Stye – StatPearls – NCBI Bookshelf

Davis Willmann; Christian P. Guier; Bhupendra C. Patel; Scott W. Melanson.

Author Information and Affiliations

Last Update: April 3, 2023.

Continuing Education Activity

Stye, or hordeolum, is an acute, painful infection of the eye which involves the upper or lower eyelid. Patients present with a pustule with erythema of the eyelid margin which is tender to palpation. This activity describes the evaluation and treatment of stye and reviews the role of the interprofessional team in managing patients with this condition.

Objectives:

• Identify the most common bacteria in the etiology of stye.

• Summarize the pathophysiology of stye.

• Outline the use of warm compresses and antibiotic eye ointment in the treatment of stye.

• Review the importance of improving care coordination among the interprofessional team to improve outcomes for patients affected by stye.

Access free multiple choice questions on this topic.

Introduction

A stye, also known as a hordeolum, is a common problem involving the eye seen in both primary and urgent care setting. It is a painful, acute infectious process of the upper or lower eyelid. Classically a hordeolum appears as a small pustule along the margin of the eyelid and can be differentiated from a chalazion which tends to involve less of an inflammatory response and follows a more chronic course.[1][2]

Etiology

An acute bacterial infection of the eyelid margin, 90% to 95% of cases of hordeolum are due to Staphylococcus aureus with Staphylococcus epidermidis being the second most common cause. An external hordeolum represents a localized abscess formation of the follicle of an eyelash whereas an internal hordeolum is an acute bacterial infection of the meibomian glands of the eyelid.[3][4]

A chalazion is an acute or chronic inflammation of the eyelid secondary to obstruction of oil glands (meibomian or Zeis) in the tarsal plate and a foreign body reaction to sebum. Processes that block the normal drainage of sebaceous glands, such as hordeolum, acne rosacea, and blepharitis, can contribute to the development of chalazia.

Epidemiology

While hordeola are very common, the exact incidence is unknown. Every age and demographic is affected although there is a slight increase in incidence in patients ages 30 to 50. There are no known differences in prevalence among populations worldwide. Patients with chronic conditions such as seborrhoeic dermatitis, diabetes, and high serum lipids may also be at increased risk.[5][6]

Pathophysiology

Three different glands within the eyelid are implicated in the pathogenesis of hordeolum when they become infected by S. aureus. Infection of Zeis and Moll glands (ciliary glands) causes pain and swelling at the base of the eyelash with localized abscess formation. Termed external hordeolum, these produce the typical appearance of a stye with a localized pustule of the eyelid margin. The meibomian glands are modified sebaceous glands that are found in the tarsal plate of the eyelids. They produce an oily layer on the surface of the eye that helps to maintain proper lubrication of the eye. When a meibomian gland becomes acutely infected, it results in an internal hordeolum. Due to its deeper position within the eyelid, internal hordeola have a less defined appearance than external hordeolum.

Chalazia occur secondary to mechanical obstruction and dysfunction of the meibomian gland with subsequent stasis and blockage of the release of sebum. This condition tends to be subacute to chronic and presents with a painless nodule within the eyelid or at the lid margin.

History and Physical

Usually, patients present complaining of a confined burning, tender swelling on one eyelid. Either the upper or lower lid may be involved. In some cases, the complaint may start as generalized edema and erythema of the lid that later becomes localized. Patients will frequently have a history of similar prior lesions of the eyelid. With external hordeolum, pain, edema, and swelling are localized to a discrete area of the eyelid that is tender to palpation. The stye generally appears as a pustule with mild erythema of the lid margin. Pustular exudate may be present.

Patients with internal hordeolum present with more diffuse tenderness and erythema of the lid given the relatively larger meibomian gland. Diagnosis may be made by everting the lid to reveal a small pustule of the conjunctival surface. The physical exam may appear very similar to an external hordeolum in cases when the gland is infected but without obstruction. Treatment for both internal and external hordeolum is the same, so differentiation of the two is not of significant clinical importance.

