Stye

A stye, medically known as a hordeolum, is a common eye problem that causes acute infection and inflammation of the eyelid. It can be a painful and uncomfortable experience, often requiring medical attention. In this article, we will explore what a stye is, the different types, symptoms, and how they can be managed.

What is Stye?

A stye is a small, painful, red bump that appears along the edge of your eyelid, usually where the eyelashes grow. It develops when one of the tiny oil glands near the base of your lashes becomes clogged and infected, similar to how a pimple forms on the skin. Styes are quite common and often resolve on their own with simple home care, but in some instances, they may require professional attention from an eye care specialist if complications arise.

Styes can be classified into two main categories:

• External hordeolum (stye): This type of stye forms at the base of an eyelash and is usually visible on the outside of the eyelid. It is caused by an infection of the zeis or moll glands, also known as ciliary glands, which are located at the root of the eyelashes.

• Internal hordeolum: Unlike external styes, internal hordeola develop inside the eyelid, involving the meibomian glands found in the tarsal plate of the eyelids. These styes appear as a red, painful lump on the inner surface of the eyelid and may not always be as noticeable as their external counterparts.

Recognising the symptoms of a stye is crucial for prompt management and to prevent potential complications.

The primary symptom of a stye is a tender, red bump along the eyelid margin near the eyelashes, often accompanied by swelling. Additional symptoms may include:

When a stye develops, you may experience several signs and symptoms, including:

• Eyelid swelling, redness, pain, or soreness: The affected eyelid may become inflamed, red, and tender to the touch.
• Localised pustule: A small, pus-filled bump may form on the edge of the eyelid, similar to a pimple.
• Teary eye: The eye may produce excess tears as a response to the irritation caused by the stye.
• Crusting: You may notice crusting around the eyelashes, particularly upon waking up in the morning.
• Sensitivity to light: In some cases, the eye may become more sensitive to bright light, causing discomfort.
• Eye discharge: You might notice watery or pus-like fluid seeping from the affected eye, which can crust over the lashes or blur your vision temporarily.
• Soreness and itching: The eyelid often feels sore to the touch, with a persistent itching or burning sensation that can cause discomfort throughout the day.
• Scratchy or foreign body sensation: Many people with a stye feel as though there’s something gritty or lodged in their eye, creating irritation and the urge to blink frequently or rub the eye.

A stye is a painful lump that forms on the eyelid due to an infection of the oil glands or hair follicles. Here are the primary causes:

• Bacterial infection: The most common cause of a stye is an infection by bacteria, particularly Staphylococcus aureus, which can infect the eyelid's oil glands or hair follicles.
• Blocked glands: When the oil glands (meibomian glands) in the eyelid become blocked, it can lead to the buildup of oil and bacteria, resulting in a stye.
• Poor hygiene: Inadequate eye hygiene, such as not removing makeup or touching the eyes with dirty hands, can increase the risk of developing a stye.
• Skin conditions: Certain skin conditions, such as acne or seborrhoeic dermatitis, can contribute to the formation of styes by affecting the oil glands.
• Stress: Increased stress can weaken the immune system, making individuals more susceptible to infections, including those that cause styes.
• Chronic eye conditions: People with chronic conditions like blepharitis (inflammation of the eyelid margins) may be at higher risk for developing styes due to ongoing irritation and blockage of the glands.
• Contact lens use: Wearing contact lenses, especially if not cleaned properly or worn for extended periods, can introduce bacteria to the eye area and increase the likelihood of a stye.

Certain underlying conditions can increase the likelihood of developing a stye, including:

• Frequent eye rubbing, especially with unclean hands
• Using contaminated or old eye makeup
• Leaving makeup on overnight
• Suffering from blepharitis, an inflammation of the eyelids
• Having skin conditions like rosacea and seborrhoeic dermatitis
• Being diabetic
• Experiencing meibomian gland dysfunction, which affects the glands that keep eyelids moist

Who's at Risk?

Certain groups of individuals are more prone to developing styes, including:

• Individuals who have previously had styes
• Contact lens users who don't clean and handle lenses properly
• People with eyelid inflammation conditions like blepharitis
• Those with skin conditions such as rosacea, seborrhoeic dermatitis or acne
• Individuals with diabetes

While most styes are benign and resolve on their own, there can be complications if left untreated or if they recur frequently. Here are some potential complications:

• Chalazion: A stye that does not heal properly may develop into a chalazion, which is a larger, painless lump resulting from blocked oil glands.

• Infection spread: In some cases, the infection from a stye can spread to surrounding tissues, leading to conditions such as cellulitis, which requires medical treatment.

• Recurrence: Frequent styes may indicate underlying issues, such as chronic blepharitis or meibomian gland dysfunction, leading to repeated episodes.

• Vision problems: Though rare, complications such as corneal irritation or scarring can occur if the stye causes persistent irritation to the eye.

