Styes and Chalazia

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What are styes and chalazia?

Styes and chalazia are lumps in or along the edge of an eyelid. They may be painful or annoying, but they are rarely serious. Most will go away on their own without treatment.

• A stye is an infection that causes a tender red lump on the eyelid. Most styes occur along the edge of the eyelid. When a stye occurs inside the eyelid, it is called an internal hordeolum (say “hor-dee-OH-lum”).
• A chalazion (say “kuh-LAY-zee-on”) is a lump in the eyelid. Chalazia (plural) may look like styes, but they are usually larger and may not be painful.

Styes and chalazia may be related to blepharitis, a common problem that causes inflammation of the eyelids.

What causes a stye or chalazion?

Styes are caused by a bacterial infection. Usually the bacteria grow in the root (follicle) of an eyelash. An internal hordeolum is caused by infection in one of the tiny oil glands inside the eyelid.

A chalazion develops when an oil gland in the eyelid becomes blocked. If an internal hordeolum doesn't drain and heal, it can turn into a chalazion.

What are the symptoms?

A stye usually starts as a red bump that looks like a pimple along the edge of the eyelid.

• As the stye grows, the eyelid becomes swollen and painful, and the eye may water.
• Most styes swell for about 3 days before they break open and drain.
• Styes usually heal in about a week.

A chalazion forms a firm lump or cyst under the skin of the eyelid.

• Chalazia grow more slowly than styes. If a chalazion gets large enough, it may interfere with vision.
• The inflammation and swelling may spread to the area surrounding the eye.
• Chalazia often go away in a few months without treatment.

How is a stye or chalazion diagnosed?

Doctors diagnose a stye or chalazion by closely examining the eyelid. It may be hard to tell the difference between a stye and a chalazion. If there is a hard lump inside the eyelid, the doctor will probably diagnose it as a chalazion.

How are they treated?

Home treatment is all that is needed for most styes and chalazia.

• Apply warm, wet compresses 3 to 6 times a day. This usually helps styes and chalazia heal faster. It may also help open a blocked pore so that it can drain and begin to heal.
• Use an over-the-counter treatment. Try an ointment (such as Stye), solution (such as Bausch and Lomb Eye Wash), or medicated pads (such as Ocusoft Lid Scrub).
• Let it open on its own. Do not squeeze or open a stye or chalazion.
• Don't wear eye makeup or contact lenses until after the stye or chalazion heals.

If a stye is not getting better with home treatment, talk to your doctor. You may need a prescription antibiotic eye ointment or eyedrops. You may need to take antibiotic pills if infection has spread to the eyelid or eye.

If a stye or chalazion gets very large, the doctor may need to pierce (lance) it so it can drain and heal. Do not try to lance it yourself.

How can you prevent styes and chalazia?

To help prevent styes and chalazia:

• Don't rub your eyes. This can irritate your eyes and let in bacteria. If you need to touch your eyes, wash your hands first.
• Replace eye makeup, especially mascara, at least every 6 months. Bacteria can grow in makeup.
• Treat any inflammation or infection of the eyelid promptly. If you get styes or chalazia often, wash your eyelids regularly with a little bit of baby shampoo mixed in warm water.

Frequently Asked Questions

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	Eye problems: Using eyedrops and eye ointment

A stye usually starts as a sensitive, red, swollen area on the surface of the eyelid along the eyelash line. This changes into a small, tender bump similar to an acne pimple. The eye may water, and the eyelid may be painful. Typically the stye comes to a head (clear or yellow fluid collects in the stye) and breaks open within about 3 days. After the stye opens, it usually heals and goes away. See a picture of a stye.

An internal hordeolum, though deeper inside the eyelid, has the same symptoms as a stye.

A chalazion tends to grow more slowly and deeper into the eyelid than a stye, usually does not cause pain, and may last for several months. A chalazion may form a firm lump under the skin of the eyelid, especially when the pore of the oil gland is blocked and material builds up inside the gland. The inflammation and swelling may spread beyond the eyelid to the areas near the eye, such as the eyebrow. It may grow large enough to interfere with vision. See a picture of a chalazion.

It is often hard to tell the difference between styes and chalazia, which are minor problems of the eyelid. Both are diagnosed by a close visual exam of the eyelid. If there is a hard bump deep inside the eyelid, it is usually diagnosed as a chalazion.

If a stye does not heal with home treatment, your doctor may order culture and sensitivity tests of the fluid inside the stye. These tests will help your doctor find out what kind of bacteria is causing the infection and help guide further treatment.

Home treatment is all that is needed for most styes and internal hordeola, which are minor problems of the eyelid. If home treatment does not work, prescription medicines, such as eye ointments or eyedrops, may be needed. To learn the best way to use these medicines, see:

Eye problems: Using eyedrops and eye ointment.

Talk with a health professional if:

• A stye becomes very painful, grows larger quickly, or continues to drain (particularly if the drainage is pus).
• The redness and swelling around a stye spreads over the eyelid, inside the eyelid, or over the eyeball.
• You have vision problems.
• A stye does not begin to improve after 3 days of home treatment or does not heal in one week.

If the infection spreads to the eyelid or the eyeball, you may need oral antibiotics (pills).

