From the Guidelines
For the treatment of a hordeolum, warm compresses and over-the-counter pain relievers are the initial recommended treatments, with antibiotic ointments considered if the stye persists or worsens, as most styes are caused by Staphylococcus bacteria and resolve within 7-10 days with supportive care 1.
Initial Treatment
- Apply warm compresses to the affected eye for 10-15 minutes, 4-6 times daily to help bring the stye to a head and promote drainage.
- Use over-the-counter pain relievers like ibuprofen (400mg every 6-8 hours) or acetaminophen (500mg every 6 hours) to manage discomfort.
- Avoid touching or squeezing the stye to prevent further irritation and potential infection spread.
- Discontinue contact lens wear and eye makeup until the stye resolves to reduce the risk of complications.
Prevention of Recurrence
- Practice good eyelid hygiene, including regular cleansing with mild soap or baby shampoo, to help prevent the blockage of oil glands and reduce the risk of recurrence.
- Recognize that styes are typically caused by bacteria, such as Staphylococcus, which can be introduced through touching the eyes or sharing makeup 1.
Consideration for Antibiotic Therapy
- If the stye persists beyond a week, grows larger, affects vision, or spreads to other areas, seek medical attention for potential antibiotic ointment prescription, such as erythromycin or bacitracin.
- In recurrent or severe cases, a doctor might consider incision and drainage as a treatment option, especially if there's suspicion of a more complex infection or if initial treatments are ineffective 1.
From the Research
Definition and Causes of Hordeolum
- Hordeolum is a common, painful inflammation of the eyelid margin that is usually caused by a bacterial infection 2, 3, 4.
- The infection affects oil glands of the eyelid and can be internal or external.
Symptoms and Complications
- In many cases, the lesion drains spontaneously and resolves untreated; however, the inflammation can spread to other ocular glands or tissues, and recurrences are common 2, 3, 4.
- If unresolved, acute internal hordeolum can become chronic or develop into a chalazion 2, 3, 4.
Treatment and Interventions
- Non-surgical interventions of interest include the use of hot or warm compresses, lid scrubs, antibiotics, or steroids compared with observation, placebo, or other active interventions 2, 3, 4.
- However, no relevant studies were found to support the effectiveness of these interventions for the treatment of acute internal hordeolum 2, 3, 4.
- Controlled clinical trials would be useful in determining which interventions are effective for the treatment of acute internal hordeolum 2, 3, 4.
Research Gaps and Limitations
- Most of the references identified through searches reported on external hordeola or chronic internal hordeola, rather than acute internal hordeolum 2, 3, 4.
- The few references specific to acute internal hordeolum reported mostly recommendations for treatment or were reports of interventional case series, case studies, or other types of observational study designs, and were published more than 20 years ago 2, 3, 4.