Stye in the Eye: Causes, Symptoms & Treatment

Written by Vasileios Skouteris MD, FEBO, Ophthalmic Surgeon

Page contents

1. What is a stye?
2. What causes a stye?
3. Symptoms
4. Stye or chalazion: what is the difference?
5. How is a stye diagnosed?
6. How to get rid of a stye: treatment step by step
7. Styes in children
8. How can styes be prevented?
9. When to see an ophthalmologist
10. How a stye progresses day by day
11. Why do I keep getting styes? The causes behind recurrences
12. Home remedies for a stye: what works and what does not
13. When a stye becomes dangerous: complications
14. What happens at the practice
15. Styes, make-up and contact lenses
16. Styes during pregnancy and breastfeeding
17. School, work and styes
18. Stye on the upper or lower eyelid: is there a difference?
19. A practical guide to warm compresses that actually work
20. Styes and vision: can a stye affect the eye?
21. Frequently Asked Questions about Styes

A stye in the eye is an acute, painful inflammation on the edge of the eyelid that looks like a small red spot and often forms a yellow head of pus. It is usually caused by a bacterial infection of an eyelid gland and, in most cases, clears up within 1-2 weeks with warm compresses.

What is a stye?

A stye, known medically as a hordeolum, is a small localised infection in one of the glands of the eyelid. It is not a serious condition and rarely affects vision, but it can be quite uncomfortable and keeps coming back in some people. There are two forms, depending on which gland is affected.

External stye

This is the most common form. It develops at the root of an eyelash, in the small sebaceous or sweat glands along the edge of the eyelid. It looks like a spot on the eyelid, right at the edge where the lashes grow, and often develops a yellow centre.

Internal stye

This develops in a meibomian gland, within the tarsal plate of the eyelid, and is easier to see if the eyelid is turned outwards. It is usually more painful, takes longer to settle and, if it does not resolve completely, can turn into a chalazion.

What causes a stye?

In most cases a stye is caused by staphylococcus, a bacterium that normally lives on the skin. When the duct of a gland becomes blocked and bacteria multiply, inflammation and a small abscess develop. The likelihood increases with:

• chronic blepharitis, an inflammation of the eyelid margins with scales and crusts on the lashes,
• meibomian gland dysfunction,
• frequently rubbing the eyes with unwashed hands,
• eye make-up left on overnight or old eye cosmetics,
• poor hygiene when using contact lenses,
• skin conditions such as rosacea or seborrhoeic dermatitis,
• poorly controlled diabetes.

A stye is not particularly contagious, but it is best not to share towels and cosmetics while the inflammation lasts.

Symptoms

Symptoms usually appear within a few hours to a day:

• a red, swollen lump on the edge of the eyelid,
• pain and tenderness to the touch,
• a foreign body sensation or a feeling that “something is bothering” the eye,
• watering and sensitivity to light,
• a yellow head that may burst and drain on its own,
• in some cases, swelling of the whole eyelid.

Vision is normally not affected. If it becomes blurred or the swelling spreads quickly, you need an examination.

Stye or chalazion: what is the difference?

A stye is often confused with a chalazion, as both appear as a lump on the eyelid. The distinction matters, because they progress differently and are treated differently.

You can find more information about chalazion treatment, and about when a minor removal procedure is needed, on the page about chalazion of the eyelid.

How is a stye diagnosed?

The diagnosis is clinical and is made by examination with a slit lamp. The ophthalmologist examines the eyelid from both sides, checks the condition of the glands and lashes, and rules out other conditions, such as inflammation of the tissue around the eye, conjunctivitis or, less commonly, a lump that is not inflammatory. Laboratory tests are usually not needed.

When the same lump keeps coming back in the same place, especially in older people, or when it is accompanied by loss of eyelashes, a biopsy may be needed to rule out a rare but important condition of the eyelid skin.

How to get rid of a stye: treatment step by step

Most styes burst and drain on their own. The aim of treatment is to help drainage, reduce discomfort and stop the infection from spreading.

Warm compresses

This is the most effective measure at home. Soak a clean cloth in warm, not hot, water and hold it on the closed eyelid for 10-15 minutes, 3-4 times a day. The heat softens the contents of the gland and helps it open.

