Eye Styes and Chalazia
What Is an Eye Stye? What Is a Chalazion?
…And What’s the Difference Between the Two?
Styes and chalazia are similar problems that cause lumps in or around the eye. They are not the same thing, although they are often confused. While both styes (also called hordeolums) and chalazia tend to present as eyelid redness, swelling, and pain, they have quite different causes and treatments.
A chalazion is a non-infectious obstruction of a gland inside the eyelid. This forms a small, slow-growing lump, usually on the upper eyelid. Chalazia can show up in both eyes at once. The gland concerned is one of your meibomian glands, which produce an oil that moistens and protects your eyes.
A stye, on the other hand, is caused by an infection of abscess, usually some form of staph bacteria. The majority form on the outside of the eyelid, and may be caused by follicle obstruction. Rarely, you might get a stye on the inside, caused by an infection of the meibomian glands.
The two conditions can be clinically indistinguishable for the first couple of days, but they then show distinct differences. One of the primary differences is that styes tend to be full of pus and may resemble very large pimples. Styes are also more painful than chalazia and often result in excessive tear production.
If there is no lump, then you may have conjunctivitis (pink eye) or blepharitis (an infection of the eyelid). If you have both a lump and a reddening of the eyelid, then you may have both a stye and blepharitis. (People with chronic blepharitis are more prone to styes).
Close up of a chalazion (A) and a stye (B), in two different women’s eyes
Should You See Your Doctor?
It depends. If it is clearly a stye, on the outside of the eyelid and with pus visible, then you should try home care first. Apply a warm washcloth to your closed eye for five to ten minutes, several times a day. Gently massage the eyelid.
If the stye is still bad after 48 hours or if the redness extends to other parts of your face, then you should see your doctor. Also, if the stye is painful, take a mild over the counter painkiller such as ibuprofen.
If the lump is inside your eyelid, then it is most likely a chalazion. You should make an appointment right away, as chalazia can be a sign of other conditions. Another warning that it might be chalazia is if you have lumps in both eyes at the same time.
If you have any vision changes, you need to see an eye doctor immediately. Vision changes to monitor for include double vision, which is commonly associated with an eyelid lump.
What Will Your Doctor Do to Treat a Chalazion?
For chalazia, they will suggest hot compresses on the eyelid and monitor it. If the chalazion is persistent, it may have to be surgically removed or injected with corticosteroids to hasten the resolution of the problem.
Hot compresses will hasten resolution of either kind of lump and should be applied for five to ten minutes, several times a day.
However, for chalazia, your doctor may want to rule out other eye problems, and they are likely to also refer you to an eye doctor who can check you for conditions such as blepharitis or meibomian gland dysfunction, which can cause chalazia to recur. In rare cases, especially in the elderly, certain forms of cancer can masquerade as chalazia in the early stages. Therefore, it is important to have your doctor check them to rule out sebaceous gland carcinoma, basal cell carcinoma, squamous cell carcinoma, or Merkel cell carcinoma. It is extremely rare for a chalazion to turn out to be cancer. However, if the chalazion is not responding to treatment or keeps recurring in the same place, it can be suspicious.
Remember that the vast majority of both styes and chalazia resolve on their own or with minimal treatment. Neither is associated with any damage to vision. In most cases, a hot compress for a few days will resolve the problem. However, your doctor will want to be sure there is nothing else going on.
Recurring Styes
If you keep getting styes over and over, talk to your doctor. You might have acne rosacea or blepharitis, a chronic condition caused by the inflammation of the oil glands in your eyelids. Allergies or blocked glands can produce Blepharitis. If you are a contact lens wearer, make sure to get a pair of backup glasses. Wearing contact lenses when you have a stye can cause it to recur by reinfecting the area.
One tip is that if you wear eye makeup, applying a hot compress before bed will effectively remove your eye makeup and is particularly good for preventing styes. It is also cheaper than buying makeup remover (and remember, makeup remover can also expire and get bacteria in it).
Stress can also sometimes cause styes, due to the effect on your immune system. If your styes are recurring and you are busy or stressed, you may want to look into various stress management techniques.