Styes (Hordeolum)

What a stye is

The lid margin carries lash follicles with small oil glands, and the meibomian glands open just behind the lashes. When bacteria, usually staphylococcus from the skin, infect one of these, a stye forms. An external stye sits at a lash base and points outward; an internal stye involves a meibomian gland and is felt as a tender swelling within the lid, pointing to the inner surface. Both are painful, red and swollen, and the whole lid may puff up.

Treatment at home

A clean cloth soaked in warm water, or a microwaveable eye mask, held on the closed lid for ten minutes four times a day brings the stye to a head and helps it drain. Keep the lids clean with a lid cleanser. Do not squeeze or pierce it. Stop eye makeup and contact lenses until it has resolved. Most styes drain and settle within a week.

When to see an eye doctor

• Redness or swelling spreading across the lid or onto the cheek, or fever, which suggest cellulitis needing oral antibiotics
• No improvement after a week of compresses, or a lump that remains after the pain has gone, which is likely a chalazion
• A stye affecting vision, or one that keeps recurring
• A stye in a very young child or in a patient with diabetes or a weakened immune system

Treatment may include antibiotic ointment, oral antibiotics, or a quick incision and drainage under local anesthetic for a stye that will not drain.

Preventing recurrent styes

Repeated styes almost always mean blepharitis, chronic inflammation of the lid margin, or meibomian gland dysfunction. Treating those, with daily lid hygiene, warm compresses and, where needed, treatment of demodex mites or rosacea, prevents the next stye. Replace eye makeup regularly and remove it fully every night.