Eyelid cleaning

After the compress, gently clean the edge of the eyelid with special eyelid wipes or with diluted mild baby shampoo on a cotton bud. Regular cleaning also helps prevent new episodes.

What to avoid

• Do not squeeze or try to burst the stye, as the infection can spread to the surrounding tissues.
• Do not wear contact lenses until it has completely cleared.
• Avoid make-up on the affected eye and throw away the eye cosmetics you were using before the episode.

Medical and surgical treatment

If the stye does not improve within a few days or the inflammation is spreading, the ophthalmologist may recommend topical antibiotic treatment and, in more extensive cases, oral antibiotics. When an abscess forms that does not open, a small drainage incision is made at the practice under local anaesthetic. This should only be done by an ophthalmologist, under sterile conditions.

Styes in children

Children often get styes because they rub their eyes with hands that are not always clean. Treatment is the same, with careful warm compresses supervised by a parent. Because in young children an eyelid infection can spread more easily, an examination by an ophthalmologist should not be delayed if the whole eyelid swells or the child has a fever. For eye conditions in childhood, see the page on paediatric ophthalmology.

How can styes be prevented?

• Wash your hands before touching your eyes or your contact lenses.
• Always remove make-up before going to bed.
• Replace mascara and eye pencils regularly.
• If you have blepharitis, follow a daily eyelid hygiene routine even when you have no symptoms.

When to see an ophthalmologist

Book an examination if:

• the stye does not improve within a week or lasts more than two weeks,
• the swelling and redness spread over the whole eyelid or to the cheek,
• you develop a fever or severe pain,
• your vision becomes blurred or the eye itself hurts,
• styes come back often or appear in the same place.

For an eyelid examination at the practice in Neo Psychiko, book an appointment.

How a stye progresses day by day

Most styes follow a predictable course. If you know what to expect, you can tell when everything is going well and when you need an examination.

• Days 1 to 2: Tenderness and slight redness at the edge of the eyelid. Many people describe it as “something bothers me when I blink”. This is the best time to start warm compresses.
• Days 2 to 4: The swelling increases, the eyelid may become quite swollen and painful when pressed. A yellow head, like a spot, often appears.
• Days 4 to 7: The pus usually drains on its own, the pain eases noticeably and the swelling starts to go down.
• Up to 2 weeks: The eyelid returns completely to normal.

If after a week of proper compresses the stye is not improving, is getting bigger or the swelling is spreading over the whole eyelid, you need to see an ophthalmologist.

Why do I keep getting styes? The causes behind recurrences

A stye every few years is common. But when they appear one after another, there is usually an underlying problem that has not been addressed. The most common are:

• Chronic blepharitis: Inflammation at the base of the lashes and meibomian gland dysfunction create favourable conditions for new infections. This is the most common cause.
• Rosacea and seborrhoeic dermatitis: Skin conditions that also affect the eyelids, making the oil in the glands thicker.
• Poorly controlled diabetes: This reduces the body’s resistance to skin infections.
• Habits: Rubbing the eyes with unwashed hands, make-up left on overnight, old eye cosmetics and poor contact lens hygiene.

The solution to recurrences is not to treat each stye separately but to treat the cause. With daily eyelid hygiene and, where needed, targeted treatment, episodes become much less frequent.

Home remedies for a stye: what works and what does not

There is plenty of old-fashioned advice about styes. Some of it is harmless, but some can do damage.

What helps

• A clean, warm (not hot) compress, for 10 minutes, 3 to 4 times a day.
• A black or chamomile tea bag, once it has cooled to a comfortable temperature, simply works as a warm compress. Use a new tea bag each time and a different one for each eye.
• A gentle eyelid massage after the compress, with clean hands.

What does not help or causes harm

• Rubbing with a gold ring or other objects has no therapeutic effect and transfers germs.
• Squeezing or piercing with a needle can push the infection deeper into the eyelid.
• Using steroid ointments or drops without a prescription can make an infection worse and raise the pressure in the eye.
• “Natural” substances applied directly to the eye, such as oils or juices, irritate the cornea.

