Styes are painful, small lumps that develop either inside or outside of the eyelid. Often, the eyelid turns red and the eye becomes watery. The medical term for a stye is a “hordeolum” and it usually occurs in one eye only, but it is possible to have it in both eyes, or even to have multiple styes in a single eye. They do not affect vision and they usually get better by themselves. After a few days, they tend to burst, releasing pus, and then start to vanish. However, it is not advisable to try to burst the stye yourself. Furthermore, if it becomes very painful, you should see a physician.

Different Types of Stye

There are two main types:

1. The external hordeolum, which is a swelling along the eyelid’s edge. It is often painful to the touch and it fills with yellow colored pus.
2. The internal hordeolum, which is a swelling inside the eyelid itself. It usually the more painful of the two conditions.

Causes of Stye

Most of the time, a stye is caused by a staphylococcal infection. This bacteria actually lives naturally on the skin and generally doesn’t cause any harm. However, sometimes, an overproduction or other underlying conditions lead to an infection.

The most common causes of external styes include:

• Infection of the eyelash follicle, which is the small pore in the skin out of which each eyelash grows.
• Infection of the Zeis (sebaceous) gland, which is attached to the follicle of the eyelash to produce sebum, an oily substance that lubricates eyelashes and prevents them from drying out.
• Infection of the Moll (apocrine) gland, which is a sweat gland that empties in the follicles of the eyelashes, preventing the eye from drying out.

Internal styes, by contrast, are almost exclusively caused by Meibomian gland infections. The Meibomian glands are located on the eyelids themselves. Their role is to produce the oily element of the tear film that covers and protects the eye. If an infection happens in those glands, you could develop a stye.

Lastly, some styes are complications of blepharitis. Blepharitis is an inflammation of the eyelids, leading to them becoming swollen and red. Usually, people also experience itchy eyelids, crusty eyelids on waking up, and sore or burning eyes. Blepharitis is often caused by bacterial infection, although it can also be a symptom of rosacea, which is a skin condition that people get on the face.

Stye Treatments

In most cases, no medical treatment is needed to help with a stye. Generally, they get better by themselves within just a few weeks. However, there are some things that you can do to find relief and to speed up the healing process. These include:

1. Warm compresses, made with clean flannels dipped in hot water. It is very important to make sure that the flannel is completely clean before being used, and that you replaced it with a new one before applying another compress. Furthermore, the water should not be too warm, particularly if the compress is to be used on children. Leave the compress on the eye for between five and ten minutes, and you can do this as much as four times per day until the stye is gone. Warm compresses often help the stye to release pus. Once that happens, the symptoms should improve rapidly. After you have used a warm compress, you should also be able to easily wipe away any crusting around the eyes.
2. Painkillers, which are available over the counter. Ibuprofen and paracetamol are both good options. Do make sure, however, that you check the label to make sure that you can safely take the medication. Aspirin should not be given to children under the age of 16.

In some cases, a physician may prescribe medication, particularly if you also have other medical conditions, such as:

• If you have conjunctivitis, your physician is likely to prescribe antibiotics to you.
• If you have blepharitis, you will need to pay particular attention to your eye hygiene and provide you with the tools you need to keep your eyes clean.

However, these medications and strategies do not actually treat the stye. In fact, there is no evidence to suggest that antibiotics have any effect on styes. However, if your stye leads to complications, such as Meibomian cysts (chalazions), you may need antibiotics for that.

When Do You Need a Physician?

If the pain of an external stye starts to become unbearable, you may need to see a physician, Some of your eyelashes found near the stye may need to be removed, particularly if a follicle infection caused it to appear. The doctor may also make an incision in the stye with a clean, thin needle to help drain the pus.

You may also be referred to an ophthalmologist if:

• Your stye does not respond to any conventional treatment.
• Your stye is internal as well as very painful or particularly large.

An ophthalmologist will usually drain the pus away by making an incision. He or she may also collect some of the pus for laboratory examination, to determine whether you there is an underlying infection.

Complications for Styes

It is possible for styes to lead to complications although these usually aren’t serious. Possible complications include:

• Meibomian cysts (chalazions), which are common in people who have had a stye for a prolonged period of time, blocking a gland in the eyelid itself. This condition is generally painless, unless an infection also takes place, in which case an antibiotic prescription may be required. If you have a chalazion, you are likely to be able to find relief by using a warm compress. If you can manage it, then the cysts, just like the stye, are likely to disappear on their own after a while. If it does become unmanageable, a local anesthetic surgical procedure may be required.
• Preseptal cellulitis, which is an infection of the eye’s surrounding tissue. This means that the infection that led to you getting a stye in the first place also caused infections in other tissues around the eye. This condition is also known as periorbital cellulitis and makes the eyelids swollen and red. Antibiotic treatment is required.

Telling the Difference between Chalazions and Styes

It is very easy to mistake a chalazion for a stye because they do look very similar. Chalazions actually mimic styes, particularly during the first few days of the condition. After that, however, a chalazion will transform into a hard, white bump that is completely painless.  Usually, as well, the chalazion is further away from the eyelid than what a stye would usually be.

When styes are treated, chalazions are treated as well. However, it usually takes several months for the treatment to truly become effective. If, after several months, you still have a chalazion, it may be time to speak to a physician in order to find out whether something else is going on.

Other Bumps That Are Not Styes

There are a number of other bumps that can be confused with styes. These include:

• Milia, which are also known as oil seeds or milk spots. They are actually cysts, but really tiny ones, and they happen on the epidermis, the outer layer of skin, particularly around the nose, eyes, and eyelid. These bumps are very common, particularly in babies. However, they can appear in anyone. Usually, adults who are affected do require medical treatment, including surgical extensions completed by a dermatologist.
• Xanthelasma, which is a xanthoma type. This is a condition of the skin whereby people develop disc-like lesions as a result of an overproduction of fats and cholesterol. They are non-cancerous growths, but it always best to have them investigated regardless. This condition is generally asymptomatic.

Resources and References:

All About Vision – 7 Eye Stye Facts: Symptoms, Causes and Treatment (AllAboutVision.com)

Mayo Clinic – Diseases and Conditions: Sty (MayoClinic.org)