|ICD-10||H 00 00.|
|eMedicine||emerg / 755|
Barley (hordeolum) - acute purulent inflammation of the hair follicle of the eyelashes or the sebaceous glands of Zeis, which is located near the eyelash bulb. There is also the so-called. domestic barleywhen the lobule of the meibomian gland becomes inflamed. Symptoms of both forms - inflammation and swelling of the edge of the eyelid, redness, tenderness. Barley is caused by a bacterial infection (in 90-95% of cases - Staphylococcus aureus) and is most often observed with weakened immunity (for example, after colds).
At the edge of the eyelid, a painful, limited swelling, swelling, and redness of the conjunctiva of the eyelid appear. After 2−4 days on the top of the swelling a yellowish head forms, at the opening of which pus with particles of dead tissue appears. The appearance of several barley is possible.
In some cases, possible headaches, fever, enlarged lymph nodes. Squeezing pus is contraindicated, such an attempt can lead to the spread of infection in the direction of the orbit with the occurrence of phlegmon of the orbit, thrombosis of the cavernous sinus of the brain, meningitis, even fatal outcome is possible.
Macomite Local barley symptoms (incremental)
- The itch of a century in the field of the future barley
- Soreness when blinking and touching the eyelid
- Redness of the century
- Foreign body sensation in the eye
- Yellowish vesicle at the apex of swelling outside the eyelid (outer) or on the inner surface of the eyelid (inner), which appears after 3-4 days of illness.
- Spontaneous opening of the vesicle, which is accompanied by the release of pus for 4-5 days.
In weakened people, in children, with multiple and recurrent barley, common symptoms may develop: hyperthermia, headache, weakness, swollen lymph nodes.
Causes and provoking factors of hordeolum
Why does barley appear on the eye? The etiological pathogen of barley is Staphylococcus aureus, a permanent inhabitant of human skin and hair, conditionally pathogenic microbe. Less commonly, barley is caused by streptococci. Pathological activity and reproduction of a microorganism occurs in the presence of certain factors:
- Hypothermia in which the body’s defenses are reduced
- Reduced immunity (compared to other diseases, stress, overwork, physical overload, malnutrition, passion for diets)
- Hypovitaminosis (see avitaminosis and hypovitaminosis)
- Diabetes when disrupted nutrition century
- Diseases of the gastrointestinal tract, in which the absorption of vitamins, microelements in the intestine is impaired and, accordingly, immunity suffers.
- Carriage of Staphylococcus aureus resistant to antimicrobial agents (see Staphylococcus aureus in the intestines of a child).
- Chronic infections (caries, adenoiditis, tonsillitis)
- Hereditary predisposition
- Worm infestation (see the symptoms of worms in humans)
- Non-compliance with hygiene rules (wiping eyes with dirty hands)
- Wearing contact lenses (as such is not the cause, but in conjunction with other factors aggravates the condition).
Barley on the child's eye
The mechanism of barley on the eye of a child is no different from that of an adult, but here it can flow harder. Due to the imperfections of immunity, as well as the difficulty of providing rest to the patient's eye (the child can touch the eyelid with hands, scratch, aggravating the situation) complications such as blephoritis, abscess, phlegmon, and hollyion often occur.
The fiber lining the eyelid from the inside is more loose in children than in adults, so the inflammatory focus is not limited and quickly spreads to the surrounding tissue. In the most serious cases, barley can lead to meningitis. Therefore, the answer to the question of how to cure barley in the eye of a child is as follows: it is most reasonable to start treatment of barley at the doctor and not to neglect his prescriptions. With the development of complications, hospitalization is indicated.
A piece of cotton with a match head is moistened in vodka or medical alcohol, diluted with water 1: 1, well wring out and cauterize the reddened part of the century at the very base of the eyelashes. This method, when carried out in a timely manner, with the observance of precautionary measures (alcohol should not get into the eye) and time guarantees full regression of barley on that day. Instead of alcohol, you can use iodine or brilliant green (alcohol).
This is an effective remedy for barley. The egg is boiled hard-boiled, wrapped in a rag in a hot dish and applied to the eye and kept until cool. You can also use sea salt heated in a pan, flax seed, as a source of heat.
This method is no less effective, but it works only at the onset of the disease. If you have pus - you can not warm!
