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Stye

 

A stye, also known as a hordeolum, is a small abscess (painful collection of pus) on the eyelid. It appears as a painful lump on the outside or inside of the eyelid.

A stye is usually caused by an infection with staphylococcus bacteria.

How common are styes?

Styes are fairly common. A person may have one or two styes during their lifetime.

Chronic blepharitis (inflammation of the eyelids) may increase the risk of styes.

Outlook

Most styes get better without any treatment within one to three weeks. External styes may turn into yellow spots and release pus around three or four days later. Internal styes are more painful and may last slightly longer.

A warm compress (a cloth warmed with hot water) held against the eye encourages the stye to release pus and heal more quickly. Further treatment is not usually needed.

Some people may find that their stye reoccurs.

A stye (also called a hordeolum) causes a painful swelling on the outside or inside of your eyelid. You may also have other symptoms, such as:

  • a watery eye (epiphora)
  • a red eye and eyelid

A stye normally affects just one eye, although it is possible to have styes in both eyes, or to have more than one stye in the same eye. A stye should not affect your vision.

There are two types of stye:

  • an external stye (external hordeolum) - this is a swelling that appears along the edge of your eyelid, which may turn into a yellow pus-filled spot that is painful to touch
  • an internal stye (internal hordeolum) - this is a swelling that appears on the inside of your eyelid and is usually more painful than an external stye

A stye (hordeolum) is usually caused by an infection with staphylococcus bacteria. These bacteria often live on the skin without causing any harm. S

Causes of external styes

An external stye (on the outside of your eyelid) may be caused by one of the following:

  • an infection of an eyelash follicle (a small hole in your skin that an individual eyelash grows out of)
  • an infection of the sebaceous (Zeis) gland - this gland is attached to the eyelash follicle and produces an oily substance called sebum, which lubricates the eyelash to prevent it drying out
  • an infection of the apocrine (Moll) gland - this sweat gland empties into the eyelash follicle; the fluid joins the tear film that covers your eye and prevents the eye from drying out

Causes of internal styes

An internal stye is caused by an infection of the Meibomian gland. Meibomian glands are found on the eyelids and they produce a fatty liquid, which makes up part of the tear film that covers your eye.

Blepharitis

A stye can be a complication of another condition called blepharitis. Blepharitis causes the rims of your eyelids to become inflamed (red and swollen), which can result in symptoms such as:

  • burning or sore eyes
  • crusty eyelashes
  • itchy eyelids

Blepharitis can be caused by a bacterial infection, or it can be a complication of a skin condition such as rosacea (a long-term condition causing spots and redness of the face).

If you have chronic (long-term) blepharitis, you may be at increased risk of developing styes.

Your GP will usually be able to diagnose a stye (hordeolum) by:

  • examining your eye
  • asking about your symptoms

You may not always need to see your GP, although this will depend on your symptoms. 

A stye (hordeolum) often gets better without any treatment, particularly after it bursts and has released some pus. Most styes should go away on their own within one to three weeks. Do not try to burst the stye yourself.

In the meantime, try the treatments listed below to ease your symptoms.

Warm compress

You can use a warm compress to treat your stye. A warm compress is a cloth or flannel warmed with hot water. Do not use scalding water, particularly on children.

You should:

  • hold the warm compress over the affected eye for 5 to 10 minutes
  • repeat this three or four times a day until the stye either clears up or releases some pus

The warmth of the compress encourages the stye to release any pus, which will drain away. After this, your symptoms should quickly improve.

Painkillers

If your stye is very painful, your GP may prescribe or recommend painkillers, such as paracetamol or ibuprofen. These are also available over the counter in pharmacies. Always read the manufacturer's instructions to make sure:

  • the medication is suitable for you
  • you take the correct dose .

When to see your GP

See your GP if you have an external stye (on the outside of your eyelid) that is very painful. Your GP may:

  • remove the eyelash closest to the stye - if the stye involves an infected eyelash follicle (a small hole in your skin that an individual eyelash grows out of)
  • use a very thin, clean needle to make an incision (cut) into the stye and drain away the pus

Do not try to remove the eyelash or burst the stye yourself.

Referral

Your GP may refer you to an ophthalmologist (medical doctor who specialises in eye disease) if:

  • your stye does not improve after using the above treatments
  • you have an internal stye (on the inside of your eyelid) that is particularly large or painful

Your ophthalmologist may make an incision (cut) into the stye and drain out any pus. 

Incision
An incision is a cut made in the body with a surgical instrument during an operation.
Ophthalmologist
An ophthalmologist is a medical doctor who specialises in eye disease and its treatment or surgery. They mainly work in hospitals and hospital eye departments.

Other eye conditions

If you have any other eye condition that may be making your stye worse, your GP may prescribe separate medication for this or advise a different course of treatment. For example:

  • if you have conjunctivitis (swelling of the layer of cells that covers the white part of your eyeball and the inner surfaces of the eyelids), your GP may prescribe antibiotics (medication to treat bacterial infections)
  • if you have blepharitis (when the rims of your eyelids become red and swollen),  your GP may advise using eye hygiene measures, such as using a cotton bud to clean the rim of your eyelids

Antibiotics

Antibiotics are not recommended for the treatment of styes because:

  • there is little evidence that they are effective
  • styes usually get better on their own

While styes (hordeolums) normally get better without treatment, they may cause some complications. These are rarely serious.

Chalazion (meibomian cyst)

If you have a long-term stye on the inside of your eyelid (internal stye), this can develop into a chalazion. Chalazions are also called meibomian cysts. They can develop if one of the glands on your eyelid becomes blocked.

These cysts are normally painless unless they get infected. In this case, you may need to take antibiotics (medication to treat bacterial infections).

Applying a warm compress (a cloth warmed with hot water) to the cyst should help bring the cyst down, although most cysts disappear by themselves. If a cyst does not disappear, it can be removed with a simple surgical procedure carried out under local anaesthetic (the area is numbed).

Preseptal cellulitis

If the infection that caused your stye spreads to the tissues around your eye, it can cause preseptal cellulitis. Preseptal cellulitis, also known as periorbital cellulitis, is inflammation (redness and swelling) in the layers of skin around your eye. It can make your eyelids swollen and red.

Preseptal cellulitis can be treated with antibiotics.

Inflammation
Inflammation is the body's response to infection, irritation or injury, which causes redness, swelling, pain and sometimes a feeling of heat in the affected area.
Meibomian glands
The Meibomian glands are located on the inside front edge of your eyelids. They produce a fatty liquid that makes up the outer layer of the tear film and protects your eyes.

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.