Stye

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at August 3, 2016
StartDiseasesStye

A stye is a pimple or abscess that forms on the eyelid when the oil glands get clogged/blocked. They are easy to diagnose and most can be treated at home. For recurring styes, treatment by a physician may become necessary. 

Contents

Definition & Facts

A stye results when inflammation occurs due to blockage of the oil glands. A stye can occur on the outside or inside of the eyelid. External styes are more common and, at first, appear like a pimple that continues to grow, becoming red and painful. After several days, styes burst or rupture, releasing pus after which they begin to heal.

Internal styes form on the inside of the eyelid and do not have a whitehead because of their location. They form the same red and sometimes painful bump. Most styes clear up with simple home treatment. If they do not, internal styes can leave behind a fluid-filled cyst

Symptoms & Complaints

The most common symptoms of a stye are:

  • Sensation of something in the eye, like a grain of sand (most commonly felt when blinking)
  • Pressure
  • Pain in the area of the bump
  • Blurred vision if the stye is leaking fluid

Once styes have formed, they feel hot, sore, and tender to the touch. External styes are easily visible on the outside of the eye, while internal styes may be harder to find until they get large.

If the stye is leaking fluid, the eyelash area may become encrusted with dried pus. Watery tears can also form in response to the irritation and pain.

A chronic stye can turn into a chalazion, a hardened lump where the stye was once located. They do not usually hurt like a stye but can be large enough to cause impaired vision. Many of the same treatments that apply to a stye can be used to treat a chalazion.

Causes 

Styes are caused by an infection of a blocked oil glands or tear ducts. Staphylococcal bacteria are the most common cause. Styes are often caused by friendly bacteria that naturally live on the surface of the skin. This bacteria begins to build up and gets trapped in the blocked gland.

While some styes may result from touching the eyes with unwashed hands, most of the time such a cause is not apparent. There is a condition called blepharitis that can cause recurring styes and chalazia. Rosacea is another condition that can cause recurrent styes and must be diagnosed by a dermatologist.

Diagnosis & Tests 

A family physician or primary care provider can diagnose a stye. In severe or complicated cases such as a recurring or badly infected stye, an eye specialist or ophthalmologist may be called upon for treatment. The physician will physically examine the eyelid to locate the opening of the clogged gland. Any signs of foreign bodies, scar tissue, or underlying chronic conditions will also be looked for. 

Treatment & Therapy 

The most common, noninvasive treatment is the use of a warm compress over the infected area. This softens the surface of the skin to allow for the stye to drain and heal on its own. A warm washcloth is enough to provide the gentle warmth needed for treatment. Squeezing, popping, or cutting the surface of the stye is not recommended as it can cause scarring.

If the infection from the stye appears to be spreading, oral antibiotics may be prescribed. Because a small infection that begins to spread can lead to orbital cellulitis, an infection of the orbit of the eye, intravenous antibiotics may be used in severe cases. The infection can also lead to pink eye that can be treated with topical ointments or eye drops.

If a chalazion has formed, warm compresses can help but the healing process will take longer. Some may take only a few weeks to heal while others may take a year or more to shrink in size. Corticosteroid injections may also be performed by an ophthalmologist but they do carry the risk of:

As a last resort, a chalazion can be cut and drained. Most physicians leave this as a last resort when all other methods have been exhausted. During this procedure, the eyelid is numbed and a clamp is placed around the affected area.

The eyelid is cut from the inside edge to avoid the outside surface of the eye. Any waxy sebum that has built up in the chalazion is then scooped out with a special instrument. Usually, this treatment clears the chalazion but if there is an underlying condition that has not been addressed, it may return. 

Prevention & Prophylaxis 

There are some preventative measures that can be taken to prevent a stye. 

  • Hand washing – Washing the hands with warm water and soap or using an alcohol-based hand sanitizer should be used regularly to keep the hands free of bacteria. Keep the hands away from the eyes as much as possible. 
  • Cosmetics – Throw away old cosmetics because bacteria can build up on them. Do not use or borrow cosmetics from other people. Removing makeup before bed can also keep glands from getting clogged and bacteria from growing near the eyes. 
  • Proper care of contact lenses – Always follow directions given for proper disinfection and handling of contact lenses. Wash your hands before placing or removing lenses.
  • Clean towels – Regularly clean towels so that built up bacteria does not have access to the eyes. 

Recurrent styes may be a sign of improper eyelid care. A mixture of baby shampoo and water can be rubbed on the eyelids to effectively remove any debris or harmful bacteria. This can be done at the sink or in the shower.

Using a warm compress as soon as any tenderness is detected can prevent the stye from fully forming. This is particularly helpful for those that have recurrent issues with styes or chalazia. For those with blepharitis, following physician instructions for care can help to prevent the formation of a stye.

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