Antibiotic eye drops
Designed to combat microorganisms and prevent the spread of the process. selecting preparations (drops from barley) sulfacetamide (for treating accompanying conjunctivitis) Sofradeks, 1% Penicillin solution, Gentamycin, Erythromycin, chloramphenicol, Tsiprolet, Tobreks, Chloramphenicol, Futsitalmik, Tobrom, Tobramycin, Vigamoks.
Application: instillation into the eye 3-6 times a day.
Antibiotic Eye Ointment
Perform a similar task, but are intended for use at night, because they impair the quality of vision. The feasibility of their use is high - drops work during the day, and ointment at night, which contributes to faster recovery.
Preparations of choice (barley ointment): Tetracycline, Erythromycin eye ointment, Tobrax, Kolbiotsin, Eubetal, Floksal (ofloxacin).
Application: Laid overnight. Thoroughly wash their hands and squeeze 3-4 mm of ointment onto the finger, with the second hand they delay the eyelid and carefully lay the ointment. You can lay the ointment in the afternoon, if the work does not require precise action.
When purchasing ointment or drops in a pharmacy, do not forget to clarify that you need a preparation for the eyes! Ointments for application to the skin have many times greater concentration of the active substance and can cause irreparable harm. Use ointments and drops for external use with the same name instead of the eye is strictly prohibited!
The use of ointments with corticosteroids (hormones such as dexamethasone, hydrocortisone ointment) during the bacterial process is not permissible, since they are contraindicated for purulent inflammation.
Antibiotics for oral administration
Shown in multiple and complicated barley, in the presence of common symptoms, lack of efficacy from local treatment, in barley in debilitated patients and often in children. They act on the etiological factor and prevent further spread of the infection.
Drugs of choice: Doxycycline (Unidox Soluteb), Ampicillin, can be inhibitor-protected (Amoxiclav, Augmentin, Flemoklav Solyutab, etc.), second-line drugs - macrolides (Azithromycin, Sumamed, Azitrox, etc.), third-line drugs, third-row drugs - Id, I, I, I, I, I, I, I, 3)
Application: according to the instruction of 5-7 days.
Folk remedies are actively used by people. Some of them are really effective, some succumb to great doubt, for example, a fig or spit in a sore eye, rubbing the eye with salt if barley appeared, etc. One should think a hundred times before using grandma's methods, since these are eyes that a person has only two in order not to harm health. How to remove barley from the eye:
- Moxibustion of barley alcohol tincture of valerian. Cotton swab dipped in tincture and gently cauterize barley 5-10 minutes. Many people note the high efficiency of the method with an early start.
- Green tea (see harm to tea bags). Moisten a sterile bandage in freshly brewed tea and apply it warm to the eye. You can use 2-3 times a day at the beginning of the disease, in the presence of pus it is impossible to soften the eye tissue.
- Silver item. A corner of a clean silver spoon or fork is held several times over the sore eyelid at the eyelash growth line. Effectively at the beginning of the process.
- Tincture of calendula . Alcohol tincture diluted with water 1:10. A sterile bandage is moistened in a solution, pressed and applied to the eye for 5-10 minutes.
- Aloe. From the freshly cut and left for 12 hours in the fridge of the aloe leaf, squeeze out the juice and dilute with water 1:10, use lotion liquid (you do not need to wet the bandage much).
- Onion . The onion circle 1 cm thick is fried in vegetable oil over low heat, put warm in gauze and applied to the eyelid until the onions cool. Repeat several times.
- Baby shampoo without tears. Apply with the revealed barley, to clear the eyes of pus and crusts. Dilute 1:20 with warm boiled water and drip a few drops into the eye, blink and rub the eyelid from the outside inwards with a sterile bandage.
- Birch juice . Is ingested 0.5 l daily. It is believed that it purifies the blood.
- Beet Juice After squeezing, the juice should be left in the refrigerator for 3 hours, then first use 1/5 cup, gradually increasing the volume to half a cup per day. Also has the property of cleansing the blood and tonic effect.
Barley (hordeolum) is the most common eyelid disease in ophthalmology. According to statistics, during the life of barley on the face of 80% of the population. The disease most often occurs in children and adults aged 30–50 years. Barley is characterized by acute purulent inflammation caused by a bacterial infection and developing in the hair follicle of the eyelashes and the adjacent sebaceous gland. It should be remembered that the barley on the eye is not just a cosmetic problem, but a disease that, with self-treatment, can lead to severe purulent-septic complications or chronic process. Under the guise of barley, other eyelid diseases can hide - chalazion, cysts, eyelid tumors.