In contrast to hordeola, chalazion will have a more indolent and chronic presentation. Patients complain of non-tender nodules of the eyelid with minimal to no surrounding erythema. For persistent chalazion, chronic skin changes can develop around the underlying nodule.

Evaluation

The diagnosis of a stye (hordeolum) and chalazion requires only a history and physical exam. No diagnostic tests are required or useful in their diagnosis. Colonization with noninvasive bacteria is common, and bacterial cultures of discharge from the area usually do not correlate with clinical improvement nor aid in treatment. The clinical presentation of an acute chalazion and an internal hordeolum may be challenging to differentiate, but fortunately, management is the same.

Treatment / Management

A stye is usually a self-limiting condition with resolution occurring spontaneously within a week. Both internal and external hordeola are treated similarly. To hasten recovery and prevent the spread of infection, warm compresses and erythromycin ophthalmic ointment applied twice a day are usually sufficient treatment. There is little evidence demonstrating a benefit from the use of topical antibiotics but erythromycin ointment use for 7 to 10 days has been recommended. Warm compresses should be applied for 15 minutes at least four times a day. Gentle massage of the nodule has also been suggested to assist in the expression of the obstructed material. Oral antibiotics are rarely indicated unless there are significant surrounding erythema and a concern for periorbital cellulitis. For very large hordeola in which incision and drainage are considered, referral to an ophthalmologist is appropriate. Reevaluation within 2 to 3 days is appropriate to assess response to treatment.[7][8][9]

Conservative treatment is the mainstay of therapy for chalazia. Warm compresses and washing the affected eyelid with a gentle soap such as baby shampoo will usually be the only treatment required. Given that the etiology is inflammatory and not infectious, antibiotics are not necessary. For recurrent chalazion or those refractory to conservative treatment, corticosteroid injection into the lesion or incision and curettage may be needed. These procedures necessitate referral to an ophthalmologist. Patients with chalazia should be referred to an ophthalmologist for nonurgent evaluation.

Differential Diagnosis

• Chalazion

• Pneumo-Orbita

Pearls and Other Issues

Although it occurs very uncommonly, an untreated stye may evolve into a localized cellulitis of the eyelid and surrounding skin. Periorbital, or rarely, orbital cellulitis, may ensue if progression of the infection is allowed to occur. Any worsening erythema and edema beyond a localized pustule should be monitored closely for cellulitis, which may require systemic antibiotics. For infections that are not well localized, blood tests including a complete blood count (CBC) with differential and blood cultures may be needed, in addition to an orbital CT scan if orbital cellulitis is a possibility.

Blepharitis is a related condition that involves inflammation of the eyelid margin characterized by erythematous, pruritic eyelids, conjunctival injection, crusting or matting of the eyelids, and occasionally flaking of the eyelid skin. In contradistinction to hordeolum and chalazion, blepharitis should not have a discrete nodule within the eyelid. Treatment involves warm compresses, gentle washing of the eyelids with warm water or diluted baby shampoo, and if these attempts are unsuccessful, a topical antibiotic such as erythromycin.

Enhancing Healthcare Team Outcomes

A Stye may be encountered by the emergency department physician, nurse practitioner, internist or the primary care provider. Most styes can be managed conservatively by these healthcare professionals, but if there is any doubt about the diagnosis, the patient should be referred to an ophthalmologist. Styes do respond rapidly to warm compresses and erythromycin ointment. However, the patient must be seen again within 48 to 72 hours to ensure that healing is taking place.

The outcomes for most patients with a stye are excellent.[10] (Level II)

Review Questions

• Access free multiple choice questions on this topic.

• Comment on this article.

Figure

Stye (external Hordeolum). Contributed by the Public Domain

Figure

hordeolum of the lower eyelid. Image courtesy S Bhimji MD

References

1.

Bragg KJ, Le PH, Le JK. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 14, 2022. Hordeolum. [PubMed: 28723014]

2.

Lindsley K, Nichols JJ, Dickersin K. Non-surgical interventions for acute internal hordeolum. Cochrane Database Syst Rev. 2017 Jan 09;1(1):CD007742. [PMC free article: PMC5370090] [PubMed: 28068454]

3.

