Alamo Optometry Blog

January 13, 2011


Filed under: Uncategorized — gkblog @ 10:43 am


 (As appeared in Alamo Today, January 2011, pg. 26)

            I was recently asked by one of my patients who read my articles to discuss eyelid styes.  I was so excited that at least someone was reading the articles besides family members that I would honor her request.  These are very common and can happen in any age group.  Most of the time no drug treatment is needed unless the area affected is large and painful.

            The first distinction to be made is to define the differences between a stye and a chalazion.  A stye, or hordeolum, is an infection or blocking of the glands that are at the edges of the eyelids.  These infections are mostly caused by normal bacteria that live on and around the eyes.  Lid hygiene is very important to keep the lids clean, for women it is very important to completely remove all makeup around the eye as that can lead clogged ducts.   A stye usually starts out as a localized area of swelling, irritation, and discomfort that can last for a few weeks and takes on the appearance of a pimple.  Styes generally do not directly cause decreased vision but can cause some tearing and irritation which can blur your vision.  I always recommend warm compresses to help the stye express.  The more you apply warm moist heat, the better; I recommend at least 15-20 minutes at a time.  I have found that boiling an egg and then wrapping it in a moist washcloth works best because the egg will hold its heat for a long period of time.  Simply putting the washcloth in the microwave does not work because the cloth cools off too quickly and is of little use.  Depending on the size and how solid the stye is, it can take anywhere from a few days to a few weeks to resolve.  It is very important to not attempt to express these on your own as without correct diagnosis and treatment; styes can cause further issues and mild bacterial infections of the front part of the eye.

            By distinction, a chalazion is best described as a cyst in the eyelid that is caused by inflammation in the glands in the eyelids; chalazions are much more common in the upper lids than the lower lids.  These nodules, or cysts, generally are painless and don’t cause the tearing and irritation that styes cause.  Topical and oral antibiotics are of little use because the root of the problem is not an infection.  Chalazions don’t look like a stye because there is not a drainage channel for the contents to escape.  Chalazions tend to take longer to resolve, for some people up to a few months.  Again, warm compresses are recommended, but if there is no resolution, injection with steroids to help shrink the nodule or surgical excision are options.  If excision is needed, it is done in office with local anesthetic, and the recovery is quick.

            As a general rule, most people use the word “stye” as a catch-all for both hordeolums and chalazions.  When I see patients in the office, I can assess the situation and try to express the stye in the office.  It might cause a little more discomfort initially, but will ultimately help the process along.  Because of the infectious nature of the stye and the bacteria present in the glands, I always prescribe an antibiotic drop to be used for a few days just as a prophylaxis against a conjunctivitis or corneal infection.  Most of the time styes will heal on their own with persistent use of warm compresses.  However, it is very important to not just assume any eyelid bump is a stye or chalazion.  More severe eyelid and systemic issues can mimic the initial appearance of a stye but require prompt medical treatment.  Anytime you have an eyelid bump of any kind, we can see you in the office and initiate treatment or send you to a specialist if needed.

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