit mirror.
If antibiotic eye ointment was prescribed, that is applied in thin layers on the stye before bedtime.
If you were prescribed antibiotic drops, the application is made by pulling down with two fingers the lower eyelid to create such a ditch between the eye and the eyelid, where the solution will be dripped. The eye remains closed a few minutes for the drops to spread on the surface of the eye and eyelid.
To children, the drops are appled when the child is lying and has the eyes closed. Put a drop in the inner corner ( that which is near the nose) of the infected eye. Then the child will open his eye and the drop will flow inside. Do not let your child rub the treated eye.

 

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