Carlisle RT, Digiovanni J. Differential Diagnosis of the Swollen Red Eyelid. Am Fam Physician. 2015 Jul 15;92(2):106-12. [PubMed: 26176369]

4.

Amato M, Pershing S, Walvick M, Tanaka S. Trends in ophthalmic manifestations of methicillin-resistant Staphylococcus aureus (MRSA) in a northern California pediatric population. J AAPOS. 2013 Jun;17(3):243-7. [PubMed: 23623773]

5.

Moriya K, Shimizu H, Handa S, Sasaki T, Sasaki Y, Takahashi H, Nakamura S, Yoshida H, Kato Y. Incidence of Ophthalmic Disorders in Patients Treated with the Antineoplastic Agent S-1. Gan To Kagaku Ryoho. 2017 Jun;44(6):501-506. [PubMed: 28698442]

6.

Ansari AS, de Lusignan S, Hinton W, Munro N, McGovern A. The association between diabetes, level of glycaemic control and eye infection: Cohort database study. Prim Care Diabetes. 2017 Oct;11(5):421-429. [PubMed: 28648963]

7.

Pflipsen M, Massaquoi M, Wolf S. Evaluation of the Painful Eye. Am Fam Physician. 2016 Jun 15;93(12):991-8. [PubMed: 27304768]

8.

John AM, John ES, Hansberry DR, Thomas PJ, Guo S. Analysis of online patient education materials in pediatric ophthalmology. J AAPOS. 2015 Oct;19(5):430-4. [PubMed: 26486024]

9.

Machalińska A, Zakrzewska A, Safranow K, Wiszniewska B, Machaliński B. Risk Factors and Symptoms of Meibomian Gland Loss in a Healthy Population. J Ophthalmol. 2016;2016:7526120. [PMC free article: PMC5124676] [PubMed: 27965892]

10.

Hirunwiwatkul P, Wachirasereechai K. Effectiveness of combined antibiotic ophthalmic solution in the treatment of hordeolum after incision and curettage: a randomized, placebo-controlled trial: a pilot study. J Med Assoc Thai. 2005 May;88(5):647-50. [PubMed: 16149682]

Disclosure: Davis Willmann declares no relevant financial relationships with ineligible companies.

Disclosure: Christian Guier declares no relevant financial relationships with ineligible companies.

Disclosure: Bhupendra Patel declares no relevant financial relationships with ineligible companies.

Disclosure: Scott Melanson declares no relevant financial relationships with ineligible companies.

Stye – StatPearls – NCBI Bookshelf

Davis Willmann; Christian P. Guier; Bhupendra C. Patel; Scott W. Melanson.

Author Information and Affiliations

Last Update: April 3, 2023.

Continuing Education Activity

Stye, or hordeolum, is an acute, painful infection of the eye which involves the upper or lower eyelid. Patients present with a pustule with erythema of the eyelid margin which is tender to palpation. This activity describes the evaluation and treatment of stye and reviews the role of the interprofessional team in managing patients with this condition.

Objectives:

• Identify the most common bacteria in the etiology of stye.

• Summarize the pathophysiology of stye.

• Outline the use of warm compresses and antibiotic eye ointment in the treatment of stye.

• Review the importance of improving care coordination among the interprofessional team to improve outcomes for patients affected by stye.

Access free multiple choice questions on this topic.

Introduction

A stye, also known as a hordeolum, is a common problem involving the eye seen in both primary and urgent care setting. It is a painful, acute infectious process of the upper or lower eyelid. Classically a hordeolum appears as a small pustule along the margin of the eyelid and can be differentiated from a chalazion which tends to involve less of an inflammatory response and follows a more chronic course. [1][2]

Etiology

An acute bacterial infection of the eyelid margin, 90% to 95% of cases of hordeolum are due to Staphylococcus aureus with Staphylococcus epidermidis being the second most common cause. An external hordeolum represents a localized abscess formation of the follicle of an eyelash whereas an internal hordeolum is an acute bacterial infection of the meibomian glands of the eyelid.[3][4]

A chalazion is an acute or chronic inflammation of the eyelid secondary to obstruction of oil glands (meibomian or Zeis) in the tarsal plate and a foreign body reaction to sebum. Processes that block the normal drainage of sebaceous glands, such as hordeolum, acne rosacea, and blepharitis, can contribute to the development of chalazia.

