From the Guidelines
Treating a hordeolum, commonly known as a stye, can be effectively managed with warm compresses applied to the affected eyelid for several minutes, 4-6 times daily, as this helps bring the stye to a head and promotes drainage, as recommended in the 2024 blepharitis preferred practice pattern 1. The treatment approach for a hordeolum is largely similar to that of blepharitis, given the shared underlying causes related to eyelid hygiene and meibomian gland dysfunction.
- Warm compresses are a cornerstone of treatment, helping to soften and express any blockages in the meibomian glands, which can contribute to the development of a stye.
- In addition to warm compresses, eyelid cleansing with gentle massage can be beneficial, using diluted baby shampoo or commercially available eyelid cleaners, as these methods can help remove bacteria and reduce inflammation, as noted in the study 1.
- It's crucial for patients to understand that while these treatments can significantly improve symptoms, a cure is usually not possible without continual daily management, emphasizing the importance of persistence and a trial-and-error approach to find the most effective regimen, as discussed in the 2024 study 1.
- Topical antibiotics may be prescribed in some cases, but their use should be judicious and based on the severity of the condition and the presence of any underlying infections, considering the potential for adverse effects and the development of antibiotic resistance.
- Over-the-counter pain relievers can help manage discomfort associated with a stye, but patients should be advised against touching or squeezing the stye, as this can lead to further complications, including the spread of infection or the development of more severe inflammation.
- In severe or recurrent cases, further evaluation may be necessary to rule out underlying conditions that could be contributing to the development of styes, such as blepharitis or meibomian gland dysfunction, highlighting the importance of a comprehensive approach to managing eyelid health, as outlined in the preferred practice pattern 1.
From the Research
Treatment Options for Hordeolum
- Hordeolum is a common, painful inflammation of the eyelid margin that is usually caused by bacterial infection 2, 3.
- The infection affects oil glands of the eyelid and can be internal or external.
- 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.
Effectiveness of Nonsurgical Treatments
- There is no evidence for or against the effectiveness of nonsurgical interventions for the treatment of hordeolum 2, 3.
- Controlled clinical trials would be useful in determining which interventions are effective for the treatment of acute internal hordeolum.
- Nonsurgical interventions of interest include the use of hot or warm compresses, lid scrubs, antibiotics, or steroids compared to observation, placebo, or other active interventions.
Challenges in Finding Relevant Studies
- Most of the references identified from searches reported on external hordeola or chronic internal hordeola 2, 3.
- 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.