Barley on the eye

A stye on the eye (hordeolum) is an acute, painful, purulent local inflammation of the hair follicle, sebaceous glands of Zeiss or sweat glands of Müll (external stye).

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Causes of barley

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

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How does barley manifest itself?

At the beginning of the development of barley, a painful point is felt on the edge of the eyelid. Then, corresponding to the painful point, a limited reddish dense swelling develops, which is very painful. The swelling of the eyelid is sometimes so strong that the eyelids do not open. The intensity of the pain usually corresponds to the degree of swelling. After 2-3 days, a purulent point appears at the edge of the eyelid 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 opens, and purulent contents with pieces of necrotic tissue come out of it. After spontaneous opening, by the end of the week, the symptoms (edema, hyperemia) quickly disappear. A delicate scar may form at the site of the opening of the pustule.

Sometimes several styes may appear at the same time, sometimes they merge into one, abscess. This condition is accompanied by an increase in body temperature, headache, swelling of the preauricular and submandibular lymph nodes, and a deterioration in general health. Due to the peculiarity of the blood supply to the eyelids (abundant venous network, outflow of venous blood into the veins of the face and the veins of the orbit, the absence of valves in the veins of the orbit), styes of the eyelid can be complicated by phlegmon of the orbit, thrombophlebitis of the orbital veins, thrombosis of the cavernous sinus, meningitis and sepsis. These dangerous complications often develop after attempts to squeeze out pus from an abscessing sty.

Barley is differentiated from chalazion (dense on palpation) and dacryoadenitis (other localization of the inflammation site).

External hordeolum results from infection or blockage of the eyelash follicle and adjacent glands of Zeiss or Mohl. It often occurs in combination with blepharitis. Symptoms include pain, redness and tenderness of the eyelid margin, sometimes with lacrimation, photophobia and a foreign body sensation. When "ripening", a small yellowish spot appears at the base of the eyelashes, indicating suppuration, surrounded by redness, compaction and diffuse edema. After 2-4 days, the lesion opens with the release of pus and a decrease in pain.

An internal hordeolum, which is much less common, results from infection of the meibomian gland. The symptoms are the same as those of a chalazion, with pain, redness, and swelling of the posterior conjunctival cartilage. Examination of the tarsal conjunctiva reveals a small elevation or yellow area at the site of the affected gland. An abscess later forms, maturing on the conjunctival side of the eyelid; it sometimes breaks through the skin. Spontaneous rupture is rare, and recurrence is common.

Often, styes develop in weakened and anemic people with reduced body resistance.

Sometimes styes recur, which is usually combined with general furunculosis, especially in diabetes mellitus. In this case, the disruption of the physiological activity of the intestinal tract, caused by habitual constipation, is of great importance.

How to recognize a stye on the eye?

The diagnosis of both types of hordeolum is clinical; internal hordeolum is very rare and may be suspected when there is severe inflammation or systemic signs of infection. If the hordeolum is located near the internal commissure of the eyelids, it must be differentiated from dacryocystitis, the diagnosis of which can usually be excluded by detecting maximum induration and tenderness in the eyelid for chalazion and in the nose for dacryocystitis. In case of successful lavage of the lacrimal canal, dacryocystitis can be excluded.

How to treat barley?

At the very beginning of the development of barley, the painful point on the edge of the eyelid should be lubricated 2-3 times a day with 70% alcohol or a 1% solution of brilliant green in 70% alcohol. Often, this simple method can prevent further development of barley. A 30% solution of sodium sulfacyl or an antibiotic solution is instilled into the eye 6-8 times a day. Treatment of barley should be accompanied by the use 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 stye, a compress is placed behind the eyelids, since wetting the skin leads to its maceration and the penetration of infection into the openings of the excretory ducts of other sebaceous glands.

If barley is accompanied by an increase in body temperature and general malaise, it is necessary to prescribe sulfonamide drugs orally, or even better, antibiotics.

Sometimes a mature stye needs to be opened by cutting the skin thinned by pus. In no case should you squeeze out the stye. This can lead to the spread of infection to deeper parts of the eyelid and even the orbit.

Treatment for an internal stye involves oral antibiotics and incision and drainage if needed. Topical antibiotics are usually ineffective.

In case of recurrent styes, a thorough general examination and general strengthening treatment are necessary to increase the body's resistance. Courses of antibiotic therapy, vitamin therapy, the use of the dietary supplement "Brewer's yeast", autohemotherapy are indicated. It is necessary to monitor blood glucose.

A stye on the eye usually has a good prognosis.