What is an internal stye called?

Internal Hordeolum Terminology

An internal hordeolum is medically referred to as a meibomian gland abscess or internal stye. 1

Definition and Characteristics

• An internal hordeolum is an acute, purulent inflammation affecting the meibomian gland in the tarsal plate of the eyelid 1, 2
• It differs from external hordeolum (stye), which affects the glands of Zeis or Moll associated with eyelash follicles 2
• Internal hordeola are commonly associated with posterior blepharitis or meibomian gland dysfunction (MGD) 1

Clinical Presentation

• Presents as a painful, localized swelling or nodule within the tarsal plate of the eyelid 1
• May cause redness, irritation, burning, and discomfort of the affected eyelid 1
• Can be distinguished from external hordeolum by its location deeper in the eyelid tissue rather than at the eyelid margin 2
• If unresolved, an internal hordeolum can develop into a chalazion (a chronic, granulomatous inflammation) 3, 4

Etiology

• Usually caused by bacterial infection, with Staphylococcus species being the most common pathogens 1, 3
• Staphylococcus aureus is isolated with greater frequency from patients with clinical diagnoses of staphylococcal blepharitis 1
• Obstruction of the meibomian gland orifice leads to retention of sebaceous secretions and subsequent infection 1

Associated Conditions

• Often occurs in patients with underlying blepharitis or meibomian gland dysfunction 1
• May be associated with rosacea, seborrheic dermatitis, or other dermatologic conditions 1, 5
• Recurrent hordeola may indicate an underlying systemic condition or immunodeficiency 6

Clinical Course

• Many internal hordeola resolve spontaneously within 7-10 days with drainage of the abscess 3, 4
• If left untreated, can spread to adjacent glands and tissues 2
• Recurrences are common, particularly in patients with chronic blepharitis or MGD 1

Examination Findings

• Eyelid examination may reveal localized swelling, erythema, and tenderness of the affected area 1
• Slit-lamp biomicroscopy can help identify abnormalities of meibomian orifices such as capping, pouting, or obstruction 1
• Expression of the meibomian glands may produce thick, turbid secretions rather than the normal clear oil 1

Differential Diagnosis

• External hordeolum (stye) - affects the glands of Zeis or Moll at the eyelid margin 2
• Chalazion - a chronic, granulomatous inflammation of the meibomian gland 7
• Sebaceous gland carcinoma - should be considered in cases of recurrent or atypical presentation 7

Remember that proper identification of the type of hordeolum (internal vs. external) is important for appropriate management and treatment 2.