Styes or hordeola are a common, yet frustrating eye condition affecting many people. They can cause discomfort, pain, and embarrassment due to their appearance. At our practice, we have developed a unique and effective protocol for treating these persistent styes, providing relief and long-lasting results for our patients. This article will outline the pathophysiology of styes, why traditional treatments may not always work, and our innovative approach to tackling this issue.
Pathophysiology of Styes
Styes are usually a result of the chronic, long-term blockage of meibomian glands. These glands are responsible for producing the oily component of tears, called meibum. When the meibum becomes thickened, it can back up into the gland, congealing and causing obstruction within the glands. This can lead to inflammation and infection, resulting in the formation of a stye.
Traditional Treatments and Their Limitations
Most commonly, patients are advised to use warm compresses and prescribed topical ointments to treat a chalazion or stye. If discovered early enough, these measures can help to melt the plug and drain the chalazion. Unfortunately, all too often, by the time the chalazion is discovered by the patient, it is too late.
At this stage, the body has formed a dense capsule around the plugged, inflamed gland, trying to limit the spread of infection. This means that neither topical nor systemic antibiotics can effectively penetrate the capsule. Heating the area usually doesn't make anything better. The hordeolum may shrink and turn into a "cold nodule," which can sometimes wax and wane but never completely disappear. This situation can be incredibly frustrating for both the patient and the physician.
Our Unique Treatment Protocol for Styes
At our practice, we have developed an effective protocol for approaching these annoying styes:
1. If the stye presents as generalized swelling, redness, and tenderness without a sharply defined capsule (tender, pea-sized nodule), we administer an injection of a specialized cocktail of medications. This mixture consists of Lidocaine (anesthetic), Sodium Bicarbonate, 5-fluorouracil (antifibrotic agent), and Kenalog (long-acting depot steroid).
This treatment usually results in the resolution of the stye within a week.
2. If the stye is already encapsulated, the treatment will require evacuation and drainage of the stye, with an injection of the same medication mixture mentioned above.
This helps to dissolve the capsule. In addition to the injection, we also use localized Intense Pulsed Light (IPL) therapy to speed up the resolution of the stye.
Follow-up and Maintenance
After the above treatments, we recommend a follow-up within 2-3 weeks. Should there be persistent signs of inflammation, the injection may have to be repeated. Once the stye is resolved, attention must be turned to the underlying cause, which is often blepharitis.
At this point, additional treatments such as BlephEx, LipiFlow, and IPL may be recommended to bring the problem under control and prevent recurrence.
Our innovative approach to treating styes has proven to be highly effective in providing relief and long-lasting results for our patients. By addressing both the stye itself and its underlying cause, we can help our patients achieve healthier eyes and a better quality of life.
If you're struggling with persistent styes, consider visiting our clinic to experience our unique treatment protocol.