A hordeolum, or stye, is an acute infection of an eyelid gland, usually by Staphylococcus aureus. It forms a tender red bump on the lid, and most drain and heal on their own within 1 to 2 weeks.
Key symptoms
- Painful red lump on the edge of the eyelid
- Eyelid swelling and tenderness
- Tearing or a gritty feeling
- Normal vision
What you find on exam
- Tender, localized swelling, often with a yellow point at the lash line
- Distinguish from a chalazion, which is firm and painless
- Vision and eye movements should be normal
- Look for spreading redness of the lid (preseptal cellulitis)
Tests
- Diagnosis is clinical
- No routine labs or cultures
- Biopsy of a lesion that keeps coming back in the same place
Treatment basics
- Warm compresses for 10 to 15 minutes, 3 to 4 times a day
- Gentle lid hygiene; do not squeeze the bump
- No eye makeup or contact lenses until healed
- Oral antibiotics only if cellulitis spreads around the lid
- Incision and drainage by ophthalmology if it persists
Red flags
- Pain with eye movement, bulging eye or vision change (orbital cellulitis)
- Fever with redness spreading over the face
- Recurrent lesion in the same spot in an older adult (possible cancer)
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Sources: NCCPA PANCE Content Blueprint; NBOME COMLEX-USA clinical presentations. Written by Making Synapses. Making Synapses is not affiliated with these organizations.