Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Job Classification

In most duration tables, five job classifications are displayed. These job classifications are based on the amount of physical effort required to perform the work. The classifications correspond to the Strength Factor classifications described in the United States Department of Labor's Dictionary of Occupational Titles. The following definitions are quoted directly from that publication.

Sedentary Work Exerting up to 10 pounds (4.5 kg) of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects, including the human body. Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and other sedentary criteria are met.

Light Work Exerting up to 20 pounds (9.1 kg) of force occasionally and/or up to 10 pounds (4.5 kg) of force frequently, and/or negligible amount of force constantly to move objects. Physical demand requirements are in excess of those for Sedentary Work. Light Work usually requires walking or standing to a significant degree. However, if the use of the arm and/or leg controls requires exertion of forces greater than that for Sedentary Work and the worker sits most the time, the job is rated Light Work.

Medium Work Exerting up to 50 (22.7 kg) pounds of force occasionally, and/or up to 25 pounds (11.3 kg) of force frequently, and/or up to 10 pounds (4.5 kg) of forces constantly to move objects.

Heavy Work Exerting up to 100 pounds (45.4 kg) of force occasionally, and/or up to 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Very Heavy Work Exerting in excess of 100 pounds (45.4 kg) of force occasionally, and/or in excess of 50 pounds (22.7 kg) of force frequently, and/or in excess of 20 pounds (9.1 kg) of force constantly to move objects.

Stye


Related Terms

  • Chalazion
  • Hordeolum

Differential Diagnosis

Specialists

  • Cardiologist, Cardiovascular Physician
  • Dermatologist
  • Ophthalmologist

Comorbid Conditions

  • Acne
  • Diabetes mellitus
  • Endocrine disorders
  • Eyelid infection (chronic blepharitis)
  • Immune system disorders
  • Rosacea
  • Seborrheic dermatitis

Factors Influencing Duration

Recurrences may be lessened when individuals are instructed in and apply proper lid hygiene.

Medical Codes

ICD-9-CM:
373.11 - Hordeolum Externum; Hordeolum NOS; Stye
373.12 - Hordeolum Internum; Infection of Meibomian Gland
373.13 - Abscess of Eyelid; Furuncle of Eyelid
373.2 - Chalazion; Meibomian (Gland) Cyst

Overview

The normal function of the eyelid is to protect the eye and to produce tear film, which moistens the outer eye surface, helps remove particles of debris, and provides nourishment to the cornea. Within the eyelid, there are numerous sebaceous glands that help produce the components of tear film. Externally, Zeiss glands secrete lipids and are associated with the eyelash hair roots (follicles); specialized sweat glands (glands of Moll) are adjacent to the follicles. The lubricant-producing meibomian glands are found internally on both the upper and lower eyelids and produce an oily substance (sebum) that helps to prevent tear film evaporation.

A stye (hordeolum) is a localized infection of the eyelid that involves the hair follicles of the eyelashes or specialized sebaceous glands (meibomian glands) on the eyelid. A chalazion may look like a hordeolum initially, with inflammation and tenderness, but it is a sterile, chronic inflammation of a meibomian gland.

An external hordeolum is caused by an infection of Zeiss or Moll glands near the lash follicles, whereas an internal hordeolum results from infection of the meibomian glands. Although often located near the inner corner of the eye, an external stye may develop at the base of any eyelash. Staphylococcal infection (usually Staphylococcus aureus) causes most styes, which may occur in multiple or recurrent lesions.

A chalazion is a gradually enlarging, generally painless chronic swelling that develops around an eyelid meibomian gland. It may evolve from a stye or can occur when dried sebum blocks the opening of the gland. Occasionally, chalazions will become secondarily infected and progress to a stye.

Styes tend to recur in individuals with blocked glands in the eyelids, chronic eyelid infections, and immune disorders. Poor hygiene practices such as rubbing the eyes with unwashed hands may also cause infection leading to styes. Chalazions may recur in association with acne, rosacea, or seborrheic dermatitis. Inflammation of the eyelids (bacterial blepharitis) may also cause styes and chalazions.

Incidence and Prevalence: Incidence is unknown, although styes and chalazions are very common.

Source: Medical Disability Advisor



Causation and Known Risk Factors

Although eyelid inflammation affects all age groups, styes and chalazions occur with increased frequency in adults between the ages of 30 to 50 (Bessette). Chalazions are more common in men (Fansler).

Source: Medical Disability Advisor



Diagnosis

History: With styes, individuals may report pain, redness, blurred vision, and swelling of the eyelid. Pain intensity relates to the amount of lid swelling. Tearing (lacrimation) or a foreign-body sensation may occur. Although external styes are easy to detect, internal styes that occur on the inner surface of the eyelids but may not be readily visible. Internal styes may enlarge and then release pus, either inwardly through the delicate membrane lining the eyelid (conjunctiva), or outwardly through the skin. Individuals may report a succession of styes or may have several styes visible at the same time. Infection of the conjunctiva (bacterial conjunctivitis) can occur as a secondary infection.

Chalazions present as a chronic painless swelling, typically on the upper eyelid, that has been increasing in size over several weeks to months. With a large chalazion, individuals may report astigmatism or blurred vision.

Physical exam: With a stye, examination will reveal a red, swollen lesion, resembling a pimple or a boil at the base of an eyelash. Pus may drain from a small yellow area or point. Occasionally, tiny abscesses may involve the entire margin of the eyelid.

With a chalazion, a tender, swollen red or yellowish lesion may be visible on the inner eyelid. There may be multiple or bilateral lesions of variable size.

