Introduction  

A stye refers to an infection of an oil gland of the eyelid. This infection causes a minor bump or abscess on the brink of the eyelid. It is red, painful and can cause the swelling of the entire eyelid. A stye looks like a common acne pimple. Some people may develop a stye or two in a lifetime. Others, however, develop styes repeatedly. 
 A stye is often confused with a chalazion. While a chalazion is painless, a stye is painful. A chalazion is located farther back on the eyelid compared to a stye. A blocked oil gland causes a chalazion but it hardly causes the whole eyelid to swell.

Also Known As

  • Hordeolum
  • Bump on the eyelid
     

Sub-Types

  • External hordeolum – It begins at the base of the eyelash and looks like a pimple.  An infection in the hair follicle causes an external hordeolum.
  • Internal hordeolum – It is located inside the eyelid.  An oil gland of the eyelid causes this type of stye. However, an internal hordeolum is rare.
     

Causes and Risk Factors

A blockage in an oil gland causes a stye allowing bacteria to grow inside the blocked gland. Staphylococcal bacteria is the most common cause of eyelid infections. A stye can affect anyone but those most at risk include:

  • People with blepharitis. Blepharitis causes the eyelids to swell and become red
  • Individuals who have had a stye before
  • People with dry eyes
  • People with diabetes and other medical conditions
  • Skin conditions such as seborrheic dermatitis or acne rosacea
     

Signs & Symptoms

The following are the symptoms of a stye:

  • A very sore red swelling on the edge of the eyelid 
  • Usually, only a small area swells but the entire eyelid may swell as well
  • An eyelid that is tender to the touch
  • Feeling like there is a foreign body in the eye
  • A tiny yellowish pus spot developing at the center of the swollen area
  • Crustiness along the margin of the eyelid
  • Sensitivity to bright light
  • Feeling the need to scratch the eye
  • Tearing
  • The stye will rapture after two to three days releasing a pus-like fluid and ending the problem
  • Severe pain if it’s an internal stye and the swelling occurs beneath the eyelid
  • Sometimes fever and chills may accompany the stye
     

Diagnosis

The eye care professional can diagnose a stye by:

  • Taking a patient’s history, especially in case of a recurrence
  • Conducting an eye examination especially to distinguish an internal from an external stye
  • Conduct a visual acuity test, slit lamp examination and dilated funduscopic exam 
     

Treatment 

Treatment of a stye is directed towards eliminating the bump on the eyelid.

Medical Treatment

Most styes tend to go away within a few days even without treatment. If the stye is infected, the eye doctor may apply an antibiotic directly on the eye. A patient can also use an oral antibiotic with an internal stye after surgery or if there is an infection of the surrounding eye. The doctor may treat a very swollen stye with a cortisone (steroid) injection to reduce the swelling.

Surgical Treatment

Sometimes the stye may be too swollen as to affect vision. It may linger and refuse to go away. It could also be an external stye that cannot be drained by a warm compress. Further, an internal stye will rarely rapture by itself. In all those cases, the professional  may consider surgery to remove it. He/she will carry out the procedure using local anesthesia in the office. 
A recurring stye will need a biopsy. In a biopsy, the surgeon will remove and study a small piece of tissue to check for serious eye problems.

Home Care

A patient  can use a warm compress to help the gland clear by itself. The warmth causes a stye to rupture and drain. The patient can immerse a clean piece of cloth in hot water then gently compress it on the eyelid. He/she can do this 10-15 minutes each time three to five times per day. The patient can then gently massage the area with clean fingers. 
Patients should avoid squeezing a stye because the infection could spread into the eyelid.
Also, a stye patient should not wear eye makeup or contact lenses. 
Good eyelid hygiene is mandatory.

Prognosis/Long-term outlook

A stye usually resolves on their own. With simple treatment, the outcome is almost always excellent. However, it may recur. 
A cosmetic deformity and visual disturbance can occur. Also, improper drainage may lead to a disruption of eyelash growth, eyelid deformity, or eyelid fistula.
If the infection spreads to the rest of the eyelid with an internal stye, it may lead to a more serious problem called orbital cellulitis in children.
The chronic appearance of a stye may lead to a chalazion. Because a chalazion leads to edema of the eyelid, it may impair vision. A chalazion may grow too large and deform the cornea leading to astigmatism.
Patients may need regular checkups to monitor side effects and ensure the bump is draining.

Prevention/Follow Up

The following may help prevent a stye:

  • Individuals can take fish oil orally to avoid the blockage of oil glands
  • Wash hands thoroughly before touching the skin around the eye
  • People can use a solution of no-tears baby shampoo with warm water to clean off excess oils from the edge of the lids.