Stye, an overview

By Cristiano Antonino On Aug 2, 2023

A stye is a benign inflammation of the sebaceous glands present in the eyelashes, which manifests itself as a bubble similar to a pimple or a rounded acne pimple with a rather compact consistency; it usually appears on the outer wall of the eyelid, much less frequently on the inner wall

In addition to the blemish itself, the sty is often accompanied by pain (albeit slight), swelling and redness around the eyelid.

Since it is considered a mild disorder, it is often not reported, so it is not easy to define the incidence rate of stye.

What is certain is that the disorder does not differentiate between males and females, nor even a distinction of race.

Being an infection, stye is more frequent in subjects suffering from blepharitis, a chronic inflammation of the eyelids which is characterized by the appearance of crusts, scales and irritative ulcers along the eyelid margin.

Usually, the sty tends to disappear spontaneously in 1-2 weeks but if well cared for, its resolution is even faster.

What is a stye and how to recognize it

The sty looks like a small, often purulent nodular formation, located on the inside or outside of the eyelid.

Often the affected eyelid presents redness, itching or irritation, up to cause a strong tear.

As a rule, the sty does not cause any discomfort to the eyesight of the person who suffers from it.

In fact, in most cases, it is an inflammation of the sebaceous glands or ciliary follicles depending on whether this is located in the internal or external part of the eyelid.

It is rare that it occurs bilaterally: generally the sty develops on one eye only.

When the blemish appears, the presence of a swelling similar to an acneic pimple is evident on the eyelid, typically accompanied by redness, irritation and slight pain; usually, given its infectious nature, it develops following conditions that favor the bacterial load around the eyelid or the eye in general. In any case, its diagnosis is the responsibility of the general practitioner or ophthalmologist, who will be able to distinguish the infection from other disorders such as: eyelid xanthelasmas, chalazis and papillomas.

Frequently washing your hands and not touching your eyes can prevent the formation of the sty, but it can also relieve pain and reduce the treatment period if the blemish has already appeared.

Being an acute inflammation – and not a chronic one – it does not lead to the reappearance of the infection in the future, unless the causes that determine its formation recur or it is due to other chronic infectious conditions such as blepharitis.

If a chronic granuloma of a meibomian gland develops due to occlusion of the excretory duct and surrounding inflammation, it is called a chalazion.

Stye: the causes

The sty can be due to blepharitis in people in whom the disorder is chronic and has irritating crusts, scales and ulcers around the eyelid, but it can also be caused by other inflammatory conditions. In the event of an acute infection, the development of the sty is caused by conditions favorable to the proliferation of the bacterial load around the eyelid or eye.

Among the most frequent we find: the use of contaminated towels or wipes, the use of expired cosmetics, poor hygiene of the face or hands and, finally, the placement of contact lenses that have not been thoroughly disinfected.

In particular, poor hygiene is among the main causes (as well as the most common predisposing factor) of the formation of styes: if you do not wash your hands and face thoroughly, if you touch your eyes with dirty hands, the bacteria enter in contact with the eyes and penetrate the follicles, thus triggering the infection.

Furthermore, the contagion occurs in a rather simple way since the mere contact of dirty hands with the eyes is sufficient to allow the staphylococci to create damage, thus favoring the infection.

For these reasons, all preventive health interventions are “limited” to correct eye hygiene, as well as correct hand sanitization. In most cases, poorly cleansed skin is one of the main determinants of the development of infections, especially for those caused by staphylococci.

Stye: the symptoms

As previously mentioned, styes must be diagnosed by a general practitioner or ophthalmologist as the symptoms can be similar to other infectious conditions.

Generally, the sty manifests itself with a swelling of the eyelid, sometimes painful and red; in most cases, it can present small pus secretions in the nodular points.

Less common are tearing and the formation of mucopurulent crusts, which are typically accompanied by cases of blepharitis or other chronic infectious conditions.