Epidemiology

While hordeola are very common, the exact incidence is unknown. Every age and demographic is affected although there is a slight increase in incidence in patients ages 30 to 50. There are no known differences in prevalence among populations worldwide. Patients with chronic conditions such as seborrhoeic dermatitis, diabetes, and high serum lipids may also be at increased risk.[5][6]

Pathophysiology

Three different glands within the eyelid are implicated in the pathogenesis of hordeolum when they become infected by S. aureus. Infection of Zeis and Moll glands (ciliary glands) causes pain and swelling at the base of the eyelash with localized abscess formation. Termed external hordeolum, these produce the typical appearance of a stye with a localized pustule of the eyelid margin. The meibomian glands are modified sebaceous glands that are found in the tarsal plate of the eyelids. They produce an oily layer on the surface of the eye that helps to maintain proper lubrication of the eye. When a meibomian gland becomes acutely infected, it results in an internal hordeolum. Due to its deeper position within the eyelid, internal hordeola have a less defined appearance than external hordeolum.

Chalazia occur secondary to mechanical obstruction and dysfunction of the meibomian gland with subsequent stasis and blockage of the release of sebum. This condition tends to be subacute to chronic and presents with a painless nodule within the eyelid or at the lid margin.

History and Physical

Usually, patients present complaining of a confined burning, tender swelling on one eyelid. Either the upper or lower lid may be involved. In some cases, the complaint may start as generalized edema and erythema of the lid that later becomes localized. Patients will frequently have a history of similar prior lesions of the eyelid. With external hordeolum, pain, edema, and swelling are localized to a discrete area of the eyelid that is tender to palpation. The stye generally appears as a pustule with mild erythema of the lid margin. Pustular exudate may be present.

Patients with internal hordeolum present with more diffuse tenderness and erythema of the lid given the relatively larger meibomian gland. Diagnosis may be made by everting the lid to reveal a small pustule of the conjunctival surface. The physical exam may appear very similar to an external hordeolum in cases when the gland is infected but without obstruction. Treatment for both internal and external hordeolum is the same, so differentiation of the two is not of significant clinical importance.

In contrast to hordeola, chalazion will have a more indolent and chronic presentation. Patients complain of non-tender nodules of the eyelid with minimal to no surrounding erythema. For persistent chalazion, chronic skin changes can develop around the underlying nodule.

Evaluation

The diagnosis of a stye (hordeolum) and chalazion requires only a history and physical exam. No diagnostic tests are required or useful in their diagnosis. Colonization with noninvasive bacteria is common, and bacterial cultures of discharge from the area usually do not correlate with clinical improvement nor aid in treatment. The clinical presentation of an acute chalazion and an internal hordeolum may be challenging to differentiate, but fortunately, management is the same.

Treatment / Management

A stye is usually a self-limiting condition with resolution occurring spontaneously within a week. Both internal and external hordeola are treated similarly. To hasten recovery and prevent the spread of infection, warm compresses and erythromycin ophthalmic ointment applied twice a day are usually sufficient treatment. There is little evidence demonstrating a benefit from the use of topical antibiotics but erythromycin ointment use for 7 to 10 days has been recommended. Warm compresses should be applied for 15 minutes at least four times a day. Gentle massage of the nodule has also been suggested to assist in the expression of the obstructed material. Oral antibiotics are rarely indicated unless there are significant surrounding erythema and a concern for periorbital cellulitis. For very large hordeola in which incision and drainage are considered, referral to an ophthalmologist is appropriate. Reevaluation within 2 to 3 days is appropriate to assess response to treatment.[7][8][9]

Conservative treatment is the mainstay of therapy for chalazia. Warm compresses and washing the affected eyelid with a gentle soap such as baby shampoo will usually be the only treatment required. Given that the etiology is inflammatory and not infectious, antibiotics are not necessary. For recurrent chalazion or those refractory to conservative treatment, corticosteroid injection into the lesion or incision and curettage may be needed. These procedures necessitate referral to an ophthalmologist. Patients with chalazia should be referred to an ophthalmologist for nonurgent evaluation.

