Stye

Disease Description (Causes and Symptoms)

• Definition: A stye (hordeolum) is an acute inflammatory lesion caused by a bacterial infection of the edge of the eyelid or an eyelid gland (a gland at the base of the eyelashes or a meibomian gland).
• Causes and pathophysiology: Most cases are caused by a localized infection with Staphylococcus aureus. Styes are classified as external (infection of the base of the eyelashes, a gland of Zeis, or a hair follicle) or internal (infection of a meibomian gland). If an internal stye becomes chronic for a long time, it may develop into a chalazion, which leaves a nodular scar as the inflammation subsides.
• Main symptoms: Localized redness and swelling of the eyelid, pain or tenderness, a palpable lump (pustule or firm nodule), tearing, and a foreign-body sensation. Fever and vision changes are rare; if the infection spreads, it may progress to preseptal cellulitis.

Treatment Methods

• Conservative treatment (initial and general treatment)

  • Warm compresses: Press a warm, wet towel against the eye for 10–15 minutes, 3–4 times a day, to promote drainage and relieve inflammation.
  • Eyelid hygiene: Wash gently and keep the area around the eyelashes clean (using soap or a mildly acidic cleanser).
  • Topical antibiotic ointment: For example, apply erythromycin ophthalmic ointment to the edge of the eyelid—usually for approximately 7–10 days. The frequency and duration of application should follow the prescription.
  • Pain control: Oral analgesics, such as acetaminophen or an NSAID, may be used if needed.
  • Daily care: Stop using contact lenses and eye makeup, such as mascara.

• Medication treatment (at the physician’s discretion)

  • Oral antibiotics: These may be needed if the inflammation has spread to surrounding tissues (suspected preseptal cellulitis), in multiple or severe cases, or in people who are immunocompromised. The choice and dosage of medication should follow the physician’s prescription (for example, oral antibiotics may be used, or oral therapy for prophylaxis may be considered in chronic or recurrent cases).
  • Medication for chronic inflammation (chalazion): Oral antibiotics, particularly in chronic cases, or local steroid injections administered by an ophthalmologist may sometimes be considered.

• Procedures and surgery

  • Incision and drainage: If an acute abscess has clearly formed and drainage is needed, the procedure is performed aseptically by an ophthalmologist. Do not forcibly squeeze it at home.
  • Surgical removal of a chalazion (excision and curettage): Performed when the condition does not respond to conservative treatment or causes cosmetic problems or visual impairment.
  • If complications are suspected (reduced vision, severe pain or fever, or red swelling spreading around the eye), an immediate specialist evaluation is needed.

• Precautions

  • Never squeeze or incise it at home (this may worsen the infection, cause recurrence, or lead to scarring).
  • Seek medical attention immediately if symptoms worsen or eye function is affected, such as reduced vision, severe pain, or extensive redness.
  • To prevent recurrence, keep the eyelids clean, manage cosmetics and contact lenses properly, and avoid rubbing the eyes.

Checklist Before an Outpatient Visit (Including Sample Questions)

• Items/information to prepare

  • When the current symptoms began (when and how they have progressed) and how they have changed (becoming larger or smaller, increasing pain, etc.)
  • Recent self-treatment (frequency and method of warm compresses, and the names of medications or ointments used)
  • A list of medications currently being taken (antibiotics, blood pressure medication, anticoagulants, etc.) and any medication allergies
  • History of chronic diseases (diabetes, immunocompromised status, etc.)
  • Whether contact lenses are used and whether eye makeup has been used recently
  • Any similar history in the past (number of recurrences) or history of ophthalmic surgery
  • If possible, photographs of the lesion (including photos taken early in the course of symptoms)

• Symptoms to tell the doctor about in advance during the outpatient visit

  • Vision changes (blurred vision or partial visual-field loss)
  • Pain or restricted movement when moving the eye
  • Systemic symptoms (fever or chills)
  • Redness spreading outward, enlarged lymph nodes, etc.

Examples of General Questions to Ask the Doctor

• “What are the common side effects of this medication (ointment or oral antibiotic)?”
• “How long should I continue applying warm compresses? What indicates recovery?”
• “When can I start using contact lenses or eye makeup again in this condition?”
• “What lifestyle changes should I make to reduce the risk of recurrence?”
• “How likely is it that I will need surgery (incision and drainage or removal of a chalazion)?”

Examples of Condition-Specific Questions

• “How can I tell whether this lump is a painful acute stye or a less painful chalazion?”
• “I have diabetes. Should oral antibiotics or surgery be considered sooner in people with diabetes?”
• (For contact lens wearers) “When does the ophthalmologist determine that it is safe to resume wearing contact lenses?”

Additional guidance: Diagnosis is generally possible based on clinical findings, but culture testing or additional tests may be needed in recurrent, chronic, or severe cases. Treatment and medication choices vary according to the individual’s condition, including allergies and underlying diseases, so the final decision should be made through a medical consultation.