A barley grain is a usually festering glandular inflammation on the eye. In contrast to the hailstone, which is also an infection on the eyelid, a barley grain is caused by bacteria. Both forms of inflammation are considered harmless - but they are annoying and can always return if mistreated. How do you treat them and how do you prevent them?
What is a barley grain?
A barley grain is a common acute inflammation of the glands of the eyelid. Triggered by a bacterial infection, an accumulation of pus on the eye, which may be painful, but usually heals without complications again.
In the jargon one also speaks of a "Hordeolum" (from the Latin word hordeum - barley).
Causes of a barley grain
Purulent inflammation is most commonly caused by staphylococci. These are spherical bacteria that often colonize the human skin and mucous membranes, such as the nose. As typical pest bacteria, they cause abscesses and infect skin lesions and wounds.
If such bacteria penetrate into the sweat and sebaceous glands that sit in the edges of the eyelids, they cause a violent inflammation there - a barley grain forms.
The bacteria can enter the eye via different routes. For example, unwashed hands or improper care of the eyes can transmit germs into the eye that then cause infection. Therefore, barley grains are also common in children, who frequently catch dirty fingers.
Risk factors for a barley grain
There are several factors that can increase the risk of barley grain formation. The risk groups include people with a weakened immune system as well as with diabetes mellitus. Because these risk groups are prone to staphylococcal skin infections. Therefore, it is advisable to exclude diabetes from a doctor with a repeated occurrence of a barley grain.
In addition, a hordeolum is also often associated with acne. Wearing contact lenses or contaminants from residues of make-up may also favor the formation of a barley grain.
What are the signs of a barley grain?
A barley grain is usually characterized by a sudden inflammation. The following symptoms may occur with a barley grain on the upper or lower eyelid:
- a painful and purulent swelling
- a reddening of the corresponding spot
- pressure sensitivity
- a feeling of tension
- sometimes a swelling or redness of the conjunctiva
In the case of a barley grain, the symptoms are usually limited to the affected eye. In severe and rare cases, however, a general feeling of malaise with fever or lymph node swelling may occur.
Inner and outer barley grain
Depending on which glands are inflamed on the eye, a distinction is made between two forms of barley grain:
- The hordeolum internum (inner barley grain) affects the sebaceous glands on the inside of the eyelid - the so-called meibomian glands. In this case, the conjunctiva may also have an inflammation or the lid margin may become arched. The inner barley grain occurs more frequently than the outer, but is less recognizable.
- In the Hordeolum externum (outer barley grain), the outer Zeis glands (sebaceous glands) or Moll glands (sweat glands) are affected. Since the barley grain is located outside in this case, this shape is easier to see.
Course and duration of a barley grain
The course of a barley grain develops usually harmless and without complications. How long the inflammation lasts can be different. After a period of a few days to a week, the barley grain bursts by itself, the pus flows off and the inflammation heals.
4 facts about barley grains - © istockphoto, corbac40
Barley grain - when you should go to the doctor
Barley grains are actually harmless. In the majority of cases, a hordeolum bursts by itself and then heals.
Sometimes, however, there can be complications: For example, the inflammation can spread to the entire eye (orbital phlegmon) or cause a lid abscess. This can happen especially if those affected are pushing around on the barley grain.
As a result, the staphylococci can even get into the bloodstream in the worst case and cause, for example, meningitis. Therefore, a doctor should definitely be consulted if the inflammation extends beyond the normal appearance of a barley grain, severely hurts, or if the hordeolum does not burst by itself within a few days.
Barley grain in children
In children, a barley grain is usually harmless and heals by itself after a few days. In children, however, there is a risk that they constantly rub the inflamed eye or touch it. As a result, the bacteria can spread and the inflammation could be transferred to the other eye, for example.
In addition, the inflammation is quite painful and unpleasant. Therefore, a visit to the doctor is recommended for children. This may prescribe eye drops or an ointment that relieve symptoms and aid healing.
In case of complications such as fever or spread of the inflammation, a doctor should definitely be consulted. Of course, this also applies to adults.
Barley grain: treatment
As a rule, a barley grain heals on its own. However, one can support the healing process by various methods:
- Since barley grains are caused by bacteria, antibiotic-containing eye drops or ointments can help (for example with the active ingredient gentamicin). While these may require a prescription, they speed healing by helping to reduce swelling and disinfect the eye.
- Even non-prescriptive antiseptic eye ointments, for example, with the active ingredient Bibrocathol, work against the inflammation.
- Dry heat - for example, by irradiation with a red light lamp - has proven to be effective. It is recommended that this be done three times a day for 10 minutes.
By contrast, home remedies such as moist, warm envelopes are counterproductive - even if they are often recommended. But the bacteria are then more likely to be kidnapped and it can lead to further infections. If you would like to treat a barley grain with homeopathy, you should consult your doctor first.
If the barley grain does not break off on its own or if there is severe swelling or pain, an ophthalmologist must treat the barley grain by opening it through a puncture and thus removing it.
Stay away from the eyes!
Even if a hordeolum is harmless in itself: Never try to open a barley grain by expressing or piercing yourself. It can lead to serious infections.
In addition, because the bacteria are contagious, you should not touch the site of inflammation and regularly wash or disinfect your hands. Otherwise, it can easily happen that the infection passes to the other eye or other people - for example, by the transmission of bacteria via a door handle - infected.
What is the difference between barley grain and hail grain?
Often a barley grain is equated in the usage with the so-called hail grain - but it is about different forms of Lidentzündung. A hailstone, known in technical terms as "chalazion", is characterized by a nodular swelling of the eyelid like the barley grain. It usually develops slowly and can become pea-sized over time.
However, in contrast to the barley grain, the hailstone is not triggered by bacteria, but is a chronic disease of the eyelid, which usually brings no pain. A hailstone is caused by a blockage of the meibomian glands. In rare cases, it may be the result of a barley grain.
What to do with a hailstone?
Occasionally, smaller hailstones may self-regress spontaneously after a few weeks or months. Sometimes a hailstone bursts, allowing the secretion to drain.
Even with hailstones, a therapy with red light can promote healing. The ophthalmologist will either prescribe an ointment that stimulates regression, or he will surgically remove the hailstone. For this purpose, the hailstone is opened under local anesthesia and the secretion and the inflammatory tissue are removed.
A hailstone should always be examined by an ophthalmologist if it does not disappear by itself, in any case to rule out a tumor of the glands.
Precaution: Preventive eye care
Ophthalmologists recommend careful ophthalmology with an increased tendency to barley grains and hailstones, especially after an inflammation and after surgery of a hailstone, the lid margin is carefully cleaned, preferably with a very mild baby shampoo. Then you should pat the eyelid dry, then rub with antibiotic ointment for a while. For recurring complaints, it is advisable to exercise caution when choosing shampoo and cosmetic products.
Eyebright, a herbal drug usually in the form of drops, should prevent not only conjunctivitis, but also in chronic inflammation of the eyelid and barley grains. It also helps with eyestrain and dry eyes.
Since a weakened immune system can promote the formation of barley grains, a healthy lifestyle is also important. This includes a balanced diet as well as sufficient exercise.