What is stye?
The word ‘stye’ (pronounced as ‘sty’ – rhymes with ‘fly’) originated from an old English word stīgend meaning ‘riser’.
Stye on eyelids is an acute infection of glands of zeis which are present at the roots of eyelashes (cilia). The infection is usually caused by Staphylococcus bacteria (90-95% of cases) but other bacteria may also initiate the infection. The infection tends to center around an eyelash follicle.
Stye is equally found in both males and females. It is more common in 20 to 50 age bracket especially if the patient has some conditions such as diabetes, seborrhea and high lipid levels in the blood. They are also found in children. They may occur on upper eyelids, lower eyelids or on both eyelids together.
Stye is also called as external hordeolum. It is different from internal hordeolum which is an infection of meibomian glands which are larger glands in the eyelids. It is interesting to know that repeated episodes of styes can lead to the formation of a condition called chalazion which is a non-infective swelling of meibomian glands caused by blockage of the openings of the glands.
To minimize confusion, here is a brief comparative summary of the above lesions and how they are different from each other:
- Stye (external hordeolum): infection of zeis glands at the margin of eyelids. This condition is painful.
- Internal hordeolum: infection of meibomian glands present in the substance of the eyelids. This condition is also painful.
- Chalazion: Non-infective swelling of meibomian gland because of accumulated secretions in and around the gland. This condition is painless.
What are the symptoms of stye?
Stye looks like an acne pimple elsewhere on the body. It is a small localized swelling at the eyelid margin. The surrounding skin of the eyelid is reddish. The eyelid may also be swollen if the infection or inflammation spreads beyond the affected gland.
Sometimes the generalized eyelid swelling is visible first and the localized lesion becomes noticeable later.
Many styes resolve on their own and do not need any treatment. Some styes cause severe inflammation and the infection may involve the whole eyelid or even the tissues around the eyeball and beyond (periorbital cellulitis). The patient may feel pain which may vary from mild to severe. The pain is more prominent (tender) if the swelling is touched. Itchy eyes in the presence of stye may indicate another co-existing or causative ocular condition.
Less frequently, if the swelling becomes large, it may cause pressure effect on the cornea causing astigmatism (distortion of corneal curvature) and visual disturbance consequently. The pressure on the cornea is more common in cases of internal hordeolum which is more prominent on the underside of eyelid.
Purulent material (pus discharge) may be found in the eye or on the eyelids.
In severe cases, lymph nodes in front of ear on the affected side become enlarged. They can be felt with fingers. Fever is not uncommon in such cases.
Stye may look like early herpes virus infection of the eyelid but it is not contagious like herpes infection.
The picture above shows a localized swelling of stye on the upper eyelid.
The image above shows more generalized swelling and redness of the upper eyelid.
What causes stye?
Some people develop styes frequently and they want to know why stye keeps coming back. Basically, poor eyelid hygiene and inflammation of eyelids (blepharitis) are primarily responsible for recurrent styes.
So if you want to prevent it, keep your eyelids clean, maintain proper hygiene, avoid touching your eyes with contaminated hands, avoid eye makeup and treat any blepharitis or dry eye in the early stages.
How to treat stye
Treating a stye in early stages is simple. The treatment may not be required and stye may resolve on its own if the infection is not significant.
The medical management or surgical removal of stye on eyelids depends on how early it is noticed or diagnosed. If you suspect stye on eyelids, you should discontinue contact lenses to prevent possible corneal infection.
In the early stages when the stye swelling on the eyelid is still small, it can be managed with home remedies such as using hot compresses and cleaning the eyelids and eyelashes. If the involved eyelash is plucked, it promotes drainage of the collected pus if there is any. Warm compresses help promote drainage of the collected pus.
If the swelling of stye is larger, additional treatment with medication like topical antibiotic ointment may be needed which may or may not be combined with a steroid. Eye drops are usually ineffective in the treatment of stye. If there is a need for treatment with medicines, a consultation with an ophthalmologist becomes necessary.
Rarely, the infection may spread to cause cellulitis or even abscess involving the eyelid and surrounding the skin. If an abscess has formed, it is treated with oral or intravenous antibiotics along with surgical drainage of pus.
A stab incision with surgical blade number 11 or 18-21 gauge needle at the site of pointing usually drains the pus. Single or multiple stabs may be required depending on the size of the abscess.