Stye

What is a stye?

Styes are a type of bacterial infection of the eyelid, typically causing a painful red bump either inside or outside of it.

They are a very common eye problem and usually develop quite quickly, over a few days. Usually only one eye is affected, although you can develop more than one stye at a time, even on the same lid.

Types of stye

There are two types of stye: external styes (the common type) and internal styes (which are quite uncommon).

External stye (external hordeolum)

This is the common type of stye. Technically it is an external stye; however, it is often just called a stye. It appears along the edge of the eyelid, due to infection in the eyelash follicle (where one of your eyelashes attaches to your eyelid).

It may start off as a small red lump but, as it develops into a collection of pus (a little abscess), it looks like a yellow pus-filled spot. The edge of the eyelid around it becomes reddened and swollen, and the lid is painful.

External stye

By Andre Riemann, Public domain, via Wikimedia Commons

Internal stye (internal hordeolum)

An internal stye arises when an oil gland in the main part of the eyelid (meibomian gland) becomes clogged with oil and then infected. The infection comes to a head on the inner surface of the eyelid, against the eyeball, so that from the outside it is visible only as a swelling.

Internal styes may be painful, although often they cause a dull aching in the eyelid, sometimes with the sensation of a lump. Internal styes are much less common than external styes.

Internal stye

By Michal Klajban, CC BY-SA 3.0, via Wikimedia Commons

Stye symptoms

Signs and symptoms of a stye may include:

• A red bump on the edge of the eyelid.

• The bump may fill with yellow pus, which might leak out.

• Pain in the affected eyelid.

• Eyelid swelling.

• Watery eye.

What causes a stye?

Eye with upper eyelid stye

Most styes usually occur for no obvious reason, although if your eyelids are itchy or rubbed a lot this may make an external stye more likely.

The usual germ (bacterium) that causes the infection is called Staphylococcus aureus. It is a common germ that is often found on healthy skin. It usually does no harm. However, it can occasionally get into the skin, where it causes infections such as spots, abscesses, and styes.

Some people have an eyelid condition called blepharitis. This is an inflammation of the eyelids in which they can become swollen, dry and itchy. Blepharitis can make you more prone to developing styes. If you have acne, this can also make you more prone to developing styes.

Patient picks for Eyelid problems

Eye health

Blepharospasm

Blepharospasm is a condition in which blinking or spasmodic closing of the eyes occurs at an increased rate. It ranges from a mild, embarrassing condition of twitching or fluttering of an eyelid to severe spasms of eye closure which interrupt useful vision. Secondary blepharospasm is a common response to many common eye conditions, and can be caused by some conditions affecting the nervous system. This leaflet is mainly about primary blepharospasm, also called benign essential blepharospasm (BEB). BEB cannot be cured, but is usually successfully managed with botulinum toxin injections, repeated at intervals. In the UK, if you have blepharospasm you must notify the Driver and Vehicle Licensing Agency (DVLA).

by Dr Hayley Willacy, FRCGP

How to treat a stye

• Styes often need no treatment. The 'head' or 'point' usually bursts within 3-4 days.

• Warm compresses may help to ease soreness and draw the pus to a head.

• You should avoid wearing contact lenses and eye make-up until it resolves.

• Taking antibiotics (ointments or medicines) is not recommended.

It is sensible to discard mascara and eyeliners that you used along the edge of your eyelid as the stye was forming. This is to avoid any chance of re-infecting the eye. Options to speed up resolution of the stye are:

No treatment

Often, no treatment is necessary for a stye. Once a 'head' or 'point' has formed on a stye, most burst within 3-4 days, with the tiny amount of pus draining away and leaving no further problem.

Hot compresses

These may help to ease soreness and draw the pus to a head. You can do this yourself: Hold a clean flannel, which has been dipped in warm water and squeezed dry, gently but firmly against the closed eye. Do this for 5-10 minutes, 3-4 times a day. (The water should be hot; it should be comfortable and not scalding.)

Eventually the stye will 'pop' and drain - but do not be tempted to try to pop it yourself. You may make things worse by injuring the delicate eyelid, or by spreading infection deeper into the tissues.

Epilation of the eyelash

This is a treatment for an external stye. It means that the eyelash is plucked out. Epilation is briefly uncomfortable but it can help the infection from the hair follicle to drain.

Incision and drainage of an external stye

A health professional can perform this procedure, which is a treatment for an external stye. It is like lancing a boil. A sterile needle (or perhaps a small scalpel) can be used to open the stye and drain the pus.

You should not attempt this yourself, as you might spread the infection to the eyelid, with serious consequences.

Drainage of an internal stye

This procedure involves using an injection of local anaesthetic to numb your eyelid, which must be flipped 'inside out' in order to expose the stye before it can be scraped out.

Very occasionally this procedure is done under general anaesthetic, as it is uncomfortable and children, in particular, find it difficult. After this procedure, antibiotic eye drops are usually given.

How long does a stye last?

A stye will usually burst on its own in 3-4 days, but they can sometimes last up to 1-2 weeks.

Are styes contagious?

Styes are not contagious. However, to reduce the chance of the infection spreading:

• Always wash your hands after touching the affected eyelid.

• Do not wear contact lenses or eye make-up until the infection has settled.

Are there any complications?

Most styes are very minor infections that clear without any treatment and cause no problems. Styes do not affect your vision.

Can a stye turn into a chalazion?

Sometimes the stye doesn't go away, and can turn into a cyst called a chalazion. If this happens it doesn't look particularly red and it doesn't hurt. However, you will have a lump on your eyelid.

Can a stye turn into conjunctivitis?

Very occasionally the infection can spread. It may spread to the surface of the eye, causing conjunctivitis, which may need antibiotic ointment or drops to clear the infection.

Alternatively the infection can spread around the eyelid, causing it to become more red and swollen. If this happens you should see your GP as you may need antibiotic tablets.

Can a stye turn into orbital cellulitis?

An extremely rare complication of a stye occurs when the infection spreads to involve the whole eyelid and tissues surrounding and behind the eye. This is called orbital cellulitis.

The eyelid may be very swollen and red, it may hurt or be impossible to open the eye and you may have a lot of pain and a high temperature (fever). Sometimes the eyeball is pushed forwards so that it bulges, and you may be very sensitive to the light.

If you develop this type of complication, you need to see a medical professional urgently. Treatment of orbital cellulitis is with antibiotics, usually given into a vein (intravenously) via a drip, in hospital.

Dr Mary Lowth is an author or the original author of this leaflet.