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Stye

A stye is an infection or swelling that can develop on the outside or inside of the eyelid. People of all ages can develop a stye.

About styes 

A stye is a swelling on your eyelid, usually caused by an infection of one or more of the eyelash follicles (the root of the eyelash) in your eyelid. Styes can appear on the outside of the eyelid (an external stye) or the inside of the eyelid (an internal stye). The medical term for a stye is a hordeolum.

External stye

This is the most common type of stye. It's an abscess or boil on the skin at the edge of your eyelid. The abscess points outwards away from your eye. It develops when the area around your eyelash or a gland becomes infected.

stye eyelid bump

Internal stye

An internal stye is an abscess or boil on the inside of the eyelid. The abscess usually points inwards towards the eyeball. It develops when a meibomian gland becomes infected. These glands help to keep your eyes moist by producing an oily lubricant called sebum that prevents the watery layer on the surface of your eyes (tears) from evaporating. They're located in the middle of your eyelid, just behind your eyelashes. Each eyelid has between 50 and 70 glands.

Some people get one or two styes during their lifetime, whereas others may develop them again and again.

Symptoms of a stye 

The main symptoms of a stye are pain, redness and a swelling on your eyelid. Usually only one stye develops at a time; however, you can have more than one stye at the same time and you may get them on both eyelids. Your eye may water a lot or feel like there's something in it. Depending on whether you have an internal or external stye, you may also get some other symptoms.

With an external stye, you may also notice a yellow, pus-filled spot with a head on it close to the edge of your eyelid. When you touch it, it may feel warm and it's likely to hurt. With an internal stye, you may see a red area with a yellow spot on it on the inside of your eyelid when you turn your eyelid inside out. The skin around the swelling may look red. Internal styes usually develop more slowly and are more painful than external styes.

Possible complications 

Most styes get better within a few weeks and cause no further problems. However, occasionally a stye can lead to complications.

Chalazion

An internal stye can sometimes develop into a chalazion, which is a blocked meibomian gland.

The initial pain from the stye gets better but you're left with a painless swelling about the size of a pea. When your eyelid is lifted up and turned inside out you may see a smooth yellow cyst.

Eyelid infection

Occasionally, a stye can lead to an infection of your entire eyelid and the skin around your eye (cellulitis). If you develop increasing swelling and redness, contact your doctor.

Causes of a stye 

The most common cause of a stye is infection by bacteria called staphylococcus. Ninety per cent of styes are caused by these bacteria.

Staphylococcal infections are caused by bacteria that normally live harmlessly on your skin and inside your nose. Occasionally, these bacteria can cause infection by entering through small openings in your skin or at the edge of your eyelid. If you have blepharitis (inflammation on the edge of your eyelid) you're more likely to develop styes. Blepharitis usually affects both eyes and causes irritation and redness.

Diagnosis of a stye 

Your doctor will ask about your symptoms and examine you. You may also be asked about your medical history.

It's unlikely that you'll need to be referred to a specialist for treatment. Your GP will treat and monitor your condition.

Treatment of a stye 

Most styes go away by themselves within a few days or weeks, so treatment isn't always necessary. However, if your stye doesn't get better, there are several treatments available.

Self-help

A hot compress is a simple, effective treatment for a stye. Use a clean towel or face cloth soaked in hot water to make a compress. It should feel comfortable on your skin; it shouldn't be scalding hot. Hold the compress against your eyelid for five to 10 minutes. This will warm the fluids trapped inside the stye encouraging them to drain away. Use a hot compress three or four times a day until the stye gets better.

It's also 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 along the edge of your eyelid and rinse. If you have blepharitis as well as a stye don't wear eye make-up as this could make your condition worse or stop it getting better.

Medicines

Your doctor may prescribe topical or oral antibiotics if the infection has spread and is affecting other areas of your eye, or if your infection is severe.

Surgery

If your stye is very large or it doesn't get better using other treatments, your doctor may pierce it with a needle, or make a small cut in it to drain it.

You will be given a local anaesthetic for this procedure which 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.

If you have a small external stye, your doctor may remove an eyelash if the area around it is infected.

Prevention of styes 

It's common for styes to keep coming back. To try to prevent this, it's important to keep the skin on your eyelids clean. This means good hygiene at all times, even when you don't have a stye.

Good eye hygiene means keeping your eyelids and lashes clean and clear of any crusting or stickiness.

If you keep getting styes, see your GP who may suggest treatment or refer you to a specialist.

Further information 

Queensland Government: Eye health

access.health.qld.gov.au/hid/EyeHealth/index.asp

Optometrists Association of Australia

www.optometrists.asn.au/

Sources 

Bessette MJ. Hordeolum and Stye in Emergency Medicine. [online] New York, NY: WebMD LLC. [Last updated 24 Feb 2010, accessed 1 Jul 2011] Available from: http://emedicine.medscape.com/article/798940-overview

Clinical Knowledge Summaries. Styes (hordeola). London: National Institutes for Health and Clinical Excellence. 2010 [Accessed 1 Jul 2011] Available from: http://www.cks.nhs.uk/styes_hordeola

Personal communication, Mr Scott Robbie, NIHR Clinical Lecturer in Translational Ophthalmic Research, Biomedical Research Centre for Ophthalmology, Moorfields Eye

Hospital and UCL Insititute of Ophthalmology, 28 June 2010

PubMedHealth. Eyelid bump. [online] Bethseda, MD: US National Library of Medicine [Last updated 3 Aug 2010, accessed 1 Jul 2011] Available from: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002004/

Simon C, Everitt H, Kendrick T. Oxford handbook of general practice. 2nd ed. Oxford: Oxford University Press, 2007:938

Last published: 30 July 2011

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