Differential Diagnosis

• Chalazion

• Pneumo-Orbita

Pearls and Other Issues

Although it occurs very uncommonly, an untreated stye may evolve into a localized cellulitis of the eyelid and surrounding skin. Periorbital, or rarely, orbital cellulitis, may ensue if progression of the infection is allowed to occur. Any worsening erythema and edema beyond a localized pustule should be monitored closely for cellulitis, which may require systemic antibiotics. For infections that are not well localized, blood tests including a complete blood count (CBC) with differential and blood cultures may be needed, in addition to an orbital CT scan if orbital cellulitis is a possibility.

Blepharitis is a related condition that involves inflammation of the eyelid margin characterized by erythematous, pruritic eyelids, conjunctival injection, crusting or matting of the eyelids, and occasionally flaking of the eyelid skin. In contradistinction to hordeolum and chalazion, blepharitis should not have a discrete nodule within the eyelid. Treatment involves warm compresses, gentle washing of the eyelids with warm water or diluted baby shampoo, and if these attempts are unsuccessful, a topical antibiotic such as erythromycin.

Enhancing Healthcare Team Outcomes

A Stye may be encountered by the emergency department physician, nurse practitioner, internist or the primary care provider. Most styes can be managed conservatively by these healthcare professionals, but if there is any doubt about the diagnosis, the patient should be referred to an ophthalmologist. Styes do respond rapidly to warm compresses and erythromycin ointment. However, the patient must be seen again within 48 to 72 hours to ensure that healing is taking place.

The outcomes for most patients with a stye are excellent.[10] (Level II)

Review Questions

• Access free multiple choice questions on this topic.

• Comment on this article.

Figure

Stye (external Hordeolum). Contributed by the Public Domain

Figure

hordeolum of the lower eyelid. Image courtesy S Bhimji MD

References

1.

Bragg KJ, Le PH, Le JK. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Aug 14, 2022. Hordeolum. [PubMed: 28723014]

2.

Lindsley K, Nichols JJ, Dickersin K. Non-surgical interventions for acute internal hordeolum. Cochrane Database Syst Rev. 2017 Jan 09;1(1):CD007742. [PMC free article: PMC5370090] [PubMed: 28068454]

3.

Carlisle RT, Digiovanni J. Differential Diagnosis of the Swollen Red Eyelid. Am Fam Physician. 2015 Jul 15;92(2):106-12. [PubMed: 26176369]

4.

Amato M, Pershing S, Walvick M, Tanaka S. Trends in ophthalmic manifestations of methicillin-resistant Staphylococcus aureus (MRSA) in a northern California pediatric population. J AAPOS. 2013 Jun;17(3):243-7. [PubMed: 23623773]

5.

Moriya K, Shimizu H, Handa S, Sasaki T, Sasaki Y, Takahashi H, Nakamura S, Yoshida H, Kato Y. Incidence of Ophthalmic Disorders in Patients Treated with the Antineoplastic Agent S-1. Gan To Kagaku Ryoho. 2017 Jun;44(6):501-506. [PubMed: 28698442]

6.

Ansari AS, de Lusignan S, Hinton W, Munro N, McGovern A. The association between diabetes, level of glycaemic control and eye infection: Cohort database study. Prim Care Diabetes. 2017 Oct;11(5):421-429. [PubMed: 28648963]

7.

Pflipsen M, Massaquoi M, Wolf S. Evaluation of the Painful Eye. Am Fam Physician. 2016 Jun 15;93(12):991-8. [PubMed: 27304768]

8.

