SIGNS AND SYMPTOMS
Patients will present with an acutely swollen and edematous upper or lower eyelid. Visual function will be normal. There may be an associated conjunctivitis and possibly mucopurulent discharge. The lids will be extremely sensitive to palpation, and there may be an associated pustular, pimple-like lesion at the lid margin or, less commonly, at the dermis.
PATHOPHYSIOLOGY
A hordeolum is a bacterial infection of either the meibomian glands or ciliary glands (the glands of Zeis and Moll). If the latter are involved, the hordeolum is considered external and appears focal in nature. If the deeper meibomian glands are involved, the hordeolum is considered internal and is less circumscribed in appearance. Staphylococcus aureus and Staphylococcus epidermidis are the most likely culprits. Acute and chronic inflammation associated with hordeola, especially if improperly treated, may result in a granulomatous inflammation known as chalazia. If the infection spreads to neighboring glands or other lid tissue anterior to the tarsal plate, it may lead to preseptal cellulitis.
MANAGEMENT
Traditionally, the standard treatment has been topical antibiotic solutions and ointments. Unfortunately, this has virtually no therapeutic benefit. Topical application does not supply enough intra-tissue concentrations of antibiotics to be effective. Oral antibiotic therapy is necessary. If the hordeolum is external, you may drain and lance the lesion (anesthetic is usually unnecessary) or epilate nearby lashes to enhance drainage. Digital expression of purulent material in your office will expedite healing, but is not absolutely necessary. Antibiotic therapy could include dicloxacillin 250mg PO Q6H, erythromycin or tetracycline 250mg PO QID or amoxacillin 500mg PO TID for 10 days. Cold compresses will help to suppress inflammation.
CLINICAL PEARLS
The most common misdiagnosis of hordeola is chalazia. The distinguishing factor is pain upon palpation. If the lesion is not intensely sensitive to palpation, most likely it's a chalazion.
Avoid traditional topical therapies, which are therapeutically ineffective, and begin immediately with oral medications.
My name is Michelle. my 19 year old daughter, jane, was diagnosed of herpes 2 years ago. ever since then,we have been going from one hospital to the other. We tried all sorts of pills but all efforts to get rid of the virus was futile.
ReplyDeleteThe blisters kept on reappearing after some months. My daughter was making use of Acyclovir tablets 200mg. 2 tablets every 6hours and fusitin cream 15grams. and H5 POT. Permanganate with water to be applied 2x a day but all still show no result. So I was on the internet some months back, to sought for any other means of saving my only child. just then,i came across a comment on dr.ugo's herbal treatment and decided to give it a try. i contacted the doctor and he prepared some herbs and sent it to me together with guidelines on how to use the herbs. my daughter used it as directed and in less than 14days,my daughter regained her health.. You should contact Dr.Ugo today directly on his email address for any kind of health challenge you may have: ugoherbalhome@gmail.com..+2348104990619
I believed God has sent dr onokun to help people out from this horrible virus. i was diagnosis with hpv for 3 years, few months ago a friend introduced me to dr onokun and i only took his natural treatment for a week & 3 days, and i totally got cured with his herbal treatment. if you are suffering from hpv, you don't have to be roaming round dr onokun email is been attached to contact him on email: dronokunherbalcure@gmail.com
ReplyDelete