A stye (or sty) is an acute infection of the secretory glands of the eyelids.
Frequently, bacteria can enter and infect an eyelid oil gland, which are present in both the upper and lower eyelids, causing inflammation, pain, and redness of the eyelid, and even redness of the surrounding eyelid and cheek tissue. The medical term for stye is hordeolum.
The lump can point externally (outward) or internally (inward). These conditions are medically known respectively as an external hordeolum and internal hordeolum. Frequently, the lump appears with a visible whitish or yellowish spot that looks much like a large pimple. Usually, only one obvious area of swelling is apparent on one lid, but more than one stye can appear on one or both eyelids simultaneously.
The lump frequently disappears by itself when the blockage of the gland opening is relieved. Furthermore, the infection often goes away when the pus is drained from the stye.
What Are Stye Causes and Risk Factors?
Styes are usually caused by infections of the oil glands in the eyelid. Very frequently, they are infected by bacteria, most commonly Staphylococcus bacteria.
Seborrhea (excessive oily discharge from the glands) may increase the likelihood of developing one of these infections. Certain other factors can contribute to the infection of the glands:
What Are Symptoms and Signs of a Stye?
Symptoms and signs of a stye include the following:
- A lump on the top or bottom eyelid
- Localized swelling of the eyelid
- Tenderness to touch
- Crusting of the eyelid margins
- Burning in the eye
- Droopiness of the eyelid
- Scratchy sensation on the eyeball
- Blurred vision
- Mucous discharge in the eye
When Should Someone Seek Medical Care for a Stye?
Sometimes, complications may occur from a seemingly innocent problem. Immediately contact an ophthalmologist (a medical doctor who specializes in eye care and surgery) if any of the following problems occur:
- The eye is swollen shut.
- Redness appears around the entire eye.
- There is any change or disturbance in one's vision.
- Swelling lasts for more than three weeks.
- The stye or styes come back or bleed.
- Eyelashes fall out.
- The stye is on the bottom eyelid, near the nose.
- The white part of the eye becomes red.
- Pus or thick discharge continues to drain from the eye.
- One has a fever higher than 100.5 F.
- One has excessive persistent tearing.
- One has persistent redness of the surface of the eye.
- One has significant pain.
- The stye recurs, especially if the stye does so in the same location as a previous stye.
- One has swelling of the lymph nodes in the neck or in front of the ear on the side of the stye.
- One experiences double vision.
Go to an ophthalmologist for any of the above symptoms. If one is unable to be evaluated by an ophthalmologist, go to the hospital's emergency department if experiencing any of the above problems.
Is There a Home Remedy for a Sty (Stye)?
Most styes will drain and resolve on their own without the need for medical treatment. Application of a warm compress or warm washcloth to the affected area for 10-15 minutes, four to six times a day, can be an effective home remedy and speed drainage of the sty, also sometimes spelled stye. This will aid in the relief of symptoms. A sty should not be pressed or squeezed to facilitate drainage, since this can spread or worsen the infection. If a sty persists for several days, a doctor may drain the infection with a minor procedure under local anesthesia in his or her office. Babies or children who require surgical drainage of a sty may need a general anesthetic. Antibiotic ointments and/or steroid ointments sometimes are prescribed to treat a sty. Rarely, systemic (oral) antibiotics are recommended for persistent or multiple styes. Over-the-counter pain medications may be used to alleviate pain and tenderness. Contact lenses and eye makeup should never be worn during treatment for a sty.
What Types of Doctors Treat a Stye?
Many patients who develop a stye are taken care of by their family physician, including pediatricians. Your family physician can decide whether or not you need to see a specialist. If you wish to see a medical doctor who specializes in the treatment of only eye problems, you should contact an ophthalmologist.
What Questions Should Someone Ask the Doctor About a Sty?
- Is the eyelid infected?
- Is the cornea involved?
- Is surgery required?
- How can I prevent a recurrence?
- What is the chance that the stye may be a type of skin cancer?
- Is the tear drainage system involved?
How Do Health-Care Professionals Diagnose a Stye?
- An ophthalmologist will ask questions about whether one has had any injury or previous eye problems or surgeries. Frequently, a history of similar symptoms is useful, so be sure to tell an ophthalmologist if you have previously experienced them. One's eyelid and facial hygienic habits, along with any cosmetic usage, are also useful information for an ophthalmologist. Your doctor may ask whether styes run in the family.
- The eyes and eyelids will be examined, including the underside of the eyelid. An ophthalmologist may use a slit lamp (a microscope-like device with a powerful light) to examine the eye.
- X-rays and blood work are not usually useful, unless an ophthalmologist is concerned that an infection may have spread from the eyelid to the eye socket. In this case, a CT scan of the eye socket may be required.