When a stye becomes dangerous: complications

In the vast majority of cases a stye is harmless. There are, however, two complications you should know about.

Turning into a chalazion

When the inflammation settles but the gland remains blocked, a painless, firm nodule forms in the eyelid. This is a chalazion, which can persist for weeks or months and sometimes needs a minor procedure to remove it.

Spread of the infection

Rarely, the infection spreads to the tissues around the eye. The whole eyelid swells, becomes very red and warm, and a fever may develop. This is an infection of the tissues around the eye (periorbital cellulitis), which needs oral antibiotics and prompt assessment. If, in addition, moving the eye is painful or vision becomes blurred, you must be examined the same day.

What happens at the practice

During the slit lamp examination, the ophthalmologist confirms the diagnosis, checks for blepharitis or any other factor that encourages recurrences and examines the rest of the eye. If the stye has a mature head and does not burst on its own, a small drainage can be performed with sterile instruments under local anaesthetic. The procedure takes a few minutes and relief is almost immediate.

In adults whose styes always come back in exactly the same spot, the doctor will examine the area carefully, because on rare occasions other eyelid lesions can mimic a persistent stye.

Styes, make-up and contact lenses

While there is inflammation, avoid eye make-up, as it blocks the glands even further and contaminates brushes. Once the stye has cleared, throw away the mascara and eyeliner you used during those days. In general, replace mascara every 3 months and do not share eye cosmetics.

Contact lenses should be taken out until the inflammation has completely settled, and glasses worn instead. Daily disposable lenses are the safest option for people prone to styes.

Styes during pregnancy and breastfeeding

The hormonal changes of pregnancy can make styes slightly more frequent. The basic treatment, warm compresses and cleaning, is completely safe. If medication is needed, the ophthalmologist will choose a preparation suitable for pregnancy or breastfeeding, so do not use ointments you have at home without asking first.

School, work and styes

A stye is not a reason for a child to stay at home or for an adult to take time off work, as long as there is no fever or severe discomfort. Careful hygiene is enough: hand washing, a personal towel and avoiding rubbing. If the swelling interferes with vision or the child is very uncomfortable, a short examination will clarify the situation.

For people who work with food, in hospitals or with young children, hand hygiene is even more important. An extra pack of wet wipes and a hand sanitiser in your bag are enough to reduce the risk of transferring germs to the eye or to others.

Stye on the upper or lower eyelid: is there a difference?

A stye can appear on either eyelid, and the treatment is the same. On the upper eyelid, because the lid moves with every blink, the discomfort is usually greater and the swelling may make the eyelid droop slightly. On the lower eyelid the swelling often looks more dramatic, because the skin there is loose and easily collects fluid.

What matters is whether the stye is at the edge of the eyelid, close to a lash (external), or deeper, towards the inner surface (internal). Internal styes are usually more painful, take a little longer to settle and are more likely to leave a chalazion behind.

A practical guide to warm compresses that actually work

A compress is the most effective treatment, but only if it is done properly. The usual mistake is a towel that goes cold within a minute. To melt the thick oil inside the gland, the heat needs to stay constant for about 10 minutes.

• Soak a clean cloth in warm water, at a temperature you can comfortably tolerate on the inside of your wrist.
• Rewarm it every 1 to 2 minutes or use a special heated eye mask.
• Keep your eyes closed and do not press hard.
• Finally, massage gently in circular movements towards the edge of the eyelid.
• Use a separate, clean cloth each time.

Styes and vision: can a stye affect the eye?

A stye affects the eyelid, not the eye itself, so it does not harm your vision. A large stye on the upper eyelid can temporarily blur the image slightly because it presses on the cornea, but this corrects itself once it settles. If, however, your vision is getting worse, the eye aches deeply or you find it hard to move it, this is not a simple stye and you need an urgent examination.

If you are not sure whether it is a stye, a chalazion or something else, a short slit lamp examination will give you the answer. Book an appointment on 210 677 0007.

Frequently Asked Questions about Styes

Medically reviewed by: Dr. Vasileios Skouteris MD, FEBO