Stye
Published by Bupa's health information team, July 2008.
This factsheet is for people who have a stye, or who would like information about it.
A stye is an infection or swelling on your eyelid. It usually only affects a small area of your eyelid and can appear on the outside or the underside.
It's the most common type of eyelid disorder, and affects people of all ages.
- About stye
- Symptoms of stye
- Complications of stye
- Causes of stye
- Diagnosis of stye
- Treatment for stye
- Prevention of stye
- Questions and answers
- Video
- Related topics
- Sources
About stye
A stye is a swelling on your eyelid, usually caused by an infection. It can appear on the outside of your eyelid (an external stye) or the underside of your eyelid (an internal stye).
External stye
This is the most common type of stye. It's a boil on the skin of your eyelid. It happens when there is an infection in an eyelash root (ciliary gland) or a sebaceous gland. A sebaceous gland is a gland in your skin that produces an oily liquid (sebum) to moisten and protect your skin.
Internal stye
An internal stye is the result of an inflammation in one of the meibomian glands in your eyelid. This may be due to an infection or blockage.
Your eyelid is made up of several layers: skin on the outside, muscle, tarsal plate and the conjunctiva (the transparent layer that covers the white of your eye and lines your eyelid). Your meibomian glands are located within the tarsal plate - so an internal stye tends to appear on the underside of your eyelid not on your skin, though you may notice a lump on the outer side or the edge of your eyelid.
Your meibomian glands help to keep your eyes moist by preventing the watery layer on the surface of your eyes (tears) from evaporating. They do this by producing an oily film over your tears. Your upper eyelid has about 50 meibomian glands behind your eyelashes; your lower lid has about 25.
Symptoms of stye
The main symptoms of a stye are pain, redness and swelling on your eyelid. However, depending on whether you have an internal or external stye, the symptoms may differ slightly.
With an external stye you may also notice:
- your entire eyelid may at first be affected before the swelling settles into one small area
- a yellow, pus-filled spot with a head on it close to the edge of your eyelid
- pain when you touch your eyelid
- the swelling feels warm
With an internal stye you may find:
- a red velvety area with a yellow spot on it on the inside of your eyelid (conjunctiva) when you turn your eyelid inside out
- the swelling may point to the inner side of your eyelid or point out through your skin
- the edge of your eyelid may be inflamed
- you may have some pus or crusting around the edge of your eyelid
Complications of stye
Chalazion
If an internal stye is left untreated it can develop into a chalazion. A chalazion is when one of the meibomian gland ducts in your eyelid becomes completely blocked. Once the initial pain and inflammation of your stye has gone, you may be left with a painless pea-sized lump that can only be seen when you look at the underside of your eyelid.
Occasionally, a chalazion can affect your vision by causing astigmatism. Astigmatism is when the cornea (the front part of the eye that covers the pupil) is an irregular shape. Instead of being its usual round shape, it's oval (a bit like a rugby ball). This makes focusing difficult and vision blurred. A chalazion can occasionally put enough pressure on your cornea to make it distort.
Conjunctivitis
This is an inflammation of your conjunctiva (the transparent layer that covers the white of your eye and lines your eyelids). Your conjunctiva can react to bacteria on or in your eyelid causing inflammation and redness
Eyelid infection
Occasionally, a stye can lead to an infection of your entire eyelid and the skin around your eye (a cellulitis).
Causes of stye
The most common cause of a stye is staphylococcal infection: 90 to 95 percent of styes are caused by these bacteria. Staphylococcal infections are caused by a bacterium which lives on your skin and inside your nose and usually doesn't cause you any harm. However, it can occasionally cause infection, entering through small openings in your skin or at the edge of your eyelid. Occasionally other types of bacterial infection can be the cause of your stye.
A common condition associated with styes is blepharitis. This is a chronic inflammation of the edge of your eyelid. It can affect the inside or the outside edges of your eyelids. People who have blepharitis are far more likely to get styes because of this inflammation.
Diagnosis of stye
Your GP or optometrist (a healthcare professional who examines eyes, tests sight and dispenses glasses and contact lenses) can diagnose your stye. He or she will ask about your symptoms and examine your eyes.
It's unlikely that you will be referred to a specialist for treatment - your GP or optometrist will treat and monitor your condition.
Treatment for stye
Most styes go away by themselves within a few days, so treatment isn't always necessary. However, if your stye doesn't resolve itself, there are several treatments available.
Self-help
It's important to keep the area around your eyelids clean and clear of any oiliness or crusting, especially if your stye is related to blepharitis. You can do this using a small amount of baby shampoo diluted in water. Apply it with a cotton bud or your fingertips along the edge of your eyelid before rinsing. You should do this at least once a day. Alternatively, you can use lid wipes or scrubs - you can buy these from your pharmacist or optometrist.
A hot compress is a simple, effective treatment for a stye. Use a towel or face cloth soaked in hot water to make a compress. The compress should feel comfortable on your skin; it shouldn't be scalding hot. Hold the compress against the affected area of your eyelid for five to 10 minutes. This will warm the fluids trapped inside your stye encouraging them to drain away. You should use a hot compress four times a day until it clears up.
Medicines
Antibiotic ointment, such as chloramphenicol (eg Chloromycetin) or fusidic acid (eg Fucithalmic) may be prescribed if you have an external stye. Antibiotic ointments aren't always effective in treating internal styes, so you may be prescribed antibiotic tablets instead if there are any signs of infection.
Surgery
Occasionally, large, persistent styes may need to be drained by your doctor under local anaesthetic. This completely blocks feeling from your eye area and you will stay awake during the operation. Your doctor will prick the head of your stye from the underside of your eyelid with a needle or blade. This will allow the trapped fluids and infection to be released and the lid to heal.
For smaller external styes, your may need to have the eyelash associated with the affected follicle removed.
Prevention of stye
It's common for styes to come back. To prevent this, it's important to keep the edges of your eyelids clean and clear of any crusting or stickiness, especially if you have blepharitis. Also, using a hot compress on a regular basis will help to prevent blockages and draw out infections as soon as they start.
Related topics
Sources
- Hordeolum and chalazion treatment: the full gamut. Optometry Today. www.optometry.co.uk, accessed 17 April 2008
- Hordeolum and Stye. eMedicine. www.emedicine.com, accessed 17 April 2008
- External stye. GP Notebook. www.gpnotebook.co.uk, accessed 17 April 2008
- Simon C, Everitt H, Kendrick T. Oxford Handbook of General Practice. 2nd ed. Oxford: Oxford University Press, 2007
- Internal stye GP Notebook. www.gpnotebook.co.uk, accessed 17 April 2008
- Khaw PT, Elkington AR. ABC of Eyes. London: BMJ Publishing Group, 2002
This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
Publication date: July 2008.
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