Most people have heard of, if not experienced for themselves, an eyelid stye. The painful, red, swollen lumpy bump that always seems to appear at the most inconvenient time.
What is a Stye? Why do they occur?
A stye is better known in the medical community as a hordeolum, which is a fancy term to describe an infected oil gland.
Within the eyelids we have seven different types of oil glands: goblet cells, Meibomian glands, glands of Zeiss, glands of Moll, the main lacrimal gland, and the two accessory glands of Krause and Wolfring.
These seven different types of glands each secrete different parts of our tears and are therefore an essential part of keeping our eyes healthy and well lubricated.
There are two types of hordeolums—internal and external hordeolums.
An internal hordeolum occurs when a meibomian gland becomes infected.
An external hordeolum occurs when either a gland of Zeiss or a gland of Moll becomes infected.
Glands become infected when they are unable to secrete their oils. For whatever reason, the gland become impacted, or clogged up, and the oils cannot leave. Some of the more common causes of clogged eyelid glands is dry eye, not washing makeup off at the end of the day, and improper face washing techniques.
When glands become impacted, the oils are left stagnant making the perfect snack for bacteria. We naturally have some bacteria on our face as part of our natural flora, however when the balance of bacteria is thrown off and the bacteria replicate beyond their normal boundaries, it mediates a response by the immune system.
The Immune System Kicks In
The body’s primary way to attack infections is through the inflammatory cascade.
There are four major attributes to the inflammatory system: heat, pain, redness, and swelling, all of which occur during the active phase of a stye.
What is the best way to get rid of a stye then? Open the gland back up so the oils can be secreted and the bacteria will wash away with it!
One of the most practical ways to accomplish this is through a warm compress with digital massage.
Warm a clean cloth with warm, not hot, water and rest it over the eyes for 5-10 minutes multiple times throughout the day. Heat helps to re-liquify the stagnant oils to make them easier to express. After the impacted area has been warmed, gently massage the lid margin in a circle motion using your finger.
If material comes out of the gland, be sure to carefully clean the eyelid margin with a clean tissue or Q-tip and rinse the eye thoroughly with sterile saline.
You should never try to “pop” a stye, however. A stye is not a pimple, trying to pop it will be very painful and runs the risk of ejecting the infected fluids into the eye at a high velocity. This opens up the risk for a secondary infection, called bacterial conjunctivitis, to occur.
For this same reason, some cases of hordeolums entail infections that are too great to be managed with warm compresses alone.
When to Seek Help in Treating a Stye
Antibiotics may be required to help break up the infection and lower the amount of inflammation within the eyelid.
If you, or someone you know has a stye that has persisted for more than 2 weeks, or the stye is “growing” to encompass the entire eyelid rather than just a small bump, call your eye doctor as soon as possible for further evaluation.
Sometimes hordeolums can progress into a more serious condition called preseptal cellulitis.
In preseptal cellulitis, the infection has spread from just one gland to the entire eyelid. At this point, antibiotics will be required to get the infection under control.
But what about styes that remain for longer than two weeks but no longer hurt?
Sometimes the material within a hordeolum remains as a bump on the eyelid, but no longer show signs of active inflammation and infection.
Chalazions vs Hordeolums
At this point, the stye is no longer considered a hordeolum, but is instead referred to as a chalazion.
Chalazions consist of hardened gland material and old inflammatory debris that indicate the active phase of the infection is over. Since chalazions are not infections, they typically do not impose harm to the eye, but can be a cosmetic concern.
Chalazions can resolve slowly over time as the body reabsorbs this material, or sometimes need to be surgically removed for cosmetic purposes.
Regardless of what stage your stye is in, your doctor will be able to assess the situation and give you the best treatment recommendations for your individual situation.
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