John AM, John ES, Hansberry DR, Thomas PJ, Guo S. Analysis of online patient education materials in pediatric ophthalmology. J AAPOS. 2015 Oct;19(5):430-4. [PubMed: 26486024]

9.

Machalińska A, Zakrzewska A, Safranow K, Wiszniewska B, Machaliński B. Risk Factors and Symptoms of Meibomian Gland Loss in a Healthy Population. J Ophthalmol. 2016;2016:7526120. [PMC free article: PMC5124676] [PubMed: 27965892]

10.

Hirunwiwatkul P, Wachirasereechai K. Effectiveness of combined antibiotic ophthalmic solution in the treatment of hordeolum after incision and curettage: a randomized, placebo-controlled trial: a pilot study. J Med Assoc Thai. 2005 May;88(5):647-50. [PubMed: 16149682]

Disclosure: Davis Willmann declares no relevant financial relationships with ineligible companies.

Disclosure: Christian Guier declares no relevant financial relationships with ineligible companies.

Disclosure: Bhupendra Patel declares no relevant financial relationships with ineligible companies.

Disclosure: Scott Melanson declares no relevant financial relationships with ineligible companies.

Barley – diagnostics and treatment at the medical center “Andreevskiye Hospitals”

Barley is an acute purulent-inflammatory disease of the eyelash hair follicle or its sebaceous gland. There are single and multiple forms.

Causes of barley

barley most often occurs when:

• microbes get on the mucous membranes of the eye through dirty hands, with dust and various small foreign bodies;
• decreased immunity after acute illnesses (flu, acute respiratory infections, tonsillitis, etc.), hypothermia, stress, nervous shocks;
• using someone else’s cosmetics. Natural, beneficial bacteria (saprophytes) of the owner of cosmetics, which do not harm him, can harm your body, because they are alien to you, and the immune system will try to suppress them, thereby causing disease.

Symptoms of barley

The disease begins with the appearance of one or more itchy, slightly painful reddish dots on the eyelid. After a few hours, the primary focus increases in size and becomes sharply painful when touched and blinked. The skin in the area of ​​inflammation acquires an intense red color, becomes hot to the touch. Natural creases under or above the eyelid are smoothed out due to swelling, the eye is partially or completely closed. After 2-3 days, a yellowish dot appears along the edge of the eyelid – an outlet of the sebaceous duct covered with a thin layer of the epidermis with a drop of pus oozing from it. In the future, pus breaks out, and the symptoms of the disease subside.

The general condition rarely worsens. As a rule, fever, headaches and other signs of illness appear only with the multiple form of barley.

Diagnosis of barley

Diagnosis is not difficult in the presence of the above symptoms. An ophthalmologist can clarify the diagnosis, which is recommended due to the possibility of developing severe complications. The most common of them – an abscess or phlegmon of the infraorbital region and orbit of the eye – can lead to partial or complete irreversible loss of vision. Very rarely, meningitis and cavernous sinus thrombosis develop.

Treatment of barley

Appointed by a specialist after examination. Most often, doctors prescribe:

• Tobradex ointment. Contains the antibiotic tobramycin and the hormone dexamethasone. It has antimicrobial, anti-allergic and anti-inflammatory effects. It is laid behind the eyelid just before bedtime;
• Tetracycline eye ointment 1%. Contains a broad spectrum antibiotic. Method of application, similar to the ointment “Tobradex”;
• eye drops “Tobrex”. The same drug as Tobradex, only in the form of drops;
• drops “Sofradex” with dexamethasone and gramicidin, “Oftamirin” with miramistin;
• warming up. Warm compresses of steeply brewed black tea.

Prevention of barley

It consists in observing the rules of personal hygiene: To do this, it is better to use napkins;

Other people’s cosmetics should not touch your eyes. It is better to delay applying makeup than to get out of the situation by using other people’s cosmetics.

