From the Guidelines
Topical antibiotics, such as erythromycin or bacitracin ointment, are the primary recommended medications for treating hordeolum, applied to the affected eyelid margin 2-4 times daily for 7-10 days. The treatment of hordeolum, also known as a stye, typically involves addressing the bacterial infection that causes the condition [ 1 ].
Key Considerations
- Before applying any medication, gently cleansing the eyelid with warm compresses for 10-15 minutes, 3-4 times daily, can help soften and drain the infected material.
- Patients should apply the ointment with clean hands or a sterile cotton swab to prevent spreading the infection.
- It is essential to avoid sharing towels or washcloths to minimize the risk of transmission.
Treatment Options
- Erythromycin ophthalmic ointment (0.5%) or bacitracin ophthalmic ointment are commonly used topical antibiotics for treating hordeolum [ 1 ].
- For more severe cases, combination antibiotic-steroid preparations like neomycin-polymyxin B-dexamethasone may be used, but these should be prescribed with caution due to potential steroid side effects.
Monitoring and Follow-Up
- If symptoms do not improve within 48-72 hours of treatment, or if vision changes, pain increases, or the redness spreads, medical attention should be sought as oral antibiotics may be necessary [ 1 ].
From the Research
Topical Medications for Hordeolum Treatment
- There is limited evidence on the effectiveness of topical medications for the treatment of hordeolum 2, 3.
- A pilot study compared the effectiveness of combined antibiotic ophthalmic solution with a placebo in the treatment of hordeolum after incision and curettage, and found no statistically significant differences between the two groups 4.
- A retrospective review of patients treated for chalazia or hordeola found that the addition of an antibiotic to conservative measures was not associated with an increased likelihood of treatment success 5.
- The use of antibiotics was more likely to be prescribed in emergency or acute care settings for chalazia, and older age was associated with a higher risk of receiving an antibiotic for hordeolum 5.
Recommended Topical Medications
- There is no clear evidence to support the use of specific topical medications for the treatment of hordeolum 2, 3.
- Combined antibiotic ophthalmic solutions, such as neomycin sulfate, polymyxin B sulfate, and gramicidin, have been studied, but their effectiveness is unclear 4.
- Artificial tears may be used as a placebo or to help with symptoms, but their effectiveness in treating hordeolum is unknown 4.
Treatment Approaches
- Conservative measures, such as warm compresses and lid scrubs, may be recommended for the treatment of hordeolum, but the effectiveness of these approaches is not well established 2, 3.
- Incision and curettage may be performed in some cases, but the effectiveness of this procedure is not well studied 4.
- The use of antibiotics is common in the treatment of hordeolum, but their effectiveness is unclear, and they may not improve treatment outcomes 5.