The cause of barley is a bacterial infection, in 90% of cases - Staphylococcus aureus. In some cases, the root cause of barley may be a microscopic demodex mite that lives on eyelashes, or fungi. The penetration of microorganisms into the cavity of the sebaceous gland or the hair follicle leads to blockage of the excretory duct opening into the follicle, inflammation of the walls of the cavities and accumulation of purulent secretions.
The infection of the hair follicle and the cavity of the sebaceous gland contributes to non-compliance with the rules of hygiene - wiping the face with a dirty towel, wiping the eyes with hands, brushing the eyelids, using poor-quality cosmetics, soiled brushes, applicators for applying makeup, etc.
Chronic diseases (diabetes, seborrhea, furunculosis, hyperlipidemia, gastrointestinal diseases, helminthic invasion), oily skin, acne vulgaris, stress, deficiency of vitamins A, B and C, reduced immunity, HIV infection, general exhaustion predispose to the development and recurrence of barley. , anemia, prolonged eyestrain, pollution of the room or atmospheric air. Often, barley accompanies the course of other eye diseases - blepharitis, conjunctivitis, and also occurs when contact lenses are used and stored improperly.
Localization distinguish between outer and inner barley. Outdoor barley is most common and is an abscess on the ciliary edge of the century, from the outside. Inner barley (meybomite) develops in the thickness of the century with the infection of the meibomian glands and the inflammation of the cartilage plate of the century. Chronic meybomit leads to the development of chalazion.
By the number of ulcers, eye barley can be single or multiple, occur on one or both eyes. Multiple recurrent barley occurs when the infection spreads from one hair follicle to another and is usually seen in debilitated patients.
Barley development usually occurs acutely, at short notice. First, the itching of the edge of the eyelid appears, then hyperemia and local swelling develop, which is accompanied by pain at rest and with pressure on the inflamed hearth. Sometimes the swelling of the eyelid is so pronounced that the patient cannot open the eye. The formation of multiple barley on the eye is accompanied by common symptoms: fever, headache, malaise, swelling of the parotid and submandibular lymph nodes.
After 2-3 days in the area of the inflammatory focus appears pustula - purulent head, at the same time the pain subsides. When barley is opened independently, purulent contents are released from it, after which all symptoms gradually regress. Usually purulent-inflammatory process with barley takes about one week.
Inner barley is located from the inside of the eyelid, deep in the cartilage. It is determined by inverting the eyelid as a local hyperemia and conjunctival edema. After 2-3 days, as the barley ripens, yellowish pus appears through the mucous membrane. Spontaneous opening of the internal barley occurs from the side of the conjunctiva. Subsequently, leaf-like granulations often grow on the mucous membrane of the eyelid.
The content of ripe barley can never be squeezed by yourself. Otherwise, it is possible the infection gets into the saphenous veins of the face, and according to them - into the deep veins of the orbit. Further, multiple eyelid abscesses may develop, orbital cellulitis, orbital eyelid thrombophlebitis, and in severe cases - purulent meningitis and lethal sepsis.
Undertreated barley leads to chronic infection and recurrence of inflammation, a complication that requires surgical treatment can be a complication of the internal barley.
When barley appears on the eye, it is advisable to consult an ophthalmologist. Usually, recognition of indoor or outdoor barley is carried out by visual inspection of the eye with eversion of the eyelids with side lighting. Additional eye diagnosis in most cases is not required.
When often recurrent barley, you may need to consult other specialists (endocrinologist, gastroenterologist, dermatologist), determination of blood and urine glucose, conducting a glucose-tolerant test, eyelashes for demodex and feces on helminth eggs. Bacteriological examination of the conjunctival smear is carried out to identify the causative agent of barley, blood culture for sterility.
Differential diagnosis of barley is carried out with chalazion, dacryoadenitis, cysts and eyelid tumors.
Century Barley Treatment
At the first manifestations (itching, redness of the century) it is recommended to treat the problem focus 2-3 times a day with 70% ethyl alcohol, a solution of iodine or brilliant green. Instillations are made into the conjunctival cavity of a solution of sulphacetamide or antibiotics, the initiation of eye ointments with antimicrobial action (chloramphenicol, tetracycline, erythromycin). Sometimes with the help of such measures it is possible to prevent the further development of barley on the eye.
