Barley on the eye

Barley on the eye (hordeolum) is an acute, painful purulent local inflammation of the hair follicle, sebaceous glands of Zeiss or sweat glands of Mull (outer barley). 

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Causes of barley

The main cause of barley development is staphylococcal infection (Staphylococcus aureus). Barley often occurs against the background of diabetes mellitus, chronic diseases of the gastrointestinal tract and is combined with vulgar acne, hypovitaminosis and immunodeficiency states (HIV infection, AIDS).

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How does barley appear?

At the beginning of the development of barley on the edge of the century, there is a painful point. Then, respectively, a painful point develops a limited reddish dense swelling, very painful. The edema of the eyelid is sometimes so strong that the eyelids do not open. The intensity of pain usually corresponds to the degree of swelling. After 2-3 days, at the edge of the eyelid, a purulent spot appears in the inflammatory focus, a purulent pustule (head) is formed. The pain stops. On the 3-4th day of the development of barley, the pustule is opened, and purulent contents come out of it with pieces of necrotic tissue. After a spontaneous dissection by the end of the week, symptoms (swelling, hyperemia) quickly disappear. At the site of opening the pustules, a tender hem can form.

Sometimes several barley may appear simultaneously, sometimes they merge into one, they are abscessed. This condition is accompanied by an increase in body temperature, headache, swelling of the premaxillary and submandibular lymph nodes, the general state of health worsens. Due to the peculiarities of the blood supply to the eyelids (abundant venous network, venous blood flow to veins of the face and veins of the orbit, absence of valves in the veins of the orbit), barley of the eyelids can be complicated by phlegm of the orbit, thrombophlebitis of orbital veins, cavernous sinus thrombosis, meningitis and sepsis. These dangerous complications develop more often after attempts to squeeze out pus from abscessed barley.

Barley is differentiated with chalazion (with dense palpation) and dacryoadenitis (another localization of the inflammation focus).

Outer barley is the result of infection or blockage of the follicle of the eyelashes and the adjacent glands of Zeiss or Mole. It often occurs in combination with blepharitis. Symptoms include pain, redness and tenderness of the edge of the eyelid, sometimes with lacrimation, photophobia and sensation of a foreign body. When "ripening" appears a small yellowish spot in the base of the eyelashes, indicating a festering, surrounded by redness, tightness and diffuse edema. After 2-4 days, the hearth is opened with the release of pus and the easing of pain.

Internal barley, which occurs much less frequently, is the result of infection of the meibomian gland. Symptoms are the same as in chalazion, with pain, redness and swelling of the posterior surface of the cartilage conjunctiva. Examination of the tarsal conjunctiva reveals a slight elevation or a yellow area in the site of the affected gland. Later, an abscess is formed, ripening on the conjunctive side of the eyelid; sometimes it breaks through the skin. Spontaneous rupture is rare, and often a relapse occurs.

Often barley develops in weakened and anemic people, with a reduced resistance of the body.

Sometimes barley recur, which is usually combined with general furunculosis, especially in diabetes mellitus. In this case, the violation of the physiological activity of the intestinal tract, due to habitual constipation, is of great importance.

How to recognize barley on the eye?

The diagnosis of both types of barley is established clinically; internal barley is very rare and can be suspected when there is severe inflammation or there are systemic signs of infection. If the barley is located near the internal adhesion of the eyelids, it needs to be differentiated from dacryocystitis, the diagnosis of which can usually be ruled out by revealing the maximum compaction and pain in the eyelid region for the chalazion and nose for dacryocystitis. In case of successful lachrymal lavage, dacryocystitis can be excluded.

How to treat barley?

At the very beginning of the development of barley, a painful point along the edge of the eyelid should be lubricated 2-3 times a day with 70% alcohol or 1% solution of brilliant green on 70% alcohol. Often this simple method can prevent further development of barley. In the eye, 6-8 times a day, a 30% solution of sulfacyl sodium or a solution of antibiotics is instilled. Treatment of barley should be accompanied by the application of dry heat - blue light, UHF-therapy. The use of moist heat is unacceptable, as it provokes the appearance of new abscesses.

After opening the barley, a compress is applied for the eyelids, since wetting the skin leads to its maceration and penetration of the infection into the holes of the excretory ducts of other sebaceous glands.

If barley is accompanied by an increase in body temperature, a general malaise, it is necessary to prescribe sulfanilamide preparations, or even better, antibiotics.

Sometimes ripe barley must be opened with a cut of thinned skin of pus. In no case should you squeeze out barley. This can lead to the spread of infection in deeper parts of the century and even orbit.

Treatment of internal barley consists of taking oral antibiotics, cutting and draining, if necessary. Local antibiotics are usually ineffective.
 

With relapsing barley, a thorough general examination and restorative treatment is necessary to increase the body's resistance. The courses of antibiotic therapy, vitamin therapy, the use of bioadditives "Brewer's yeast", autohemotherapy are shown. Be sure to monitor blood glucose.

Barley on the eye has usually a good prognosis.