Styes (122)

Hordeolum

The Facts

Styes are minor, short-term bacterial infections affecting the edge of the eyelid or eye. A stye is also called a hordeolum.

Glands around the edge of the eyelid get clogged and swell until a sore like a small pimple or boil appears. It may also be due to a blockage in a follicle of an eyelash. The sore causes eye pain and becomes temporarily filled with pus. A second, more serious type of stye can develop deeper inside the eyelid and swell until it needs the attention of a doctor.

Styes are one of the most common type of eyelid infection. The average person has a good chance of having 1 or 2 styes in their lifetime, though some people develop them repeatedly. They can be annoying and painful but are usually not serious.

Causes

There are actually 2 distinct types of stye. Both are usually caused by a bacterium known as staphylococcus, or "staph" for short. It's a common bacterium on your skin that can over-reproduce and start infections.

When it causes the type of ordinary stye called an external hordeolum, it begins by infecting an eyelash at the root (the follicle), unleashing a process that results in swelling. This kind of stye can also start from a staph infection in an area close to the follicles called the glands of Moll and Zeiss. When the stye swells and begins to infect or clog other glands around the eyelid, it causes pain and discomfort. At this point, you may often see and feel a nodule, a small pimple-like reddish abscess that begins to fill with pus.

Not all styes are visible. A stye that forms beneath the surface of the eyelid will hurt, but it may never develop an external nodule. Styes form most commonly in the upper eyelid near the eyelashes, but can develop on the lower eyelid as well. Usually, only a small area of the eyelid swells, but the entire lid may occasionally become inflamed.

The second kind of stye, the internal hordeolum, is a more serious form of staph infection. It originates in a gland called the meibomian beneath the surface of the middle of the eyelid. Because it's buried in the central part of the eyelid, an internal hordeolum is more painful than the external kind. While the pus in an external stye will usually drain on its own, an internal one won't. The person will most likely have to visit a doctor to have it opened and drained.

Both external and internal styes are not contagious and are never a sign of cancer. 

Symptoms and Complications

Symptoms of styes include redness, swelling, pain, or tenderness in part of the eye. These sensations are usually accompanied by slightly blurred vision, a teary sensation, and the feeling of something in the eye. An external stye can be easily verified by finding the nodule on the eyelid. Sometimes, people with internal stye experience fever or chills.

People generally get a single stye at a time. Some people get more than one stye at a time. A few suffer from the condition chronically and have repeated infections. The staph infection that starts as a stye can sometimes spread to the tissue of the eye. A stye that grows rapidly like this or opens to drain pus into the eye needs medical attention. People with recurring styes can also develop a chronic eyelid infection called staph blepharitis.

Making the Diagnosis

Diagnosis is based on the appearance of the eyelid. Unless you experience the more serious type of stye that requires a doctor to drain and treat, you may safely diagnose your own condition and decide to treat it on your own. Remember that styes are usually mild, short-term infections that can be cured by applying simple treatments at home.

Treatment and Prevention

Styes can go away on their own within a week or 2, usually when the pus inside them drains without any help. For more persistent or recurrent styes, antibiotic eye drops or ointments can be used. Antibiotic treatment in pill form may be necessary to treat an internal hordeolum. Because an ordinary stye is like other minor inflammations in the skin, effective home treatments are similar to techniques to get rid of infected pimples.

To help drain the stye's pus and ease the pain, take a folded clean cloth and use it as a compress. Dip the compress in warm water and then wring it out until it's barely dripping. The temperature of the water should be what is considered tolerably warm to touch. Gently hold it to the affected part of the eye for 10 to 15 minutes up to 4 times a day. Using a clean cloth each time, apply the warm compresses for 2 to 3 days. You should see a noticeable improvement within a day or two. Complete healing should take place within a week.

If there is no improvement in the stye after more than 48 hours, or if there are multiple styes, you should see your family doctor.

If you have an internal stye that doesn't begin to drain when you apply a compress to it, don't try to squeeze or drain it yourself. This will spread the infection and may cause cellulitis, a more serious skin infection that needs treatment with antibiotics. Instead, have a doctor lance the stye with sterile equipment. You may also need a prescription for antibiotics, a treatment course usually lasting 5 to 7 days. If symptoms persist after medical attention, get your eye checked again.

Washing the area of the eye more thoroughly (especially for children) will prevent styes from recurring. Parents can use baby shampoo to gently wash the eyelids of children. Antibiotics are recommended for people who have chronic stye conditions or other chronic eyelid infections, as well as for people with compromised immune systems.

Here are some ways to prevent spreading or worsening the stye:

• Use a clean compress each time.
• Wash your hands before and after touching the affected eye.
• Avoid touching the tip of any prescribed eye drops, ointments, or gels directly to the eyelashes or eyelid.
• Avoid applying or using cosmetics on your eyelid area or wearing contact lenses for the time that the stye is present.
• Remove your eye makeup every night and throw away old makeup.