Stye: what it is, how to get rid of it and when to see a doctor

The eyelid has tiny oil glands. According to MedlinePlus, a stye forms when one of those glands gets blocked and bacteria grow inside it. It shows up as a red, swollen, painful bump on the edge of the eyelid, often with a spot of pus.

A chalazion looks similar but is different: it is a firm bump that is not painful, farther back on the eyelid, caused by a blocked gland without infection. We explain the difference below.

What causes a stye? According to MedlinePlus, it forms when an eyelid oil gland gets blocked and bacteria grow inside, and it is more likely if you have blepharitis, an inflammation of the eyelid edge. While you have one, the American Academy of Ophthalmology advises skipping eye makeup and contact lenses.

The difference is pain and infection. According to the American Academy of Ophthalmology and MedlinePlus, a stye is an infection, usually bacterial, of an eyelash root or an eyelid gland: it hurts, it is red and it sits on the edge of the eyelid. A chalazion is a blocked oil gland of the eyelid (a meibomian gland) without infection: a firm bump that is usually not painful and sits farther back on the lid, away from the edge. Sometimes a chalazion is left behind after a stye heals.

Home care is the same for both: warm compresses for 10 to 15 minutes, several times a day (MedlinePlus says at least 4 times a day for a chalazion), with water that is comfortably warm, not hot, and a gentle eyelid massage afterward to help it drain. Don’t squeeze or pop it: the American Academy of Ophthalmology warns that it can spread the infection into the eyelid. According to MedlinePlus, a chalazion often goes away on its own in about a month.

• Stye: painful, red and swollen, on the edge of the eyelid, often with a spot of pus.
• Chalazion: usually painless, a firm bump farther back on the eyelid that grows slowly.

The doctor evaluates the bump by video and, if needed, refers you to an ophthalmologist in person. That happens when a chalazion lasts longer than about a month or keeps growing; when it affects your vision; when it keeps coming back in the same spot, especially in an adult; when eyelashes fall out over it; or when redness or swelling spreads across the eyelid.

According to the American Academy of Ophthalmology and MedlinePlus, an ophthalmologist can drain it in the office, usually from the inside of the eyelid, or give it a steroid injection. If it keeps coming back in the same spot, they may take a small tissue sample (biopsy) to rule out a more serious problem.

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The most common symptoms, according to MedlinePlus and the American Academy of Ophthalmology, are:

• A red, swollen, painful bump on the edge of the eyelid
• A spot of pus in the center
• A gritty feeling in the eye
• Sensitivity to light
• A watery eye

The main treatment is heat. MedlinePlus recommends a warm, wet cloth over the eye for 10 minutes, 4 times a day; the American Academy of Ophthalmology suggests 10 to 15 minutes, 3 to 5 times a day. For a chalazion, gently massaging the eyelid after the compress helps it drain.

• Don’t squeeze or pop it. Let it drain on its own; squeezing can spread the infection.
• Skip eye makeup and contact lenses until it heals.
• Wash your hands before touching your eyes.
• If compresses don’t help, the doctor may prescribe an antibiotic ointment, if appropriate.
• A chalazion that doesn’t go away in about a month may need an injection or drainage, which is done in person.

According to MedlinePlus, see a doctor if the bump gets worse or doesn’t improve within 1 to 2 weeks, becomes very large or painful, the whole eyelid or eye turns red, it bleeds, or styes keep coming back. If they keep recurring, the American Academy of Ophthalmology advises an exam by an ophthalmologist.

Get seen in person if you notice any change in your vision or the redness spreads across the eyelid or the skin around the eye: that is not handled by video alone.

For your safety, go to the emergency room the same day if swelling or redness spreads around the eye with fever, it hurts to move your eye, the eye bulges, or your vision is blurry or double. These can be signs of orbital cellulitis, a deep infection that MedlinePlus calls a medical emergency, especially in children. See when to go to the ER.