A chalazion/stye can occur on the outer angle of the eyelid. A chalazion/stye can occur at the eyelid edge. This large chalazion is most likely painful and must be treated vigorously to avoid developing bacterial complications. A chalazion/stye can occur on the inner surface of the eyelid (tarsal side). A cheese-like (sebaceous) discharge from the chalazion is often seen, especially after applying hot compresses.
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Stye (Hordeolum and Chalazion)  Information for adults

Picture of Stye (Hordeolum and Chalazion): A chalazion/stye can occur on the outer angle of the eyelid. Divider line
A chalazion/stye can occur on the outer angle of the eyelid.
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Overview
A stye (hordeolum) is a local, acutely inflamed growth (swelling, lesion) of the eyelid. They can occur at the lid margin or farther up the lid on either the inner (tarsal) side or the outer (skin) side of the lid. A chalazion is the chronic form of a stye, and its cellular makeup is different than that of a stye.

Both the meibomian and sebaceous oil glands of the lid can be involved in this process, which begins with a blockage of the normal openings of these glands, leading to the swelling. Typically, there is bacterial contamination.
Who's At Risk
Styes and chalazions are extremely common. You are more likely to have this problem if you have:

  • Dry skin problems
  • Blepharitis
  • Acne rosacea
  • Poor lid hygiene
  • Incomplete removal of eye makeup
  • Outdated or infected cosmetics
  • Increased stress
  • Hormonal changes
Signs and Symptoms
One should be suspicious of having a stye when there is the rather rapid development of a pus-filled bump (pustule) or swelling on the edge of the eyelid or on the lid itself. Chalazions are more of a rounded lump and are harder in consistency.

Some of the things you may experience include:

  • Pain
  • Redness of the eye
  • Discharge from the swelling
  • Tenderness to touch
  • Tearing
  • Very mild blurring of vision
  • Burning sensation
  • Scratchy feeling in the eye
  • Drooping of the eyelid
  • Crusting of the eyelid edges
Self-Care Guidelines
Apply frequent (4–6 times daily) very warm compresses until there is no more drainage from the stye or chalazion. The compresses must be hot enough to help drain the growth yet not so hot as to burn the very delicate eyelid skin. It usually takes 7–10 days, at most, for the problem to resolve. Good lid hygiene is also mandatory. Over-the-counter ointments or drops have no treatment value.

Note: Recurring styes or chalazions without other related factors suggest possible serious disease. With the start of very warm compresses, the growth may get larger temporarily before draining.
When to Seek Medical Care
You should seek medical advice if:

  • The eyelids are swollen shut.
  • There is no improvement after using frequent very warm compresses for 10–14 days.
  • There is pus or very thick drainage from the eye.
  • Pain or tenderness is increasing despite compresses.
  • The swelling is increasing beyond the first 2–3 days.
  • The eyelid is hot to the touch.
  • You develop a fever.
  • Recurrences are frequent, especially at the same location.
  • Progressive vision changes are experienced, including double vision.

Treatments Your Physician May Prescribe
Treatment may involve any or all of the following:
  • Surgical incision and drainage
  • Injection of steroid into the growth
  • Antibiotic ointments
  • Antibiotic drops
  • Oral antibiotics (especially if there is possible lid infection suspected)
  • Treatment for underlying/contributing conditions such as dandruff, acne rosacea, psoriasis, etc.

References

Kanski JJ, Nischal KK, eds. Ophthalmology: Clinical Signs and Differential Diagnosis. pp. 17, 91. Philadelphia: Mosby, 1999.

Yanoff M, Duker JS, eds. Ophthalmology. 2nd ed, pp. 708-709. St. Louis, MO: Mosby, 2004.
Last Updated: 22 Dec 2008