• Scarring: Severe or untreated styes can lead to scarring of the eyelid or surrounding skin, which may affect appearance and function.

If you experience complications or persistent symptoms associated with a stye, it’s important to seek medical advice for appropriate management.

Taking proactive measures can significantly reduce the risk of developing a stye. Here are effective prevention strategies:

• Practice good hygiene: Regularly wash your hands and avoid touching your eyes with unclean hands. Ensure that you remove eye makeup thoroughly before bed.

• Avoid contaminated makeup: Use fresh, non-expired eye makeup products, and avoid sharing cosmetics. Discard old makeup to minimise the risk of bacterial contamination.

• Manage skin conditions: If you have conditions like blepharitis, rosacea, or seborrhoeic dermatitis, work with a doctor to manage these issues effectively.

• Care for contact lenses: If you wear contact lenses, ensure you clean and handle them properly. Follow the recommended guidelines for wearing and storing lenses.

• Limit eye rubbing: Try to avoid rubbing your eyes, especially if your hands are not clean, as this can introduce bacteria to the eyelid area.

• Use warm compresses: Applying warm compresses to your eyelids can help keep the oil glands functioning properly and reduce the risk of blockages.

While most styes heal without medical intervention, some can be persistent and may need evaluation by a healthcare provider. If your stye worsens, doesn’t improve within a few days, or begins to affect your vision, it’s important to seek medical advice. During your visit, your provider will assess your eyelid through a physical examination and inquire about any other symptoms you're experiencing. This clinical assessment is typically sufficient for diagnosing a stye without the need for further testing.

Diagnosing a stye typically involves a straightforward clinical evaluation. Here’s how doctors generally approach the diagnosis:

• Medical history: The doctor will start by taking a detailed medical history, asking about symptoms, the duration of the stye, and any previous occurrences. Information about any underlying conditions, such as blepharitis or diabetes, may also be relevant.
• Physical examination: A thorough examination of the eyelid will be conducted to assess the size, location, and characteristics of the lump. The doctor will look for signs of redness, swelling, and discharge.

In most cases, no further tests are required; however, if the stye is recurrent or if there are concerns about other eye conditions, the doctor may recommend additional tests or refer you to an ophthalmologist for further evaluation.

Managing a stye typically involves a combination of self-care measures and medical treatments, depending on the severity and duration of the symptoms. The common approaches include:

• Warm compresses: Applying a warm compress to the affected eyelid for 10-15 minutes several times a day can help relieve discomfort, promote drainage, and speed up healing.
• Good hygiene: Maintaining cleanliness around the eyes is essential. Wash your hands frequently, and avoid touching or rubbing your eyes to prevent further irritation or infection.
• Topical treatments: In some cases, over-the-counter antibiotic ointments may be applied to the eyelid, although this is generally less common. Consult a doctor before using any topical treatments.
• Oral medications: If the stye is severe or does not improve with self-care, a doctor may prescribe oral antibiotics to treat any underlying bacterial infection.
• Drainage: If the stye persists or develops into a chalazion (a larger lump), a doctor may need to drain it in a sterile environment to alleviate pain and pressure.
• Avoid makeup and contact lenses: Refrain from using eye makeup and contact lenses until the stye has healed to prevent further irritation and contamination.

Medications for Stye

When treating a stye, medication is often used to manage the infection and alleviate symptoms. Topical antibiotics, such as erythromycin ointment and bacitracin ophthalmic ointment, are commonly prescribed in the form of eye drops or creams. In more severe cases or when the infection spreads, oral antibiotics like erythromycin, tetracycline (including doxycycline), amoxicillin, and cephalosporins (including cephalexin) may be prescribed to prevent the infection from spreading. Steroid injections, creams, and eye drops can also be used to promote healing and reduce pain, but it is crucial to consult a doctor before using these.

If a stye does not show any signs of improvement after 48 hours or worsens over time, it is important to seek medical attention. You should also consult a doctor if redness and swelling extend across the entire eyelid or to other parts of the face or if you experience other signs of infection such as fever or blood oozing from the eyelid. Recurring styes or frequent eyelid irritation may warrant further evaluation as well. Additionally, if the stye affects your vision or causes the eyelid to swell shut, it's crucial to seek medical advice to prevent complications and ensure appropriate treatment.

• Styes are common eyelid infections caused by bacteria, usually Staphylococcus aureus.

• Risk factors include poor eyelid hygiene, using old makeup, and certain medical conditions.

• Styes present as a painful red lump with localised swelling and may be internal or external.

• Warm compresses, gentle eyelid cleansing, and not wearing contacts aid in treatment.

• Topical and oral antibiotics are used for more severe cases.

• See a doctor if the stye worsens, affects vision, or frequently recurs.

• Preventing styes involves practicing good eyelid hygiene and avoiding touching or rubbing eyes.