The meibomian glands are located deep within the eyelid tissue and open at the eyelid margin. Bacteria invade the glands through these openings at the eyelid margin, traveling along the ducts and causing inflammation. This condition is commonly known as a hordeolum. In Chinese medicine, a hordeolum is referred to as a stye, colloquially called a stye. It is caused by excessive consumption of rich foods, accumulation of heat in the spleen and stomach, and external contraction of wind pathogens.

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﹝Complications﹞

﹝Efficacy Evaluation﹞

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Differential Diagnosis

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Hordeolum is divided into two types.

1. External hordeolum (hordeolum externum) is an acute suppurative inflammation of the Zeis glands. Initially, there is localized congestion and swelling at the eyelid margin. After about 2 to 3 days, a hard nodule forms, with significant pain and tenderness. Subsequently, the nodule gradually softens, forming a yellow pustule at the root of the eyelash, which ruptures, expelling pus, and heals quickly. If the pathogen is highly virulent, it may also cause edema in the eyelid and nearby conjunctiva. Preauricular lymph nodes may become swollen and tender, especially near the outer canthus. Severe cases may present with systemic symptoms such as fear of cold and fever.

2. Internal hordeolum (hordeolum internum) is an acute suppurative inflammation of the meibomian glands. Its clinical symptoms are less severe than those of external hordeolum because the inflamed meibomian glands are surrounded by firm tarsal tissue. Yellowish pus may be faintly visible beneath the congested conjunctiva, and it may spontaneously rupture, expelling pus into the conjunctival sac. The opening of the meibomian gland may show grade I swelling and congestion, and pus may also drain along the glandular duct. In rare cases, pus may rupture through the skin. If the tarsal plate fails to rupture and the pathogen is highly virulent, the inflammation may spread, involving the entire tarsal tissue and forming an eyelid abscess.

1. The eyelid shows localized redness, swelling, heat, and pain, with adjacent bulbar conjunctival edema.

2. After 3–5 days, a pustule forms, presenting with a yellow purulent head. External hordeolum occurs in the sebaceous glands at the base of the eyelashes and manifests on the skin surface; internal hordeolum occurs in the meibomian glands and manifests on the conjunctival surface. Pain subsides and redness/swelling resolves after rupture and pus discharge.

3. Severe cases may be accompanied by enlargement and tenderness of the preauricular or submandibular lymph nodes, along with systemic symptoms such as chills and fever.

bubble_chart Treatment Measures

1. In the early stage, apply dampness-heat compresses or rotating magnetic therapy to promote the absorption of infiltration or rapid suppuration of indurations.

2. Surgical incision: When pus points form, an incision can be made to expel pus. However, note that the incision for external hordeolum should be parallel to the eyelid margin, while the incision for internal hordeolum should be perpendicular to the eyelid margin. Avoid inappropriate squeezing to prevent the spread of inflammation into the orbit or cranial cavity, which may lead to orbital cellulitis, cavernous sinus thrombophlebitis, meningitis, or abscesses, endangering life.

3. For stubborn or recurrent cases, autologous immunotherapy may be used. For patients with systemic fever, preauricular or submandibular lymphadenopathy, antibiotics and sulfonamides can be administered.