Sty (Stye)

Picture of a stye on a lower eyelid. A stye is not contagious.

A stye (or sty) is an acute infection of the sebaceous glands of the eyelids.

There are multiple secretory glands present in both the upper and lower eyelids. These produce oils that enter the tear film through tiny ducts that open at the margins of the lids. These make the tears less subject to the evaporative effects of the environment. Bacteria can frequently enter one or more of the eyelid oil glands and, if the opening of the duct clogs, an infection of the gland, or stye, may occur. The stye causes a variable degree of inflammation, pain, and redness of the eyelid, and sometimes redness of the surrounding eyelid and cheek tissue. The medical term for stye is hordeolum.

The lump can point externally (outward) or internally (inward). Medical professionals call these conditions external hordeolum and internal hordeolum, respectively. Frequently, the lump appears with a visible whitish or yellowish spot that looks much like a large pimple. Usually, only one obvious area of swelling is apparent on one lid, but more than one stye can appear on one or both eyelids simultaneously.

The lump frequently disappears by itself when the blockage of the gland opening is relieved. Furthermore, the infection often goes away when the pus drains from the stye.

A stye is not contagious.

Staph bacteria often cause styes in the eyelid.

Infections of the oil glands in the eyelid cause styes. Very frequently, bacteria (most commonly Staphylococcus bacteria) infect the oil glands in the eyelids.

Seborrhea (excessive oily discharge from the glands) may increase the likelihood of developing one of these infections. Certain other factors can contribute to the infection of the glands:

• Improper or incomplete removal of eye makeup
• Scar tissue or a foreign substance
• Use of outdated or contaminated cosmetics
• Poor eyelid hygiene
• Inflammatory diseases of the eyelid, such as blepharitis, meibomitis, and acne rosacea
• Stress
• Hormonal changes

Redness and swelling can indicate a stye.

Symptoms and signs of a stye include the following:

• A lump on the top or bottom eyelid
• Localized swelling of the eyelid
• Pain
• Redness
• Tenderness to touch
• Crusting of the eyelid margins
• Burning in the eye
• Droopiness of the eyelid
• Scratchy sensation on the eyeball
• Blurred vision
• Mucous discharge in the eye

If your eye swells shut, call your doctor right away.

Sometimes, complications may occur from a seemingly innocent problem. Immediately contact an ophthalmologist (a medical doctor who specializes in eye diseases and surgery) if any of the following problems occur:

• The eye is swollen shut.
• Redness appears around the entire eye.
• There is any change or disturbance in one's vision.
• Swelling lasts for more than three weeks.
• The stye or styes come back or bleed.
• Eyelashes fall out.
• The stye is on the bottom eyelid, near the nose.
• The white part of the eye becomes red.
• Pus or thick discharge continues to drain from the eye.
• One has a fever higher than 100.5 F.
• One has excessive persistent tearing.
• One has persistent redness on the surface of the eye.
• One has significant pain.
• The stye recurs, especially if the stye does so in the same location as a previous stye.
• One has swelling of the lymph nodes in the neck or in front of the ear on the side of the stye.
• One experiences double vision.

Go to an ophthalmologist for any of the above symptoms. If one is unable to be evaluated by an ophthalmologist, go to the hospital's emergency department if experiencing any of the above problems.

Family physicians, including pediatricians, treat many patients who develop styes. Your family physician can decide whether you need to see a specialist. If you wish to see a medical doctor who specializes in the treatment of only eye problems, you should contact an ophthalmologist.

• Is the eyelid infected?
• Is the cornea involved?
• How should I treat this?
• Is surgery required?
• How can I prevent a recurrence?
• What is the chance that the stye may be a type of skin cancer?
• Is the tear drainage system involved?

• An ophthalmologist will ask questions about whether one has had any injury or previous eye problems or surgeries. Frequently, a history of similar symptoms is useful, so be sure to tell an ophthalmologist if you have previously experienced them. One's eyelid and facial hygienic habits, along with any cosmetic usage, are also useful information for an ophthalmologist. Your doctor may ask whether styes run in the family.
• The eyes and eyelids will be examined, including the inside surface of the eyelid. An ophthalmologist may use a slit lamp (a microscope-like device with a powerful light) to examine the eye.
• X-rays and blood work are not usually useful unless an ophthalmologist is concerned that an infection may have spread from the area of the eyelid to the face or entire eye socket. In this case, a CT scan of the eye socket may be required.

