1Clear denominators by multiplying through by $4xy$: $4y + 4x = xy$, i.e. $xy - 4x - 4y = 0$.
2Apply SFFT: add $16$ to both sides so the left factors — $xy - 4x - 4y + 16 = 16$, giving $(x - 4)(y - 4) = 16$.
3Each ordered factorization of $16$ as a product of two positive integers gives a solution; $16 = 2^4$ has $\tau(16) = 5$ positive divisors, so there are $5$ ordered pairs $(x-4, y-4) \in \{(1,16),(2,8),(4,4),(8,2),(16,1)\}$.
4Each yields $x, y > 4 > 0$, so all $5$ are valid (e.g. $(x,y) = (5, 20)$, $(6, 12)$, $(8, 8)$, $(12, 6)$, $(20, 5)$).