Ophthalmologist Ophthalmologist (Clinic in Krasnogorsk) Ophthalmologist (Clinic in Mytishchi) Ophthalmologist (Clinic in Troitsk) Ophthalmologist (Clinic in Varshavka) Ophthalmologist (Clinic in Leninsky) Ophthalmologist (Clinic in Korolev)

Barley: description of the disease, causes, symptoms, cost treatment in Moscow

When the hair follicle of an eyelash or sebaceous gland becomes inflamed, barley is diagnosed. If the localization of the stye is a lobule of the meibomian gland, it is an internal stye. The scientific name for this disease is hordeolum. This is written in the patient’s medical record.

The appearance of barley often occurs suddenly. Every third person faced such a problem, since the disease is widespread. Symptoms are immediately noticeable, because the pathological process is rapidly developing. In most cases, a person who has barley on his eye does not perceive it as a serious problem. However, this is a signal that the immune system has malfunctioned. It follows from this that it is not recommended to leave barley unattended.

It is important to remember that self-treatment of pathology can negatively affect the human visual organs, which are very close to the brain. Any experiments, advice from traditional medicine, etc., can end in disastrous health consequences.

Basically, the inflammatory process affects one eye. Paired development of pathology is rare. In appearance, the purulent accumulation is similar to an abscess, the localization of which is the edge of the eyelid on the outer side of the eye. With the development of internal barley, which is located on the inner eyelid, the risk of various complications increases.

What are the stages of the disease

There are several stages in the development of the pathological process:

1. Stage of infiltration. This stage is characterized by the appearance of itching and burning on the eyelid. It swells. This process does not take more than three days.

2. Suppuration. In the absence of resolution of barley, an abscess is formed. This is a round, transparent formation filled with white content.

3. Abscess rupture. If there was no spontaneous breakthrough of the purulent capsule, this is done by a clinic specialist. The release of purulent contents can be observed for several days.

4. Healing. A crust is formed in the place where the barley was previously located. Under such a crust, tissues are regenerated.

Why the disease appears

Staphylococcus aureus is the cause of barley. It is directly related to the pathogenic flora, and is constantly present on the human skin or hairline. In rare cases, barley appears due to staphylococcus aureus. The reproduction of such microorganisms is directly related to reduced immunity.

It follows that the causes of barley are:

• If the body has been exposed to cold for a long time.

• Stress, illness, excessive fatigue or exercise, poor nutrition or a strict diet can adversely affect the functioning of the immune system.

• If the body does not receive enough vitamins and minerals.

• Diagnosed with diabetes mellitus, when the visual organs are inadequately supplied with blood.

• Diseases of the gastrointestinal tract, when nutrients are not absorbed by the body.

• If Staphylococcus aureus is present in the body, resistant to antibiotics.

• There is a chronic inflammatory process in the body. These include caries, adenoids, tonsillitis.

• With hereditary predisposition.

• The body is infected with helminths.

• Failure to maintain good hygiene. Penetration of infection into the eyelid can occur due to dirty hands.

• A person uses contact lenses. They are not an independent cause of barley, but if another risk factor is present, an inflammatory process may begin.

In a child, an inflammatory process in the eye develops for similar reasons. However, the course of the pathology is more severe. This happens because children have an imperfect immune system. Also, the child is hard and restless, because the barley itches, you have to rub your eyes with your hands. This will negatively affect the course of the pathological process. As a result, an abscess, phlegmon, blepharitis may develop.

In a child, the inner side of the eyelid is covered with loose tissue, and the inflammatory process rapidly affects the surrounding tissue. If the disease is severe, meningitis may occur. Based on this, parents should immediately contact a medical institution, and not self-medicate barley in a child. In the presence of other pathological processes that have arisen against the background of barley, the child is hospitalized.

Prohibited actions with barley

If barley has formed on the eyelid, a person should remember a number of actions that cannot be performed until the pathology disappears. Namely:

• Do not press on the stye in order to extrude the purulent mass.

• Do not use eye cosmetics throughout the treatment.

• Do not use wet lotions on the eyes.

• Do not visit saunas, baths.

• Do not rub the site of the inflammatory process with your hands.

• Do not stay in the cold for a long time. If this is not possible, apply a dry, clean bandage to the eye.