Tests: Because most styes are caused by staphylococcal infections, culture of the pus inside a stye is rarely required.

Source: Medical Disability Advisor



Treatment

Styes are usually self-limiting, with spontaneous drainage of the abscess and resolution of symptoms within 5 to 7 days. Warm, wet compresses may be applied 3 to 4 times daily to help the infection resolve. If resolution does not begin within 48 hours, the stye may be drained by nicking the gland near the occluded opening with a sharp needle or surgical blade tip, and then applying focal pressure to provide drainage for the pus. However, incision and drainage can cause scarring or disruption in the normal growth pattern of the eyelashes, so it should be done judiciously. Typically, no anesthesia is required. Antibiotic ointment may be prescribed to promote healing and help prevent recurrence. Oral antibiotics are usually not necessary unless bacterial infection has progressed to the underlying tissues (cellulitis).

A small chalazion may disappear spontaneously. Persistent lesions may be treated with a steroid injection into the chalazion, with a second injection 2 weeks later in unresponsive cases. Surgery (excision) may be performed for chronic lesions. Pathology studies can rule out meibomian gland carcinoma. Individuals with repeated chalazions may require systemic antibiotics (tetracycline) to prevent recurrence, particularly if the chalazion is associated with other conditions such as acne, rosacea, or seborrheic dermatitis.

Source: Medical Disability Advisor



ACOEM

ACOEM's Practice Guidelines, the gold standard in effective medical treatment of occupational injuries and illnesses, are provided in this section to complement the disability duration guidelines.*
 
Eye
 
* The relationship between the MDGuidelines (MDA) content and ACOEM's guidelines is approximate and does not always link identical diagnoses. The user should consult the diagnostic codes in both guidelines, as well as the clinical descriptions, before assuming an equivalence.

Source: ACOEM Practice Guidelines



Prognosis

Styes usually open and drain within a few days, resolving completely within 1 week. However, they may recur within a short period of time. Proper application of warm compresses and topical antibiotics is essential for recovery. Recurrences may be lessened when individuals are instructed in and apply proper lid hygiene.

Small chalazia may resolve spontaneously. For larger, unresponsive lesions, there is a success rate of approximately 80% following a single steroid injection (Kanski).

Source: Medical Disability Advisor



Complications

Complications may include the simultaneous development of more than one stye on the same lid or bacterial infection of the skin that may progress to underlying tissues (cellulitis). Improper drainage can result in disruption of eyelash growth, lid deformity, or lid fistula. Occasionally, an upper lid chalazion may press on the cornea, induce astigmatism, and cause blurred vision.

Source: Medical Disability Advisor



Ability to Work (Return to Work Considerations)

Time may be needed for application of warm, wet compresses to the eyes, up to 3 to 4 times a day.

Source: Medical Disability Advisor



Failure to Recover

If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case.

Regarding diagnosis:

  • Has diagnosis of stye or chalazion been confirmed?
  • Have other conditions, such as blepharitis, eyelid tumor, dacryocystitis, papillomas, and xanthelasma, been ruled out?
  • Does individual have an underlying condition such as blocked glands in the eyelids, chronic eyelid infections, acne, rosacea, seborrheic dermatitis, or immune disorders that may affect recovery or recurrence of styes or chalazions?

Regarding treatment:

  • If symptoms persist despite treatment, has culture and sensitivity been performed to determine the most effective antibiotics and to rule out antibiotic-resistant organisms?
  • Does diagnosis need to be revisited?
  • Was steroid injection necessary to resolve chalazion? Was more than one injection necessary?
  • Was surgery (incision and drainage or excision) necessary? Was it effective?
  • Was there cellulitis? Were oral antibiotics needed to resolve bacterial infection or to prevent recurrence?

Regarding prognosis:

  • Does individual have an underlying condition that may be contributing to the recurrence?
  • Is this condition being adequately addressed?
  • Does condition tend to recur despite treatment?
  • Does individual practice good eyelid hygiene?

Source: Medical Disability Advisor



References

Cited

Bessette, Michael. "Hordeolum and Stye." eMedicine. Eds. Robin R. Hemphill, et al. 11 Mar. 2008. Medscape. 29 Dec. 2008 <http://emedicine.com/emerg/topic755.htm>.

Fansler, Jane, et al. "Chalzion." eMedicine. Eds. David F.M. Brown, et al. Jul. 2008. Medscape. 29 Dec. 2008 <http://emedicine.com/EMERG/topic94.htm>.

Kanski, J. J. "Eyelids." Clinical Ophthalmology. Philadelphia: Elsevier, Inc., 2003. 9-14.

General

Bajart, A. M. "Lid Inflammations." Principles and Practice of Ophthalmology. Eds. Daniel M. Albert and T. Jabine. 2nd ed. 6 vols. Philadelphia: W.B. Saunders, 2000. 829-832.

Gold, D. H., and R. A. Lewis, eds. "Eyelids." Clinical Eye Atlas. Chicago: AMA Press, 2002. 27-29.

Source: Medical Disability Advisor






Feedback
Send us comments, suggestions, corrections, or anything you would like us to hear. If you are not logged in, you must include your email address, in order for us to respond. We cannot, unfortunately, respond to every comment. If you are seeking medical advice, please contact your physician. Thank you!
Send this comment to:
Sales Customer Support Content Development
 
This publication is designed to provide accurate and authoritative information in regard to the subject matter covered. It is published with the understanding that the author, editors, and publisher are not engaged in rendering medical, legal, accounting or other professional service. If medical, legal, or other expert assistance is required, the service of a competent professional should be sought. We are unable to respond to requests for advice. Any Sales inquiries should include an email address or other means of communication.