What is the treatment for internal hordeolum (internal stye)?

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Last updated: April 13, 2025View editorial policy

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From the Research

Internal hordeolum should be treated with warm compresses applied to the affected eye for 10-15 minutes, 4-6 times daily to help bring the stye to a head and promote drainage, as this is the most commonly recommended approach despite a lack of strong evidence from recent studies 1.

Treatment Approach

  • Warm compresses can help manage symptoms and promote resolution of the hordeolum.
  • Over-the-counter pain relievers like acetaminophen or ibuprofen can help manage discomfort.
  • Avoid wearing contact lenses and eye makeup until the stye resolves.
  • If the stye is severe or doesn't improve within a week, antibiotic treatment may be necessary, typically erythromycin or bacitracin ophthalmic ointment applied to the affected area 2-3 times daily for 7-10 days.

Prevention and Hygiene

  • Good eyelid hygiene, including gentle cleansing with baby shampoo diluted in warm water, can help prevent recurrence by reducing bacterial load on the eyelids.
  • Never attempt to pop or squeeze a stye as this can spread the infection.

Evidence and Recommendations

Despite the lack of recent, high-quality studies on the treatment of internal hordeolum, the approach outlined above is based on the most recent and relevant evidence available 1, which emphasizes the need for controlled clinical trials to determine the effectiveness of non-surgical interventions for acute internal hordeolum. The older studies and reviews, such as those from 2010 2 and 2013 3, also highlight the common practice of using warm compresses and antibiotics but lack strong evidence to support these recommendations. A study from 2017 1 reiterates the need for clinical trials but does not provide new evidence for treatment approaches. Therefore, the recommendation is based on the most recent review of the literature, acknowledging the gap in evidence-based treatments for internal hordeolum.

References

Research

Non-surgical interventions for acute internal hordeolum.

The Cochrane database of systematic reviews, 2017

Research

Interventions for acute internal hordeolum.

The Cochrane database of systematic reviews, 2010

Research

Interventions for acute internal hordeolum.

The Cochrane database of systematic reviews, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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