There are varieties of treatments for stye. These include self-care measures, pain medication, antibiotics, and surgery.

A warm compress can help a stye to drain.

Most styes go away on their own in five to seven days with home remedies.

• Apply warm compresses four to six times a day for about 15 minutes at a time to help the stye to drain. Keep the eyes closed when applying the warm compresses.
• Gently scrub the eyelid with tap water or with a mild, nonirritating soap, or shampoo (such as baby shampoo). This may help with drainage. Close the eyes as you scrub so you do not injure your eyes.
• Do not squeeze or puncture the stye. A more serious infection may occur as a result.
• Discontinue the use of eye makeup as well as eye lotions and creams because bacteria from the infection may contaminate them.
• Discontinue wearing contact lenses while a stye is present because the infection may cause infection to spread to the cornea with the use of contact lenses.

Antibiotics and pain medicine may help you recover from a stye.

Care is mainly provided to help relieve symptoms and to hasten recovery.

• Physicians usually recommend warm compresses.
• Pain medicine, such as acetaminophen (Tylenol), may be given or recommended.
• Antibiotics may be necessary.
  • An ophthalmologist may prescribe topical antibiotics in the form of eyedrops or eye ointment.
  • Occasionally, medical professionals give oral antibiotics to people either with styes that do not go away or with multiple styes, as well as to those who have styes in addition to other conditions, such as blepharitis or rosacea.
  • People who have rosacea along with a stye may require treatment of their cheeks with an antibiotic cream, an oral antibiotic, or both.
  • Physician rarely administers IV antibiotics in unusual situation where the infection spreads to the lymph nodes or into the bloodstream.
• An ophthalmologist may remove the pus from a large or painful stye by making a small incision in the inside of the lid and then draining the pus.

An eye doctor may prescribe topical antibiotic ointments or drops to treat styes.

For a stye that has not resolved in three weeks or for multiple styes, an ophthalmologist may prescribe oral antibiotics. Doxycycline (Vibramycin, Oracea, Adoxa, Atridox) is an antibiotic that is commonly used to treat persistent or complex styes.

• If one has a stye that has not responded to medical treatment or if one experiences complications resulting from a stye, a surgical procedure may be required.
  • During this surgical procedure, an ophthalmologist makes a small incision in the eyelid. The incision is made either on the inner surface of the eyelid or on the outer surface of the eyelid if the stye is pointing externally (outward). The ophthalmologist makes the incision and then drains the pus (or blocked oil) out of the gland.
  • Doctors commonly perform this procedure in the office using a small amount of local anesthetic injection. In children, general anesthesia may be required.
  • Medical professionals usually recommend a one-week follow-up appointment after this surgical procedure.
• The ophthalmologist rarely may need to perform a biopsy on the stye. During the biopsy, a small piece of tissue from the stye is removed and sent to a laboratory for microscopic examination by a pathologist (a physician with special training in tissue diagnosis) to ensure that the stye is not a form of skin cancer.

The stye usually goes away within one week. Reevaluation is required if the stye lasts for more than three weeks.

Good hand and facial washing may prevent styes from forming or coming back.

Upon awakening, the application of a warm washcloth to the eyelids for one to two minutes may be beneficial in decreasing the occurrence of styes. This has the effect of liquefying the contents of the oil glands of the eyelid and thereby preventing blockage. People can also perform this procedure at bedtime on a nightly basis.

People should clean all cosmetics and cosmetic tools and protect them from the environment. Do not share makeup or eye cosmetic tools, such as eyelash curlers. Throw away makeup when it becomes old or contaminated.

Some studies suggest oral flaxseed supplementation may help prevent the occurrence of styes.

A stye may come back, even after appropriate medical or surgical care. These persistent styes need further evaluation and care because they may signal other health problems; rarely, they can be an indication of cancer or other health conditions including infections, inflammatory conditions, and parasites.

Astigmatism and corneal irregularity may improve after treatment of a stye.