An external stye, or hordeolum, appears as a red blemish on the eyelid which is often sore to touch. This is caused by infection which can occur at the apocrine sweat glands of Moll, or of the sebaceous glands of Zeis at the base of the lashes.
Meanwhile an internal stye occurs when the infection is of the meibomian sebaceous glands which line the inside of the eyelid. These cause redness and swelling under the eyelid which sometimes can be seen as generalized redness from the outside. Though they cause no lasting damage (unlike chalazia), styes are uncomfortable, often painful and can be unattractive to look at.
A full list of symptoms include:
- A lump on the top or bottom eyelid – either on the outside or inside
- Localized pain and swelling
- Crusting of the eyelid
- Pus and discharge
- Burning sensations
- Droopiness or disfigurement of the eyelid
- Light sensitivity
- Discomfort when blinking
- Feeling of a foreign body in the eye
- Blurred vision
The onset of these symptoms is acute and they tend to last around 7-10 days. In other words unlike the chronic chalazia, hordeolum are self limiting and will dissipate on their own. However that said there are treatments, many of which can be used at home, in order to speed up recovery and to ease discomfort and redness. We will look at those here. If left untreated some complications may arise including progression into a chalazionwhich can result in permanent cosmetic deformity, corneal irritation and require surgical removal. Eyelid cellulitis which is an infection of the tissue can also occur. These complications are rare, but using the following treatments is still wise.
A warm compress is the primary mode of treatment and this should begin to cause the stye to dissipate after 48. Use a hot water bottle, a hot flannel or a rice sock that has been heated in the microwave, and then hold this against the hordeolum with your eye closed in order to reduce the problem. This should take 48 hours to dissipate.
Cleansing the area is also a good idea to prevent the spread of bacteria and to clean the discharge which can crust. Use mild and non-irritating soap or shampoo along with tepid tap water. Do this gently with the eye closed and be careful not to cause damage to the eye.
If the hordeolum is painful then an individual might use paracetamol or other pain killers in order to address the pain.
A doctor might prescribe acetaminophen and antibiotics in order to help address the pain and hasten the clearing of the infection (antibiotics are used in cases where the patients also suffer from blepharitis or rosacea). These will normally be administered orally. In other cases topical antibiotics can be applied topically.
If the problem does not subside after patients have taken these steps then a doctor might consider lancing and draining the stye. However it is very important that patients do not try to do this themselves as they can cause serious infection that spreads to the surrounding tissue or damage to the eye. This is only used as a last resort treatment when the hordeolum is showing no signs of clearing and does not respond to these other treatment methods. It is performed under local anesthesia by an ophthalmologist. The removed stye can be sent for histopathological examination in order to rule out skin cancer as a cause.
Note: When suffering from hordeolum, it is advisable to avoid eye makeup and other things that could potentially aggravate the eye.
Other methods can be used at home to prevent the occurrence of these hordeolum and this involves proper hygiene of both the face and hands in order to prevent the transfer of bacteria. Proper hand washing is advisable, as is washing the face each morning with a hot flannel. This can also help to break up the contents of the oil glands around the eye to prevent blockages that may lead to infection. You should never share eye makeup and tools with other people.