At the stage of ripening of barley, the use of dry heat is shown, and physiotherapeutic procedures are performed - tubus-quartz, UHF. It is strictly forbidden to apply wet compresses, as this may cause the formation of new abscesses.
After a spontaneous breakthrough of barley, instillations of eye drops containing sulfacetamide or ciprofloxacin continue, and antibacterial eye ointments are laid in the eyelid.If the barley on the eye is accompanied by general symptoms, it is necessary to administer antibiotics orally or intramuscularly.
In some cases (with a large external abscess, meibomite, in the absence of the expected effect of treatment), barley is opened in the conditions of the ophthalmic cabinet. Further daily postoperative treatment of the eyelid, local or systemic antibiotic therapy is carried out. In chronic inflammation of the eyelid resort to epilation of eyelashes.
In the case of the recurrent nature of barley, autohemotherapy, ultraviolet irradiation, vitamin therapy, bracing measures are prescribed on the eye. When a chalazion is formed, its removal is indicated by injection or surgery.
Prognosis and prevention
If the recommendations are followed and the treatment is correct, the barley on the eye passes without consequences. In the process of treatment of barley, women should abandon the use of cosmetics. With self-treatment of barley, it is necessary to wait for its ripening and spontaneous opening. Squeezing the abscess can lead to severe local (infection of the subcutaneous fat of the eyelids and orbit) or generalized (meningitis, sepsis) complications.
Barley prevention should include the identification and elimination of predisposing factors, immunity strengthening, good nutrition, hygiene and contact lens care requirements, refusal to use low-quality cosmetics, etc.
Causes and symptoms.
In most cases, the source of the appearance of barley is conditionally pathogenic microbe Staphylococcus aureus, which is constantly present in the human body, being part of the microflora of the skin and hair.
An elementary non-observance of hygiene can provoke its active reproduction.
Against a background of weakened immunity, it will be enough to scratch the eye with a dirty hand or to wipe the face with a stale towel and carry the infection.
The following factors also contribute to inflammation:
- Hypothermia (followed by a temporary decrease in immunity),
- The presence of purulent parasite Staphylococcus aureus in the body,
- Chronic infections - tonsillitis, caries, adenoiditis and others,
- The presence of such diseases as diabetes, seborrhea, chronic blepharitis, anemia, hepatitis,
- Diseases of the digestive tract with impaired intestinal microflora,
- Vitamin deficiency and hypovitaminosis (lack of one or several vitamins),
- Helminthic invasion,
- Congenital and acquired immunodeficiencies,
- In rare cases, ciliated demodex,
Wearing contact lenses or the use of poor-quality cosmetics can also be a disease-provoking factor, but it is never the root cause of the disease.
The main symptoms of hordeolum:
During the self-diagnosis of barley on the eye, some photos from the Internet can be misleading, so look above, if you do not have such inflammatory processes, you may have something else.
You need to know all the symptoms of this disease:
- Burning and itching of the century
- Foreign body sensation under the eyelid
- Blistering and redness of the century, its hardening,
- Soreness from touching the inflamed area and blinking,
- The appearance of tearing,
- The appearance on the edema of the yellow dot - accumulations of pus,
In some cases, the listed symptoms may be accompanied by headache, inflammation of the nearest lymph nodes and fever.
What not to do with barley
If you have a swelling on the eyelid, in any case can not perform the following actions:
- to brush the sore area with your hands,
- use contact lenses during the illness,
- use any cosmetics, even quality,
- try to hide the swelling with a plaster,
- warm up after the appearance of pus,
- try to squeeze out or independently open the purulent head with a sharp object,
- do wet compresses on the eyes,
- in the cold season, before going out, it is necessary to apply a dry sterile dressing to the affected eye,
- overheat the barley, go to the bath, sauna or hot shower.
Seeing on the Internet photo of barley on the eye, you can get scared and even listen to folk omens like spitting in the eye and washing it with urine. This can not be done, such actions can only lead to the introduction of an additional infection in the eye, and not to recovery!
How to quickly cure barley
The initial stage of the disease still allows you to quickly prevent relapse.
If measures are taken immediately after the onset of the primary symptoms - itching, redness and soreness - the infection may not have time to spread and suppuration will not appear, the swelling will pass without a trace within 1-2 days.
