Stye (Hordeolum)

What a stye is

The eyelids contain several kinds of glands. Each eyelash grows from a follicle with small oil and sweat glands (Zeis and Moll glands). Inside the lid are 20 to 40 long meibomian glands that release oil into the tear film. When one of these glands becomes blocked and infected with bacteria, pus collects and a stye forms.

• External hordeolum: the common type. It forms at the base of an eyelash on the lid margin and usually points outward with a yellow head.
• Internal hordeolum: an infected meibomian gland inside the lid. It can be more painful, points toward the eye surface, and takes longer to settle.

Stye symptoms

• A red, tender lump on the edge of the eyelid, often with a pimple-like yellow center
• Pain and swelling, sometimes involving the whole eyelid
• Watering of the eye and a gritty feeling
• Crusting along the lid margin
• Sensitivity to light

Symptoms usually peak over 2 to 4 days. The stye may then burst, release pus and settle rapidly.

What causes a stye?

Most styes are caused by Staphylococcus aureus, a bacterium that lives harmlessly on skin. Risk factors include:

• Blepharitis (chronic eyelid margin inflammation) and meibomian gland dysfunction
• Rosacea and seborrheic dermatitis
• Touching or rubbing your eyes with unwashed hands
• Old or shared eye makeup, and sleeping with makeup on
• Poorly cleaned contact lenses
• Diabetes and other conditions that lower immunity
• Previous styes

Stye vs chalazion

An internal stye can turn into a chalazion once the infection settles but the gland stays blocked.

Stye treatment at home

1. Warm compresses: soak a clean washcloth in warm (not hot) water, wring it out and hold it on the closed eyelid for 10 to 15 minutes, 3 to 5 times a day. Rewarm as it cools. Heat softens the blocked oil and helps the stye drain.
2. Gentle massage of the lid after compresses, toward the lashes.
3. Lid hygiene: clean the lid margin with a dilute baby shampoo solution or a commercial eyelid wipe once or twice a day.
4. Do not squeeze or pop it. This can spread infection into the lid.
5. Stop eye makeup and contact lenses until it has healed. Throw away mascara and eyeliner used just before it started.
6. Pain relief: acetaminophen (paracetamol) or ibuprofen at the label dose.
7. Wash your hands before and after touching your eyes and use your own towel.

Medical treatment

• Antibiotic ointment may be prescribed if there is crusting blepharitis or the infection is spreading on the lid surface. Antibiotic eye drops alone add little for a simple stye.
• Oral antibiotics are used if redness spreads beyond the stye, suggesting preseptal cellulitis.
• Incision and drainage: an eye doctor can numb the lid and open a large stye that does not drain on its own.
• Removing the eyelash at the center of an external stye sometimes helps it drain.
• Steroid injection is used for persistent chalazion rather than active styes.

Complications

Complications are uncommon:

• Chalazion after the infection resolves
• Preseptal cellulitis: infection of the eyelid tissues
• Orbital cellulitis: rare but serious infection behind the eye
• Recurring styes, usually from untreated blepharitis

Preventing styes

• Wash hands before touching your eyes, inserting contacts or applying makeup
• Remove makeup before bed and replace eye makeup every 3 months
• Do not share towels, washcloths or cosmetics
• Treat blepharitis with daily lid cleaning and warm compresses
• Follow contact lens cleaning and replacement instructions

Frequently asked questions

How do you get rid of a stye fast?

Apply a warm compress for 10 to 15 minutes, 3 to 5 times a day, and gently clean the lid margin. This usually brings the stye to a head and lets it drain within a few days. Do not squeeze it. Persistent or large styes can be drained by an eye doctor.

How long does a stye last?

Most styes last about 7 to 14 days. Many drain on their own within 2 to 4 days with warm compresses, then settle quickly. An internal stye may take longer. If it has not improved after 2 weeks or is getting worse, see a doctor.

What causes a stye?

A stye is caused by a bacterial infection, usually Staphylococcus aureus, of an eyelash follicle or an oil gland in the eyelid. Blepharitis, rubbing your eyes, old eye makeup, poor contact lens hygiene and conditions such as rosacea and diabetes increase the risk.

Is a stye contagious?

Styes are not considered contagious in the usual sense, and you do not need to stay home. However, the bacteria can spread through hands, towels and makeup to your other eye or to other people, so wash your hands and avoid sharing towels and cosmetics.

What is the difference between a stye and a chalazion?

A stye is a painful, red, infected lump that develops quickly, often with a pus head. A chalazion is a usually painless, firm lump caused by a blocked oil gland without active infection, developing over weeks. A stye can turn into a chalazion once the infection settles.

Should I pop a stye?

No. Squeezing or popping a stye can push infection deeper into the eyelid and cause cellulitis. Let warm compresses help it drain on its own. If it is large or not draining, an eye doctor can open it safely with sterile instruments.