The meibomian glands are located in the deep layers of the eyelid tissue and open at the eyelid margin. Bacteria invade the glands through the openings at the eyelid margin, traveling upward along the ducts and causing inflammation. This condition is commonly known as a stye. In Chinese medicine, a stye 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.

bubble_chart Clinical Manifestations

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, forming a hard nodule after about 2–3 days, with obvious swelling pain and tenderness. Later, 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 of the eyelid and nearby conjunctiva. Preauricular lymphadenopathy and tenderness are common, 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. A yellowish pus mass may be faintly visible beneath the congested conjunctiva and may rupture spontaneously, expelling pus into the conjunctival sac. The opening of the meibomian gland may show grade I swelling and congestion, and pus may also be discharged 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 root of the eyelash, manifesting on the skin surface; internal hordeolum occurs in the meibomian glands, manifesting on the conjunctival surface. Pain is relieved and redness and swelling subside after rupture and expulsion of pus.

3. Severe cases may be accompanied by enlarged and tender preauricular or submandibular lymph nodes, along with systemic symptoms such as fear of cold and fever.

bubble_chart Treatment Measures

1. In the early stage, apply dampness-heat compresses or rotary 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 inflammation from spreading into the orbit or cranial cavity, which could lead to life-threatening conditions such as orbital cellulitis, cavernous sinus thrombophlebitis, meningitis, or abscesses.

3. For stubborn or recurrent cases, autologous immunotherapy may be used. For patients with systemic fever, swollen preauricular or submandibular lymph nodes, antibiotics and sulfonamide drugs can be administered.