Stye on the eye: treatment, signs, causes of appearance

Ophthalmologist, Laser ophthalmic surgery

Karapetyan

Arevik Samvelovna

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Acute purulent inflammation in the hair follicle of the eyelash or in the sebaceous gland is called “barley” because of its characteristic round shape, reminiscent of grain. The external harmlessness of this phenomenon is deceptive: it clearly indicates a decrease in the protective properties of the immune system and requires careful treatment to prevent relapses and possible complications.

Causes of stye on the eye

Staphylococci, which prefer to settle on human skin and hair, do not manifest themselves in any way with strong immunity. Their intensive reproduction is triggered by a decrease in the protective properties of the body, its hypothermia, severe illnesses and hypovitaminosis, and the consequences of helminthic infestation. Penetrating into the structure of the hair follicle, streptococci cause inflammation and suppuration as a reaction to a pathogenic microorganism. This is the main cause of stye on the eye in patients of all ages. With an unbalanced diet, increased physical activity or stressful situations, the disease can occur in the form of several or multiple suppurations on the eyelids or mucous membranes. Also among the factors contributing to the appearance of stye on the eye is the habit of touching the eyelids with dirty hands, a large amount of dust indoors or outdoors.

The risk group for the likelihood of the appearance of barley includes:

patients with reduced immunity;
persons with diseases of the endocrine system;
patients with gastrointestinal pathologies;
persons whose professional activities involve working outdoors or in premises with difficult climatic or unsanitary conditions;
patients who have suffered inflammatory diseases of the eyes and eyelids, as well as those who have not completed the prescribed course of treatment.

Symptoms and first signs

Sometimes the disease occurs in a mild form, without causing any discomfort, and manifests itself only by the formation of a small tubercle on the lower or upper eyelid. But most often, the symptoms of stye on the eye bring a lot of inconvenience in the form of pain, itching, swelling, headache and redness of the eyes.

It is best to start treatment before a pimple appears on the skin. At the beginning, a person notices slight swelling of the eyelid and redness. After a few hours, itching appears, which only intensifies over time. After about a day, you can feel a lump forming under the skin, resembling a boil or pimple.

Symptoms of stye on the eye

Suppuration of the eyelid makes itself felt by a feeling of heaviness, swelling and inflammation along the eyelash line. The area becomes painful, the temperature of the skin of the eyelids rises. The line of edema has clear boundaries; signs of hyperemia are noticeable on the conjunctiva - redness and inflammation. Within 2-3 days from the moment the barley develops, a purulent head forms on its surface, the contents of which are dead cells of the hair follicle.

With internal barley, the pathology is localized in the area under the eyelid - in the so-called meibomian gland, which makes the disease almost invisible. The inflammatory process is indicated by the characteristic symptoms of stye - thickening and soreness of the affected eyelid. The danger of such a disease is the development of chalazion - inflammation of the cartilage around the meibomian gland, which significantly delays the healing process and forces the patient to undergo regular examinations by an ophthalmologist.

In severe cases, with barley localized inside the sebaceous gland, signs of general intoxication are observed - headache and muscle pain, fever, swollen lymph nodes. Self-medication in this case is strictly contraindicated, and the patient should immediately seek medical help.

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Classification

Depending on the number, ulcers can be multiple or single. Unlike single ones, multiple formations cause more intense symptoms and are accompanied by general malaise. This situation requires immediate consultation with an ophthalmologist.

If the disease appears for the first time, they speak of an acute course of the disease, but in the case when inflammation in the eyes appears with some frequency, barley is called recurrent.

According to localization, the abscess can be internal or external.

Interior

A small pimple appears on the side of the conjunctiva, caused by inflammation of the meibomian glands. In the first 2-3 days, a tubercle forms on the inner surface of the eyelid, accompanied by pain and itching. After 3-4 days it opens, and a small scar forms in this place.

Outer

Swelling occurs at the eyelash edge, and after a few days it fills with pus. Usually the barley opens after 3-4 days, the contents come out, the wound ceases to be painful and soon heals.

Types and stages of development of barley

Depending on the location and external signs there are:

External stye is a painful formation on the eyelash line that quickly festeres. Signs of barley in this case are visible to the naked eye, which simplifies the diagnosis;
internal barley - localized inside the eyelid, causing discomfort due to severe pain and the feeling of a foreign object in the eye. It is detected during a visual medical examination.

The formation and development of barley occurs in several stages:

infiltration process. The first characteristic signs of suppuration appear: itching, swelling, redness of the eyelid in the area of inflammation. Over the course of several hours, the discomfort intensifies;
process of suppuration. A capsule with purulent contents is visible on the surface of the formation. With an increase in the volume of pus or mechanical impact, it may break out prematurely;
the process of breakthrough of the purulent capsule. If the inflammation does not break out on its own, it is opened by a surgeon. Separation of purulent contents occurs within several days;
healing. A crust forms at the site of the ulcer, under which a thin layer of restored skin forms. Depending on the quality of the course of treatment and the state of the immune system, the healing period can range from several days to several weeks.