What Are Stye Treatments?
There are a variety of treatments for stye. These include self-care measures, pain medication, antibiotics, and surgery.
Are There Home Remedies That Get Rid of Styes?
Most styes go away on their own in five to seven days with home remedies.
- Apply warm compresses four to six times a day for about 15 minutes at a time to help the drainage. Keep the eyes closed when applying the warm compresses.
- Gently scrub the eyelid with tap water or with a mild, nonirritating soap, or shampoo (such as baby shampoo). This may help with drainage. Close the eyes as you scrub so you do not injure your eyes.
- Do not squeeze or puncture the stye. A more serious infection may occur as a result.
- Discontinue the use of eye makeup as well as eye lotions and creams because they may be contaminated with the bacteria from the infection.
- Discontinue wearing contact lenses while a stye is present because the infection may cause an infection to spread to the cornea with the continued use of contact lenses.
What Is the Medical Treatment for a Stye?
Care is mainly provided to help relieve symptoms and to hasten recovery.
- Warm compresses are usually recommended.
- Pain medicine, such as acetaminophen (Tylenol), may be given or recommended.
- Antibiotics may be necessary.
- Topical antibiotics in the form of eyedrops or eye ointment may be prescribed by an ophthalmologist.
- Occasionally, oral antibiotics are given to people either with styes that do not go away or with multiple styes as well as to those who have styes in addition to other conditions, such as blepharitis or rosacea.
- People who have rosacea along with a stye may require treatment of their cheeks with an antibiotic cream, an oral antibiotic, or both.
- IV antibiotics are rarely given in the unusual situation where the infection has spread to the lymph nodes or into the bloodstream..
- An ophthalmologist may remove the pus from a large or painful stye by making a small incision in the inside of the lid and then draining the pus.
What Medications Treat Styes?
A topical antibiotic ointment or drop may be prescribed to treat styes.
For a stye that has not resolved in three weeks or for multiple styes, one may be prescribed oral antibiotics by an ophthalmologist. Doxycycline (Vibramycin, Oracea, Adoxa, Atridox) is an antibiotic that is commonly used to treat persistent or complex styes.
When Is Surgery Necessary for a Stye?
- If one has a stye that has not responded to medical treatment or if one experiences complications resulting from a stye, a surgical procedure may be required.
- During this surgical procedure, an ophthalmologist makes a small incision in the eyelid. The incision is made either on the inner surface of the eyelid or on the outer surface of the eyelid if the stye is pointing externally (outward). Once the incision is made, the ophthalmologist then drains the pus (or blocked oil) out of the gland.
- This procedure is commonly performed in the office using a small amount of local anesthetic injection. In children, general anesthesia may be required..
- A one-week follow-up appointment is usually recommended after this surgical procedure.
- The ophthalmologist rarely may need to perform a biopsy on the stye. During the biopsy, a small piece of tissue from the stye is removed and sent to a laboratory for microscopic examination by a pathologist (a physician with special training in tissue diagnosis) to ensure that the stye is not a form of skin cancer.
The stye usually goes away within one week. Reevaluation is required if the stye lasts for more than three weeks.
Is It Possible to Prevent a Stye?
Good hand and facial washing may prevent styes from forming or coming back.
Upon awakening, application of a warm washcloth to the eyelids for one to two minutes may be beneficial in decreasing the occurrence of styes by liquefying the contents of the oil glands of the eyelid and thereby preventing blockage. This can also be performed at bedtime on a nightly basis.
All cosmetics and cosmetic tools should be kept clean and protected from the environment. Do not share makeup or eye cosmetic tools, such as eyelash curlers. Makeup should be thrown away when it becomes old or contaminated.
Some studies suggest oral flaxseed supplementation may help prevent the occurrence of styes.
What Is the Prognosis of a Stye?
A stye may come back, even after appropriate medical or surgical care. These persistent styes need further evaluation and care because they may signal other health problems; rarely, they can be an indication of cancer or other health conditions including infections, inflammatory conditions, and parasites.
Astigmatism and corneal irregularity may improve after treatment of a stye.
This woman has an acute stye on her lower eyelid and a chalazion on her upper eyelid. This child has an acute stye (hordeolum) on his lower eyelid.
Reviewed on 8/30/2017
Bagheri, A., H.R. Hasani, F. Karimian, M. Abrishami, and S. Yazdani. “Effect of Chalazion Excision on Refractive Error and Corneal Topography.” Eur J Ophthalmology 19.4 July-Aug. 2009: 521-526.
Driver, P.J., and M.A. Lemp. "Meibomian gland dysfunction." Survey of Ophthalmology 40.5 (1996): 343–367.