Danger of disease

The main danger is misdiagnosis. If the wrong treatment of the inflammatory process is started, barley will be present for a long time. In addition, the body is exhausted. When you try to independently issue a purulent mass, the risk that pus will spread will increase, which will adversely affect the brain.

In this situation, the patient is urgently hospitalized. Therefore, it must be remembered that any self-treatment is strictly prohibited, as well as squeezing, scratching the diseased eye with dirty hands, etc. Turning to an experienced and qualified doctor, you can count on making an accurate diagnosis, on the basis of which effective treatment will be started.

Otherwise, the following complications may develop:

1. Relapse of the pathological process. With a weakened name system and inadequate relief of the inflammatory process, barley will reappear on the eye.

2. Development of purulent conjunctivitis. The development of such a complication is associated with the spread of infection to the conjunctiva.

3. Chalazion formation. It is characterized by the formation of a cyst on the sebaceous gland. This cyst is filled with fluid.

4. Development of phlegmon of the orbit. It is formed when several abscesses merge. At the same time, there is an increase in eye pain, swelling of the eyelid, intense discharge of pus. In addition, there is an increase in body temperature, deterioration of vision. It is difficult for a person to move the eyeball, due to its protrusion.

5. The cavernous vascular plexus is blocked. The development of such a complication occurs in rare cases. There is a formation of exophthalmos, puffiness of the eyelid, it acquires a blue tint. A person complains of severe pain in the eye. The protein is filled with blood, there is a severe headache. Excessive fatigue of the eye is noted.

6. Development of meningitis. With the spread of bacteria in the brain, an inflammatory process develops in it. As a result, a person’s body temperature rises, vomiting appears, and the headache intensifies. There is an increased risk of coma or death.

7. Development of sepsis. When blood poisoning is diagnosed, the patient is likely to die. There is a significant increase in body temperature, the skin becomes covered with a rash, blood pressure rapidly decreases. The patient is unconscious, all internal organs and systems cease to function normally.

Principles of treatment

To quickly get rid of barley on the eye, it is necessary to use complex treatment. The patient may be prescribed the use of drops, ointments based on an antibacterial drug. In severe cases of the pathological process, it is recommended to take medication systematically. If the abscess has not opened spontaneously, the patient should contact the medical center, where an experienced doctor will perform an autopsy and sanitation.

Drops. The use of drops for eye barley helps to stop the spread of the inflammatory process throughout the eye. The patient may be prescribed to use sofradex, gentamicin, erythromycin, levomycetin, tsiprolet, chloramphenicol, tobramycin, vigamox. It is necessary to drip the eye from three to six times a day. The frequency is determined only by the attending physician.

Eye ointment. Laying the ointment is carried out before bedtime. If you use the ointment in the daytime, this contributes to the deterioration of visual function. The doctor may prescribe the use of erythromycin, tetracycline ointment, as well as kolbitsion, tobrex, ofloxacin, eubetal. Before laying the eye ointment, it is recommended to wash your hands thoroughly. The ointment is applied first to the finger, then the eyelid should be pulled back and the agent should be placed there.

An important point before buying a drug is to clarify that the ointment will be applied to the eyes. There are similar means by which the treatment of the skin is carried out. In such preparations, there is much more active substance, as a result of which it is possible to greatly harm the eye.

Antibacterial preparations. In severe cases of the disease, the doctor prescribes antibiotics. They are taken orally. Such a therapeutic measure is indicated when the patient’s immunity is weakened, or barley appears in a child. In most cases, doxycycline, ampicillin, amoxiclav, augmentin, azithromycin, sumamed, chemomycin may be prescribed. Treatment with an antibacterial drug lasts at least five days.

Treatment with antiseptics. After opening the abscess, the patient must wash the affected eye with an antiseptic. In such cases, use furatsilin, sodium sulfacyl. An antiseptic is instilled into the eye, the excess is removed with a sterile swab.

Use of adjuvant therapy. At elevated body temperature, the patient may be prescribed non-steroidal anti-inflammatory drugs. This refers to the use of paracetamol, ibuprofen. During treatment, the patient is recommended to maintain proper nutrition.