A very large stye that does not go away with home treatment—or a chalazion that has grown big enough to interfere with vision—may need to be cut open (lanced) by a doctor so that it can drain and heal. You will need to use antibiotic eye ointment or eyedrops after this procedure.

Your doctor may advise you to wash your eyelid or along your eyelash line with a mild soap wash or a "no tears" shampoo (such as a baby shampoo) to reduce the chance of infection if you have recurring styes or signs of blepharitis. You can make a mild soap wash at home by mixing a nonirritating soap, such as baby shampoo, with an equal amount of warm water. Usually 2 tbsp (30 ml) of each is enough. Use a clean cloth or cotton ball dipped in this mild soap solution to gently wash the eyelid or along the eyelash line.

Home treatment for styes and chalazia

Home treatment is usually all that is needed to treat most styes and chalazia. Try the following measures to reduce the discomfort and help them heal.

• Do not wear eye makeup or contact lenses until the stye or chalazion heals.
• Apply warm, wet compresses. Warm, wet compresses applied 3 to 6 times a day usually help styes and chalazia heal faster. A warm compress may also help open a blocked pore so that it can drain and begin to heal. Wash your hands before applying a compress. Use a clean cloth or piece of gauze moistened with very warm tap water. Do not heat compresses in a microwave oven. The compress may become too hot and can burn the eyelid. Place the compress over your closed eye until it begins to cool (usually 5 to 10 minutes). To speed the healing process, you may also use normal saline solution instead of tap water.
• Allow the stye or chalazion to break open by itself. Do not squeeze or open a stye or chalazion.
• Use nonprescription treatments. Make sure that any medicine you buy without a prescription is for the eyes (ophthalmic), not for the ears (otic). Nonprescription treatments available to relieve the discomfort of styes include:
  • Ointments, such as Stye.
  • Solutions, such as Bausch and Lomb Eye Wash and Collyrium Eye Wash.
  • Medicated pads, such as Ocusoft Lid Scrub and Stygiene.

If a stye or chalazion is not healing with home treatment, talk to your doctor. You may need a prescription antibiotic eye ointment or eyedrops.

Always wash your hands before applying eye ointment or eyedrops. Do not touch the tip of the applicator with your hand. Be sure the eyedropper and ointment tip are clean, and try not to touch the eye, eyelid, or any surface with the eyedropper or ointment tip. Always use a wall mirror with good light when applying eye ointment or eyedrops.

• If antibiotic eye ointment is prescribed, apply a thin layer over the stye at bedtime.
• If antibiotic eyedrops are prescribed, apply them by pulling the lower eyelid down with two fingers to create a little pouch between the eyeball and the lid. Put the drops in the pouch. To spread the medicine over the eye and eyelid, keep the eye closed for 30 to 60 seconds after putting in the drops.
• To put eyedrops in a child's eyes, have the child lie down and close his or her eyes. Put a drop in the inner corner (corner nearest the nose) of the infected eye. Then, have the child open the eye so the drop will go in. Do not let the child rub the treated eye.

To learn the best way to use these medicines, see:

Eye problems: Using eyedrops and eye ointment.

Prevention

To help prevent styes, internal hordeola, and chalazia, which are minor problems of the eyelid:

• Do not rub your eyes. This can irritate your eyes and spread infection.
• Protect your eyes from dust and air pollution by wearing safety glasses when you are outside, particularly when you do dusty chores like raking or mowing the lawn.
• Avoid areas where dust and air pollution are heavy.
• Replace your eye makeup, especially mascara, at least every 6 months. Bacteria can grow in makeup.
• Treat any inflammation or infection of the eyelid (blepharitis) promptly. If you do not, the infection may spread to the oil glands of the eyelid and cause a stye.

Although most styes and chalazia are not contagious:

• Avoid sharing towels, washcloths, or eye makeup.
• Wash your hands often and keep them away from your eyes, especially when caring for someone with a stye or any other kind of infection.
• Wash your hands often, and keep them away from your eyes if you have an infection in another part of your body.

• Eye Problems, Noninjury
• Eyelid Problems (Blepharitis)

Other Works Consulted

• Dambro MR (2006). Hordeolum (stye). In Griffith's 5-Minute Clinical Consult, p. 520. Philadelphia: Lippincott Williams and Wilkins.

• Neff AG, Carter CD (2004). Benign eyelid lesions. In M Yanoff, JS Duker, eds., Ophthalmology, 2nd ed., pp. 698–710. St. Louis: Mosby.

• Sullivan JH (2004). Lids, lacrimal apparatus, and tears. In P Riordan-Eva, JP Whitcher, eds., Vaughan and Asbury's General Opthalmology, 16th ed., pp. 80–81. New York: McGraw-Hill.

• Trobe JD (2006). The red eye. Physician's Guide to Eye Care, 3rd ed., chap. 4, pp. 47–51. San Francisco: American Academy of Ophthalmology.

• Weinberg RS (2007). Diseases of the eyelid, conjunctiva, and anterior segment of the eye. In LR Barker et al., eds., Principles of Ambulatory Medicine, 7th ed., pp. 1816–1829. Philadelphia: Lippincott Williams and Wilkins.

• Wright KW (2003). Pediatric "pink eye". In Pediatric Ophthalmology for Primary Care, pp. 167–196. Denver: American Academy of Pediatrics.