- First of all, it is necessary to treat the affected area with an antiseptic. To do this, the usual vodka or medical alcohol. It is necessary to dilute it with water in a ratio of 1: 1, soak a cotton wool with alcohol, squeeze strongly and apply it to the inflamed area, at the very base of the diseased eyelash. Avoid eye medication! If vodka is not at hand, use diamond green or iodine with alcohol content. This method avoids the development of an abscess.
- A good tool at the very beginning of the development of infection is dry warming. To do this, you can cook a hard boiled egg, or heat sea salt in a frying pan or any buckwheat, wheat, or rice. Next, the resulting heat source should be wrapped with a clean cloth (you can use a handkerchief) and keep it on the eye until the dry compress is cool. This will accelerate the "maturation", but do not overdo it: pus can go in the opposite direction, under the eyelid, into the conjunctiva and cause sepsis.
Barley treatment medicamentally
If it was not possible to prevent the development of inflammation, the best solution would be to consult a doctor for an accurate diagnosis and preparation of a correct program of drug treatment.
Not knowing how to treat gordolom correctly, you can provoke chronic diseases such as chalazion, cystic formation, and even meningitis.
From the inflamed area must go pus. If this did not happen naturally, you should not squeeze it at home: it threatens with infection of other organs (including blood), as well as other people.
To avoid this, it is better to contact an ophthalmologist, he will make a puncture in sterile conditions, without damaging the eye glands. Scar from such a puncture does not remain.
Antibacterial eye drops
Used to destroy germs. Suitable for both treatment and prevention of hordeolum and other infectious eye diseases.
Used 3-5 times a day, during the application should avoid touching the bottle to the very eye.
In the treatment of barley suitable such drops:
- Tobrex (the safest drug),
Antibacterial eye ointment
Ointments perform similar functions, but are intended for night use: these drugs temporarily reduce vision.
The use of eye drops and ointments in the complex gives the fastest effect. But when you buy in a pharmacy, be sure to specify that you are buying a drug for the eyes!
Drops and ointments for the skin with the same name always have too high content of active substances and irreversibly harm the eyes. Preparations with an expired shelf life cannot be used categorically.
Effective with barley will be:
- tetracycline ointment 1%,
- Sintomycin emulsion,
- Floxal (ofloxacin),
Eye Wash Solutions
They are used only after the purulent vesicle has burst, or has been punctured and treated by a doctor.
Washing is performed as follows:
- the drug is instilled into the eye,
- and then remove the excess with a cotton pad
- or a sterile bandage.
Suitable for washing:
- sodium sulfacyl (30% solution),
- furatsilina solution,
- decoction of chamomile.
Barley treatment in children
If a child complains of pain and scabies in the eye, then this most often indicates the appearance of gordomolum. Unfortunately, many parents are starting to read incorrect articles about barley on the eye, looking at images that can scare the parents of the child and provoke ill-considered self-treatment, up to popular conspiracies.
If barley appeared in a child, and within 3-4 days it was not possible to stop the development of the tumor by the means described, it is necessary to contact a pediatrician.
In the case of a child under 1 year old, it is required to go to the doctor immediately - it is impossible to prescribe a baby’s treatment on its own so as not to provoke an allergic reaction.
By observing several basic rules of hygiene and a healthy lifestyle every day, it is possible to avoid not only barley disease, but also many other more dangerous diseases.
- Maintain immunity. Since the main cause of the disease of barley remains low immunity, it is necessary to settle the diet and diversify the diet with vegetables and drink a course of adaptogens (tinctures of pink radioli, schisandra, Chinese eleutherococcus or ginseng). You should also avoid possible stresses as much as possible, get enough sleep and introduce physical exercises into your daily schedule. Even a standard morning exercise for 10-15 minutes significantly improves overall health and keeps the body in good shape.
- Be sure to respect hand hygiene. It is also necessary to get rid of the habit of unconsciously touching the eyes during the day.
- In the morning and evening, while washing, clean your eyes with cotton pads or a sterile bandage. During the day, you can use moisturizing eye drops. If contact lenses are used - follow all rules of wearing and caring for them.
- Each family member should have their own towel and their own cosmetics.
- Preventive procedures in areas of the appearance of hordeolum.
By itself, this swelling on the eyelid does not pose a big threat to the body, if you do not let its development take its toll and seek help from specialists before complications appear.