"Name" scene - distinguishing between stye and chalazion from their names

Author: Diao Yumei Shandong First Medical University

Reviewer: Qi Xiaolin, Chief Physician, Ophthalmology Research Institute Affiliated to Shandong First Medical University (Shandong Provincial Ophthalmology Research Institute, Affiliated Qingdao Eye Hospital), Ophthalmology Hospital Affiliated to Shandong First Medical University (Shandong Provincial Eye Hospital)

Shan Fengmei, deputy chief physician, Shandong Eye Hospital, Shandong First Medical University

In daily life, we often hear: "I have a stye" or "I have a chalazion." So, is what "I" said correct?

In fact, whether in life or in clinical practice, confusion between hordeolum (commonly known as stye) and chalazion (also known as chalazion) has always existed.

Figure 1 Copyright image, no permission to reprint

1. Is it necessary to distinguish between stye and chalazion?

Both styes and chalazions are "pimples" that occur on the eyelids. Some people may ask: "Is it necessary to distinguish between styes and chalazions?" Styes and chalazions mainly affect the Moll glands (abnormal sweat glands), Zeis glands (abnormal sebaceous glands) and Meibomian glands (meibomian glands) of the eyelids.

Stye is an acute inflammation caused by purulent bacteria invading the eyelid glands (Meibomian glands, Zeis glands, Moll glands); invasion of the Zeis glands and Moll glands is an external stye, and invasion of the Meibomian glands is an internal stye. Chalazion is mostly caused by changes in the lipid composition of the meibomian glands (which may be related to hormones, diet, etc.), which leads to difficulty in oil discharge and then retention in the meibomian glands (sometimes involving the Zeis glands). It is a chronic granulomatous inflammation of the meibomian glands.

Since the nature of the inflammation of stye and chalazion is completely different, the corresponding treatment methods are also different. The veins of the eyelids do not have venous valves, and if the lesions in these areas are not treated properly (especially infectious lesions such as styes), inflammation accompanied by venous reflux may affect the brain and endanger life.

Therefore, it is necessary to correctly distinguish between stye and chalazion.

2. How to distinguish between stye and chalazion?

Let me share with you a simple and scientific method to distinguish and analyze "famous scenes".

Chinese characters are a broad and profound culture. In addition to their role as "symbols", their evolution and interpretation have given them specific essences and connotations.

So, how do you analyze the "famous scenes" of styes and chalazions? Here is an introduction.

wheat

Meaning: In ancient times, "麦" (wheat) was derived from "来" (come), because it is said that wheat is not a native crop in China, but "came" from the Western Regions to the Central Plains, so it has the meaning of "foreign", which corresponds to the fact that stye is a disease caused by purulent bacteria invading the human body (rather than the body's own tissue lesions);

Shape: The appearance is like a grain of wheat;

Characteristics: As the proverb goes, "Grain full, grain full, grain full". When Grain full arrives, the temperature rises and the grains gradually become full. At this time, people often eat bitter vegetables to treat fever. Stye corresponds to the warming climate and the "heat" in the body when the grains mature, which corresponds to the typical characteristics of acute inflammation of stye: redness, swelling, heat and pain.

Figure 2 Copyright image, no permission to reprint

sleet

Meaning: According to ancient books, "Hail is snow that has not yet formed into flowers. It is now commonly called rice-grain snow, which is the first frozen rain." Simply put, hailu is water vapor in the high altitude that encounters cold air and cannot diffuse and evaporate, and condenses into small ice particles. It usually appears when or before it snows, which corresponds to the fact that chalazions are mostly caused by difficulty in the discharge of oil from the meibomian glands.

Shape: It looks like a rounded hail, without the pointed top like a grain of wheat;

Characteristics: Corresponding to the formation process of graupel, it has the characteristics of "cold" lesions, that is, chronic granulomatous inflammation of the meibomian glands, which may show congestion or local swelling, but will not have the acute inflammatory characteristics of heat and pain like stye.

Figure 3 Copyright image, no permission to reprint

Therefore, by analyzing the word "麦" in the name of stye and the word "收" in chalazion, and associating stye with "hot" and corresponding chalazion with "cold", through such "famous scene" analysis, can we easily remember the disease characteristics of stye and chalazion, and easily distinguish between stye and chalazion?

3. What are the differences in the treatment of stye and chalazion?

1. Stye

Pay attention to eye hygiene to prevent the stye from getting worse, spreading and recurring.

In the early stage of the disease, local antibiotics are used to control the infection. If the infection is not well controlled, oral or intravenous antibiotics should be given and the body temperature should be closely monitored.

Physical therapy: In view of the acute inflammation of stye, cold compress can be used to relieve pain and localize inflammation when the swelling and pain are obvious; 5 to 10 minutes/time, multiple times a day. After the acute inflammation disappears, hot compress can be used to promote the absorption and regression of the lesion.

Avoid squeezing the abscess before it forms to prevent the infection from spreading or spreading into the skull (through the eyelid veins into the cavernous sinus). After the abscess is formed, most of them will rupture on their own. If they do not rupture, they can be incised and drained after the fluctuation sensation is formed.

2. Chalazion

Pay attention to eye hygiene to avoid secondary infection of chalazion;

Apply hot compress in the early stage to soften the lesion and promote absorption;

Lesions that are ineffective with physical therapy and affect appearance and vision can be surgically removed;

Especially for elderly patients with repeated recurrences, specimens should be removed for pathological examination to rule out malignant tumors.

Figure 4 Copyright image, no permission to reprint

References

[1] Kim ES, Afshin EE, Elahi E. The lowly chalazion[J]. Surv Ophthalmol, 2023,68(4):784-793.

[2] Suzuki T, Katsuki N, Tsutsumi R, et al. Reconsidering the pathogenesis of chalazion[J]. Ocul Surf, 2022,24:31-33.

[3] Nemoto R, Usui Y, Komatsu H, et al. Immunophenotypic profiles in chalazion and pyogenic granuloma associated with chalazion[J]. Graefes Arch Clin Exp Ophthalmol, 2024,262(4):1329-1335.