At a stye (Medical Hordeolum) certain glands on the eyelid are infected with bacteria. The most striking symptom is a reddened, painful and pressure-sensitive accumulation of pus (abscess) on the upper or lower edge of the eyelid. A barley grain is extremely unpleasant, but usually harmless and usually heals by itself. Learn more about the causes, symptoms, treatment and prevention of barley grain.

ICD codes for this disease: ICD codes are internationally valid medical diagnosis codes. They are found e.g. in medical reports or on incapacity certificates. H00

"Do not rub the diseased eye, it can spread the inflammation."

Dr. med. Mira SeidelArticle overviewFirst grain
  • causes
  • symptoms
  • Examinations and diagnosis
  • treatment
  • home remedies
  • Disease course and prognosis
  • prevention
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Barley Grain: Short Overview

  • Definition: Acute purulent inflammation on the edge of the eyelid
  • Reason: Bacteria that infect certain glands in the eyelids
  • Typical symptoms: red, painful and pressure-sensitive knot inside or outside the lid margin
  • investigations: Eye diagnosis, slit lamp examination
  • Treatment options: dry heat (red light bulb), possibly antibiotic ointments and drops, antiseptic ointment
  • complications: Inflammation of the eye socket and / or conjunctiva, lid abscess
  • Prevent: Ensure sufficient hand and eye hygiene
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Barley grain: causes

In most cases, a bacterial infection causes a barley grain. The exact cause is common staphylococci, more precisely Staphylococcus aureus, a bacterium that colonizes the skin and mucous membranes. Rarely, streptococcal infections cause a barley grain. These bacterial strains are mainly in the mouth and throat.

When these bacteria enter the eye, they can infect certain glands on the eyelids. This is how a barley grain is made. Depending on which glands are affected, one differentiates:

  • inner barley grain (Hordeolum internum): Here, so-called meibomian glands are inflamed. These are sebaceous glands on the inner edge of the eyelid. They release a special liquid that mixes with the tear fluid and prevents it from evaporating prematurely.
  • outer barley grain (Hordeolum externum): It is caused by inflammation of the Moll or Zeis glands. These are sweat and sebaceous glands on the lid. Outer barley grains are less common than inner ones.

If a barley grain occurs more frequently, or even several barley grains form at the same time, doctors speak of Hordeolosis, She should always be clarified by a doctor. Often, a weakened immune system is behind it, perhaps as a result of previously unrecognized diabetes (diabetes mellitus).

  • Barley grain: Eyelid care can protect

    Three questions

    Dr. med. habil. Wolfgang Herrmann,
    Ophthalmology specialist
  • 1

    Can not I simply express a barley grain myself?

    Dr. med. habil. Wolfgang Herrmann

    You should not do that! They could push the inflammatory agents into the surrounding tissue. In the worst case then threatens an inflammation of the eye socket. Usually, antibiotic eye drops or ointments slowly bring a barley grain to heal. Sometimes it is necessary that the barley grain is opened or surgically removed - and only the ophthalmologist can.

  • 2

    How long will it take to get rid of the barley grain?

    Dr. med. habil. Wolfgang Herrmann

    Usually a barley grain heals within a week. In rare cases, however, the inflammation can be encapsulated and a small palpable nodule remains. You can help with the healing of chronic problems by regular eyelid care. You treat your clogged lid margin glands with cotton pads, soaked with special cleaning solutions or baby shampoo.

  • 3

    How can I prevent a barley grain?

    Dr. med. habil. Wolfgang Herrmann

    If you often get a barley grain, you should exclude other causes such as a sugar disease. Since chronic inflammation of the eyelid leads in most cases to a barley grain, those affected can prevent the appearance of barley grains by regular eyelid care. Similar to brushing your teeth you have to do it regularly.

  • Dr. med. habil. Wolfgang Herrmann,
    Ophthalmology specialist

    Herrmann heads the Eye Clinic at the Hospital of the Brothers of Charity in Regensburg. His specialties include refractive surgery for vision defects and the treatment of retinal diseases.

Barley grain: risk factors

One weakened immune system favors the emergence of a barley grain. The immune deficiency can be based on stress or some other illness. For example, barley grain is a common side effect of diabetes mellitus (diabetes mellitus).

A barley grain often occurs in connection with acne.

Since the causative agent of barley is contagious and occurs on the skin, a Hordeolum can also originate in lack of hygiene or wrong care of the eyes to have. By unwashed hands, the pathogens easily get in the eye, if you rub your eyes. Thorough hand washing is therefore an important measure to prevent a barley grain.

Children are more susceptible to barley grain than adults because their immune system is not fully developed. Also that they play more often in the dirt and then put in the face, should be a reason for this.

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Symptoms: You recognize a barley grain

In the case of a barley grain, the sebaceous and sweat glands of the eyelid become inflamed. This manifests itself in a reddened node on the upper or lower lid margin. Typical barley grain symptoms are also:

  • distension
  • strong pain
  • red eyelid
  • swollen eyelid
  • pressure sensitivity
  • pus formation

Depending on which glands are affected by the inflammation, the symptoms occur in different places on the eye.

One inner barley grain (Hordeolum internum) occurs on the inside of the eyelid and is often not visible from the outside. Only by folding the eyelid outwards does it become visible.

The affected eyelid is initially swollen and reddened and thickened then. In rare cases, an internal barley grain also affects the conjunctiva of the eye and can cause conjunctivitis and swelling of the conjunctiva (chemosis).

Inner barley grainIn the inner barley grain, the meibomian gland in the eyelid is inflamed. But the other glands can also be affected.

The outer barley grain (Hordeolum externum) refers to the Moll or Zeis glands that lie on the edge of the eyelid. The typical barley grain symptoms (swelling and redness of the lid) occur in this form in the eyelash area. At the beginning, a reddish, painful, pus-filled nodule appears, which is easily recognizable externally.

In a barley grain, symptoms such as fever or swollen lymph nodes rarely occur in front of the ears. If the disease is severe, the inflammation may spread to the orbit (orbital phlegmon) or cause abscesses.

Although it is easy to identify a barley grain because of its symptoms, you should still consult an ophthalmologist to rule out other eye diseases.