Styes and Chalazia

Useful Terms

Styes = those sore, red lumps near the edges of the eyelids

Chalazia = those painless lumps farther away from the edges of the eyelids than styes, usually in the middle portions of the eyelids; some chalazions may be the evolution of styes that haven’t healed

Common Symptoms

  • Redness in the affected area of the eye (s)
  • Tenderness of the eyelids
  • Irritation and scratchiness in the eye (s)
  • Tearing
  • Red lump (s) along the edges of the eyelids, at the bases of the eyelids

    • Those red lumps may contain a small puss spot in their centers
  • The feeling of having a foreign body or substance in the eye (s)
  • Increased light sensitivity
  • Eyelid crusting
  • Chalazia

    • About a quarter of all chalazia will not have any symptoms and simply disappear on their own
    • Redness in the affected areas of the eye (s)
    • Inflammation in the affected areas of the eye (s)
    • Tenderness of the chalazia
    • Blurred vision (when the chalazia are large)
    • Sudden swelling of the eyelids

Risk Factors

  • Co-occurring condition of blepharitis
  • History of previous styes or chalazia
  • Co-occurring skin conditions of acnea rosacea or seborrheic dermatitis
  • Co-occurring systemic medical conditions including, and especially, diabetes
  • A consistently incomplete removal of eye cosmetics
  • The usage of old or tainted eye cosmetics

Causes

  • Styes

    • They are usually caused by the infectious bacteria, Staphylococcus, which may infect various parts of the eyelid (s) to do so
    • Types of Styes

      • Internal

        • These are caused by an infection of the meibomian glands by Staphylococcus
        • These styes usually appear inside or on the underside of the eyelid (s)
        • They take the form of red, painful lumps, but because of their location, the signature whiteheads will not emerge on the eyelid (s)
        • They may either completely vanished once the infection has past, or they could leave behind a small cyst that would have to be opened and drained of its fluids
      • External

        • These are caused by the infection of the eyelash follicles by Staphylococcus
        • They first appear as small pimples next to the eyelash (es)
        • Soon enough, they will grow into the characteristic red and painful lumps, which may be short-lived, and burst and heal on their own after just a few days
        • Those that do not heal on their own will need to be treated by the ophthalmologist
    • Blepharitis

      • This condition results in an extensive inflammation and swelling of the margins of the eyelid (s), which results in the formation of a stye
  • Chalazia

    • Defective or blocked meibomian glands may reduce output or result in the production of unusual and irregular oil secretions

      • This may lead to the irritation and inflammation of the eyes and eyelids, tearing, eyelid crusting, and subsequent formation of chalazia
    • Styes

      • Internal styes that don’t heal on their own will usually develop into chalazia

Diagnosis

  • The ophthalmologist will perform a routine eye exam, paying particularly close attention to the eyelids and eyelashes

    • This is usually all that is required to determine if there are styes or chalazia

      • Hard lumps within the eyelid (s) will be diagnosed as chalazia
  • Eye Charts

    • The patient reads letters that are at certain distances away to test for visual acuity and clarity
  • Slit Lamp Microscope

    • This tool emits a slit-like beam of light in order to illuminate various parts of the eye and magnify them to look for the extent and nature of any existing blepharitis or other skin conditions in the eye and how it may impact the other areas within and around the eye, especially the eyelids and eyelashes
  • Laboratory Analysis

    • If the inflammation looks unusual or fails to react to treatment, laboratory analysis is advised to look for the cause of the problem
    • The ophthalmologist may sample the oil or eyelid crusting with a cotton swab, which is then tested for the presence of the bacteria Staphylococcus or any allergic reactions that may have resulted in the unusual inflammation and swelling
    • Biopsy

      • This is recommended for those cases in which the chalazia recur in the same place
      • A small piece of the eyelid is collected and tested to rule out more serious diseases, such as cancer

Treatment

  • Warm Compresses

    • Use a clean washcloth, cotton swab, or commercial lint-free pad in combination with warm water to clean out the eyelids by placing the wet washcloth on the eyelid for one minute at a time for 3 – 4 repetitions, 3 – 5 times a day until the stye (s) or chalazion (chalazia) are gone

      • Don’t forget to wring out the washcloth after placing it in the warm water and to place in the warm water again after every time it cools
    • This procedure will help loosen debris from around the eyelashes that led to its initial infection
    • Additionally, it also aids in the opening of the meibomian glands and the degeneration of the abnormal oil secretions that led to the formation of chalazia
  • Antibiotics

    • This is usually recommended for those cases in which the Staphylococcus infects the chalazion (chalazia), or the condition of the stye (s) does not see any improvement after the application of warm compresses and it (they) recurs (recur)
    • A cotton swab should be used to gently apply the antibiotic ointment at the base (s) of the eyelash (es) before one goes to bed to correct the bacterial infections caused by Staphylococcus
  • Steroid Injections

    • This is used as a means of controlling and curbing the inflammation of the chalazion (chalazia)
  • Good Hygiene

    • It is best to maintain regular care and washing of the skin, eyes, and eyelids in order to prevent the reoccurrence of styes and chalazia from bacterial infection

      • Be sure to use antibacterial shampoo when washing the scalp, hair, and eyebrows
  • Treatment of Underlying Conditions

    • Since styes and chalazia may be directly caused by other co-occurring conditions, such as blepharitis, seborrheic dermatitis and acnea rosacea, they can be controlled through the treatment of these other diseases
  • Surgery

    • For those large chalazia and/or styes that don’t respond well to other treatments or start to impair vision, surgical removal is highly advised
    • The ophthalmologist will apply anesthetic eyedrops before the lumps are drained of their pus and other fluids
  • One should abstain from using eye cosmetics or wearing contact lenses until after the stye (s) and/or chalazion (chalazia) have completely healed