In addition to a slight pain around the affected part, the subject may complain of burning or localized irritation, hypersensitivity to light, foreign body sensation inside the eye or itching; it is good to remember that many of these symptoms lead the subject to frequently touch the affected part causing greater irritation and pain or, in cases where the hands are dirty, aggravating the infectious condition.

Less common, but still possible, is the condition whereby the infection is not limited to just one eye, but is bilateral, affecting both eyelids.

Styes commonly resolve within a few days with treatment or within 2 weeks without treatment.

The small nodule containing the pus secretion will open independently releasing the contents outside.

However, it is good to remember that, being an infection, it is always better to treat it and have it checked by a doctor.

The typologies

The main distinction concerns the location of the sty, which can appear on the inner eyelid or on the outer eyelid.

Internal sty. The least common form of sty is one that develops on the inside of the eyelid; in these cases, swelling forms inside and is caused by an infection of the meibomian glands (internal excretory glands of the eye).
External sty. The most common form of sty is the one that develops on the outside of the eyelid; in these cases, the swelling forms on the outside and the causes are to be found in the inflammation of the ciliary follicles, in the inflammation of one of the glands of Zeis (essential for the lubrication of the eyelashes) or in the inflammation of the Moll’s gland ( modified apocrine sweat gland located near the eyelash follicles, on the eyelid margin and anterior to the meibomian glands).

In the most severe cases, the untreated sty can evolve into a chalazion, a painful cyst that grows in the eyelid due to blockage of the excretory duct of the meibomian gland.

How stye is diagnosed

Premise: stye is an infectious condition of the eyelid and for this reason it must be diagnosed by a general practitioner or an ophthalmologist.

Detecting it is quite simple, given the obvious symptoms, but the diagnosis of sty is based solely on a medical examination.

The doctor will necessarily have to rule out whether it is a chalazion or an eyelid edge cyst, which present symptoms similar to a sty but require different treatments and treatments.

Stye: the most effective treatments

The sty is an acute infectious condition that can be easily eradicated in a few days even without specific treatment.

Obviously, as an infection it is always necessary to consult a doctor to receive treatment and to have the disorder diagnosed with certainty.

The sty tends to resolve spontaneously without the need for special treatments.

However, if the inflammation persists, the most common medical therapy consists in the administration of antibiotic-cortisone ointments following careful eye hygiene.

It is essential not to treat the sty as a common furuncle.

If it were to be “squeezed”, the infection could in fact come out and spread, further irritating the eyelid skin.

Similarly, “do-it-yourself” hot compresses are also to be avoided, as they could worsen the irritation and increase the pain.

The most common remedies for the treatment of sty are warm compresses, preferably with medicated gauze to favor suppuration and the evacuation of retained pus.

Should the infection persist beyond 15 days, the possible removal of eyelashes, follicle or abscess could be considered, after consultation with a specialist.

The main antibiotics with which the sty is treated are: Tobramycin, Chloramphenicol, Tetracycline.

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How to prevent it and effects on daily life

The sty is an infectious condition due to the entry of bacterial loads inside the eye.

Precisely from this definition we can trace the main method of prevention of this disorder, namely hygiene.

Hygiene of the eyes, face and hands is the first way to prevent the formation of the sty.

Global personal hygiene and behaviors such as: avoiding make-up that can somehow predispose to infection, avoiding mobile eyelash prostheses (better known as “false eyelashes”), always washing your hands before touching your eyes (especially when changing lenses, so as to keep them sterilized) and not wearing dubiously clean head or face clothing.

To prevent the sty you can therefore resort to a few simple gestures NOT to do

have poor personal hygiene, especially of the face
use heavy make-up, especially on the eyelid line
change contact lenses or rub your eyes with dirty hands
use clothing, helmets or other clothing and make-up of dubious origin or used by people suffering from facial infections
promote the spread of the sty by exchanging personal items such as towels, make-up, motorcycle helmets, glasses, etc.

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