Clinical Cases

Hordeolum (Stye)

Written by Sonal Sinha

Dr. Sonal Sinha discusses hordeolum and presents a brief case. Anger at trifles, right sided stye and oily perspiration were symptoms leading to the simillimum.

Hordeoleum  is an acute   inflammation   of   the   cellular   tissue   of   the   lid   leading   to   suppuration  and   pointing   at the   edge   of   the   lid. The   location   of    the   inflammation   is   usually   in   the   tissue   surrounding a  hair   follicle.  The   outside   or   the   inside   of   the   eyelid   can   be   affected.

External   hordelum is   an   acute   suppurative   inflammation   of   lash   follicle   and   zeis   glands. Stye   is   common   in   young   adults   with   refractive   errors   and   extraocular   muscular   imbalance   and   may    occur   in   crops.  It   is  often   caused   by   staphylococcus   aureus.

Internal   hordelum – It   is   a   suppurative   inflammation   of   the   meibomian   gland   associated   with   blockage   of   the   duct,  which   can   occur   due   to   secondary   infection   of   a   chalazion. It   is   less   frequent   but   a   more   violent   inflammation   than   stye. The   gland   is   enlarged   and   causes   enormous   swelling   on   the   lid.  Occasionally,  it   may   burst through   the   meibomian   duct   or   the   conjunctiva.  An   incision   may   be   required   to   evacuate the   pus.

Signs –  The stage  of   cellulitis   is   characterised   by   a localised,  firm,  red,  tender area.  There is swelling   at   the   lid margin   associated   with   marked   oedema.  Usually ,  there   is   one   stye,  but   occasionally there may be   multiple ones.

  • The stage of   abscess   formation   is   characterised   by   a   visible   pus   point   on   the   lid   margin   in   relation   to   the   affected

Symptoms –  At   first   it   appears   as   a   hard,  circumscribed   redness   and   swelling,  which   frequently   extends   so   that   the   whole   lid   will   become   oedematously   swollen.  There   is   at   first   much   severe   throbbing   pain.

Occasionally   there   are   two   or   more   at   the   same   time   and   they   often   occur   in  successive crops.   It may include   acute   pain   associated   with   swelling   of   lid,  mild   watering   and   photophobia.

A Case Of Hordeolum  (Stye)

 A  woman of 21 visited  my  OPD  on  15  Feb  2019.  She  was  Hindu  by  religion,  unmarried,  educated   as   a  Bsc.  She  was  a  resident  of  Jaipur, with  the  chief  complaint  of  inflammation  of  right eye,   redness   and   irritation  in  the eye.  Pain  in  right  eye  and  cheek .  More  lachrymation. Perspiration oily. All complaints started  in the morning.

Physical generals

Desire-  Namkeen

Aversion- Bread

Appetite – Normal

Thirst-  Normal

Bowel- Constipation  occasionally

Urine-  Normal

Thermal-  Hot

Perspiration-  Oily , odourless

Mental generals-  Anger trifle at,  irritability

Memory normal

1ST Day

4th  Day

Case analysis –This  is  an  acute  case,  so  the  acute  totality is considered first.

The following rubrics were taken on the  basis of the above –

Mind, anger trifles at

Stye – right   side

Perspiration oily

Repertorisation:

Management plan – Natrum   Muriaticum was the leading remedy  and  covered   the  rubrics  in  repertorisation. Patient was hot. Th  remedy  selected  for  the  1st  prescription  was  Natrium muraticum.

Prescription – Natrium  Muriaticum 200 BD  X  1 DAY

PL 30 BD  X  2 DAYS

Follow up – Medicine started  in  evening.  In the morning she called  me  and  said that  there  is  60% melioration  in  the  lachrymation  and  pain . On the third  day there  was  no pain or lachrymation. By the 4th day the problem resolved. The remedy was reduced gradually and  stopped  within  a  day.

 

About the author

Sonal Sinha

Dr. Sonal Sinha - BHMS, PGNAHI, (Nagpur) MD (PGR), Repertory from Swasthya Kalyan Homoeopathic Medical College, Jaipur Rajasthan, India. CGO, CCH (Maharastra). Dr. Sinha is a member of LMHI.

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