Complications of stye on the eye

The importance of seeing a doctor when barley appears is due to the high risk of developing the following complications:

conjunctivitis is an infectious lesion of the mucous membrane of the eye, causing swelling, hyperemia and some blurring of vision. Treatment of the disease is complex and lengthy;
Chalazion is a cystic formation on the inside of the eyelid. Causes inconvenience and requires long-term treatment;
phlegmon of the orbit - caused by profuse suppuration due to an attempt to independently open the stye or multiple formation of foci of suppuration with their subsequent fusion. Symptoms of this pathology are blurred vision, severe swelling, discomfort when moving the eyelid, etc.;
thrombosis of the vascular plexus - a violation of the outflow of fluid from the orbit, which causes swelling. The eyeball protrudes, the skin turns blue, the eyelids become inflamed, and vision deteriorates sharply;
thrombophlebitis is an inflammatory process in blood vessels. Characterized by headache, feeling of fatigue, decreased visual acuity, redness of the eye mucosa;
meningitis - consequences of phlegmon of the eye. Signs of a deadly pathology: temperature above 39°C and severe headache;
sepsis is blood poisoning due to the ingress of pus and pathogenic microorganisms into it. Signs of complications: intoxication of the body, chills, rapid heartbeat, rash, breathing problems.

Diagnostics

If you have a problem, you can contact an ophthalmologist. Typically, a medical history and slit-lamp examination are sufficient to diagnose stye. It is important to find out the cause of the infection. If it is hidden in systemic diseases and causes frequent relapses, you will need a consultation with specialized doctors (gastroenterologist, endocrinologist) and a detailed diagnosis:

laboratory tests to determine the pathogen;
blood/urine glucose tests;
examination for parasite infestation.

Treatment of barley

With strong immunity, the disease can go away on its own without special treatment. This happens if the adverse effects on the body have stopped and the activation of staphylococcus has been suppressed.

Self-treatment of stye on the eye with medications at home is not recommended. Moreover, folk recipes often pose a threat to vision. Tips on how to treat stye can cause rupture of the purulent capsule and infection of the eye mucosa with the most serious consequences.

A course prescribed by a specialist will be many times more effective and safer. Its components are antibacterial drugs, local antibiotics and compounds for relieving the inflammatory process. Treatment of barley should be carried out under supervision and based on the recommendations of a specialist. If a complication develops, he will immediately correct the course and take measures to prevent further inflammation.

Prevention of stye

The following will help eliminate the risk of stye:

compliance with personal hygiene rules;
measures to strengthen the body's defenses and restore immunity;
eliminating situations of overheating or hypothermia of the body;
timely treatment of serious infectious diseases;
active lifestyle;
balanced diet, taking vitamin courses.

Additional recommendations taking into account the patient’s body condition will be given by the attending physician.

Prevention

In order to prevent the development of barley, simple rules must be followed.

Before going to bed, you should wash off your decorative cosmetics with warm water and mild makeup removers.

Before touching your eyes, you should wash your hands thoroughly with soap.

Regularly visit an ophthalmologist to prevent various pathologies.

Thoroughly clean the area of the eyelash edge from dirt and accumulations of fatty deposits, especially in the presence of various eye pathologies.

Sources:

Hordeolum. Kara J. Bragg, Patrick H. Le, Jacqueline K. Le. https://www.ncbi.nlm.nih.gov/books/NBK441985/
Hordeolum: Acute abscess within an eyelid sebaceous gland. Colm McAlinden, Miguel González-Andrades, Eirini Skiadaresi. Cleveland Clinic Journal of Medicine May 2021. https://www.ccjm.org/content/83/5/332.long
The use of combined antibacterial agents in ophthalmology. Deev L. A., Belkova A. G., Malakhova A. I., Voitova S. P. Bulletin of the Smolensk State Medical Academy, 2012. p. 71-74
Inflammatory diseases of the eyelids from the perspective of an ophthalmo-oncologist. Grishina E.E. RMJ. Clinical ophthalmology No. 3, 2021. p. 190-193

Questions and answers

What causes stye on the eye?

The main cause of inflammation is infection of the sebaceous gland or hair follicle of the eyelash due to the active activity of staphylococci. This is facilitated by air pollution, a decrease in the protective properties of the immune system, and non-compliance with personal hygiene rules. Less commonly, stye appears on the eye due to difficult professional conditions or untreated infectious eye diseases.

How does stye appear?

The first signs of stye are discomfort of the eyelid, noticeable inflammation and swelling of the eyelash area, itching and a feeling of some heaviness. Within a few days, a yellow, purulent head of inflammation becomes noticeable on the surface of the skin. As it matures, it breaks through, after which a number of “inflammatory” symptoms of the disease go away, but a slight itching and an area of redness remain.

How to quickly remove stye from the eye?

Any methods of treating stye should be agreed upon with an ophthalmologist. The sooner you seek help, the faster you will be able to cope with the pathology. Antibacterial agents and topical ointments will help speed up the breakthrough of the purulent capsule. Attempts to quickly remove stye from the eye with compresses, heating or squeezing out pus are very dangerous and can cause serious inflammation of the mucous membrane and damage to the eyeball.

Stages of the disease

There are several stages in the development of the disease:

Infiltration. A small bump appears on the inner or outer surface of the eyelid, which can easily be confused with a speck that has gotten into the eye. In this area, itching, redness, and slight swelling occur, which intensify over time.
Suppuration. After some time, the swelling increases, fills with pus and causes serious discomfort when touched or blinked.
Breakthrough of the abscess. In the normal course of the disease, after 3-4 days the abscess ripens and ruptures itself, the contents coming out to the surface of the skin. if this does not happen, the purulent capsule will have to be opened surgically in the doctor’s office.
Healing. The affected area ceases to be painful, the wound heals, a crust forms, which falls off over the next few days, revealing healthy tissue.