Stye and chalazion

A stye (hordeolum) is a small, local eyelid inflammation, usually caused by bacteria. It shows up as a red, swollen, tender lump, most often at the base of the lashes and sometimes on the inner side of the lid, often with a yellowish spot of pus. The eye may water or feel gritty. Styes can happen at any age and are more common with chronic lid margin inflammation, frequent eye rubbing, or careless contact lens hygiene. Most clear up on their own within days to about two weeks.

A chalazion forms when one of the eyelid's oil glands (meibomian glands) becomes blocked. The trapped oil causes inflammation, but unlike a stye, a chalazion is usually not a bacterial infection. A stye is sore, while a chalazion is typically a firm, round, nearly painless lump a little further from the lid edge. It grows slowly and can last weeks or months, and a stye that does not fully settle can leave one behind. A large chalazion may press on the eye and blur vision.

A stye is not considered contagious in the usual sense, and there is no need to stay home from work or school. Still, the bacteria involved can travel on hands, towels and makeup, so wash your hands before and after touching the eye and do not share towels, face cloths or eye makeup. A chalazion is not contagious, since it comes from a blocked gland rather than an infection.

The main home treatment for both is warm compresses. Soak a clean cloth in warm (not boiling) water and hold it on the closed lid for about 10 to 15 minutes, several times a day. Warmth softens the oil and helps the gland drain; a gentle massage afterwards can help. Do not squeeze or pop the lump, as this can spread infection. Avoid eye makeup and contact lenses meanwhile. A stye usually improves within a few days, while a chalazion may need several weeks of steady compresses.

If the lump does not improve after a few weeks, keeps growing or affects vision, see an eye doctor. The doctor may suggest antibiotic ointment or drops, or tablets if infection is spreading. A very swollen chalazion may be treated with a steroid injection. Chalazion surgery is usually a short procedure under local anesthetic, draining the lump, usually from the inner side of the lid. A lump that keeps returning in the same spot may be sampled to rule out a rare eyelid tumor that can mimic a chalazion.

Get prompt medical attention for redness and swelling spreading across the eyelid or onto the cheek, swelling that keeps the eye shut, severe pain, fever, pain when moving the eye, or reduced vision. These can mean infection is spreading to the tissues around the eye, so see an eye doctor or go to the emergency department without delay. Also get checked if lashes fall out over the lump, if it lasts more than a few weeks, or if a baby or young child has eyelid swelling.

Repeated styes and chalazia are often linked to long term lid margin inflammation (blepharitis), oily skin or rosacea. Gentle daily lid cleaning, regular warm compresses, removing makeup before sleep, replacing eye makeup regularly and washing hands before handling contact lenses can all help. If lumps keep returning or you also have dry eye symptoms, an eye exam can target the underlying cause.