What is the pathophysiology of hordeolum (stye)?

Updated: Oct 08, 2019
  • Author: Michael J Bessette, MD, FACEP; Chief Editor: Gil Z Shlamovitz, MD, FACEP  more...
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Staphylococcus aureus is the infectious agent in 90-95% of cases of hordeolum.

An external hordeolum arises from a blockage and infection of Zeiss or Moll sebaceous glands. An internal hordeolum is a secondary infection of meibomian glands in the tarsal plate. Both types can arise as a secondary complication of blepharitis.

Untreated, the disease may spontaneously resolve or it may progress to chronic granulation with formation of a painless mass known as a chalazion. Chalazia can be quite large and can cause visual disturbance by deforming the cornea. Generalized cellulitis of the eyelid may occur if an internal hordeolum is untreated.

Most morbidity is secondary to improper drainage. Proper technique and drainage precautions are described in Treatment.

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