From the Guidelines
A toddler with a hordeolum (stye) should be suspected of having blepharokeratoconjunctivitis, a condition that can cause permanent structural damage and possible vision loss if left untreated 1.
Key Considerations
- Hordeolum is a common presentation of blepharitis in children, and it is often confused with herpetic disease 1.
- A thorough history and physical examination are essential to diagnose and manage blepharitis in children, including questions about symptoms, time of day when symptoms are worse, duration of symptoms, and unilateral or bilateral presentation 1.
- Blepharitis can be associated with systemic diseases such as rosacea, atopy, psoriasis, and graft-versus-host disease (GVHD), and a thorough medical history is necessary to identify these conditions 1.
Management
- Detection and appropriate treatment can reduce signs and symptoms of blepharitis and prevent permanent structural damage and possible vision loss 1.
- Customized treatment approaches are necessary for patients with blepharitis, as the condition can have a complex relationship with tear dysfunction 1.
From the Research
Definition and Causes of Hordeolum
- Hordeolum is a common, painful inflammation of the eyelid margin usually caused by bacterial infection 2, 3, 4, 5.
- The infection affects oil glands of the eyelid and can be internal or external 2, 3, 4, 5.
- External hordeola are also known as styes, and occur when the glands of Zeis or Moll associated with eyelash follicles are affected 6.
Treatment of Hordeolum
- Most cases of hordeolum resolve spontaneously over time, but in some instances, surgical intervention may be necessary 3.
- Non-surgical interventions such as hot or warm compresses, lid scrubs, antibiotics, or steroids may be used to treat hordeolum, but there is limited evidence to support their effectiveness 2, 4, 5.
- Acupuncture may provide short-term benefits for treating acute hordeolum, but the certainty of the evidence is low to very low due to methodological limitations and high risk of bias 6.
Specific Considerations for Toddlers
- There is limited evidence available on the treatment of hordeolum in toddlers, and most studies have focused on adult populations 2, 3, 4, 5, 6.
- As with adults, most cases of hordeolum in toddlers are likely to resolve spontaneously, but parents should seek medical attention if the condition persists or worsens 3.
Research Gaps
- There is a need for controlled clinical trials to determine the effectiveness of non-surgical interventions for the treatment of hordeolum 2, 4, 5.
- Further research is also needed to investigate the use of acupuncture for treating hordeolum, including its safety and efficacy in different populations 6.