What Is That Thing On Your Eye? The Need-to-Knows of Styes, Hordeolia, and Chalazia

A stye is the non-technical term for a hordeolum or chalazion. In order to treat your potential stye, you need to know what exactly it is, which is why we’re providing this comprehensive guide to styes. In the common vernacular, when someone says “stye” they can be referring to either of these things. A stye can form either on the outside or inside of the eyelid, or even within the eyelid. Typically it is the hordeolia which form on the eyelid, while Chalazions may sometimes form within the eyelid (between eyelid and eye).   The technical term for something forming on the outside of an eyelid is to label it as “externum” whereas something forming on the inside of the eyelid is “internum,” eg.:  hordeolum externum or hordeolum internum.

Both external and internal styes are caused by activities in various sebaceous glands. While there are nearly thirty glands that serve function in the ocular area of your face, two are particularly crucial in the entire process.The external sebaceous glands are known as the Glands of Zeis, and they are located around the eyelash follicles. These sebaceous glands produce sebum, a waxy, oily substance that is meant to waterproof the skin, as well as provide it with its basic oils. Sebum plays a particularly important role as it pertains to the eyelids, as the skin there is constantly near moisture because of its proximity to the tear ducts. The internal sebaceous glands are called the meibonian glands, and they line the base of the eyelid. The meibonian glands produce meibum, another oily substance which helps to control how water and tears are handled when they leave the eye. Meibum is a stopper, and in conjunction with sebum, they make sure that your eyes aren’t constantly leaking liquids down your face. As we’ll see later, it is variances in the glands that produce sebum and meibum that are responsible for creating hordeolia and chalazia.

A hordeolum is typically a short lived stye with an eyelid life of one to two weeks. The reason that hordeolia only last briefly is because they are the result of a particular instance of inflammation or infection in one of the sebaceous glands. These infections bring about redness in the infected area, which typically have a yellow dot that marks the center of the hordeolum. The bacteria, water, and oils will then form pus that makes the area swell. Hordeolia tend to be more painful than chalazia, as hordeolia come from spontaneous infections, whereas chalazia tend to be recurring in certain patients.

Chalazia differ from hordeolia in that they are generally from over-productive glands, or glands that have been partially blocked. While this is also true of hordeolia, chalazia tend to reoccur because the glands which produce them have a habitual problem of producing too much sebum or meibum. It is for this reason that chalazia last much longer than hordeolia, and that their resolution typically requires antibiotics, or even surgery in some cases. Chalazia also tend to get much bigger than hordeolia, and can last anywhere from months to years. They often have a high probability of returning because they result from glands that have a tendency to malfunction. For tips on how to treat Chalazia, and some proactive measures that can be taken to prevent getting them in the first place, be sure to check out the blog for an upcoming article.

As styes sit within popular culture, it is best to think of them as the close relative of the Pimple that you have never heard of. In medical terms, however, hordeolia, pimples, and chalazions are all forms of Cysts, and are considered Cutaneous Conditions. Generally speaking, Cutaneous Conditions are bodily happenings which affect the outer layer of the body (areas like the skin, hair, and nails). They often occur because of overproduction in certain glands. This glandular imbalance means that styes, like their more common brother pimples, are not always caused by conscious human activities, but may instead form due to some kind of biological imbalance that requires medical treatment. While there are many posts about how to prevent pimples which can apply to styes, these measures are not wholly preventative. They are measures that can be taken in order to reduce the self-imposed risk of getting a stye, but they do not provide complete protection. While not touching your face is a good way to stop unnecessary bacteria from reaching your eyes and pores, it is not a surefire method to avoiding styes.

While these are the technical definitions and classifications of hordeolia and chalazia, there are other, more worrisome things that the growths on your eye could be. This article is a good start to discovering what may be troubling you, but a professional opinion of your specific instance in always your best option. If you’re curious as to whether you have a hordeolia, chalazia, or something else entirely, you should contact Dr. Dan Landmann, an eyelid doctor who specializes in stye treatment.

What to Expect During Stye Surgery

When you have a stye and your doctor recommends a procedure to open the stye, it can be can be concerning for a lot of patients. But knowing what to expect can help you feel more comfortable. Every ophthalmologist performs this procedure slightly differently, but most of the time, it is performed in the office. The surgery for styes is called an “Incision and Curettage” or I&C for short.

The main reason to do the procedure is if a stye is not getting better, even after doing warm compresses consistently for a month. You will still have to do warm compresses after the procedure though. The goal of the surgery is to scrape out the inflammatory material that is stuck there and hopefully make the stye go away sooner. The procedure is very quick and safe, but the risks of the procedure include, but are not limited to: bleeding, infection, recurrence, pain, poor wound healing, problems with eyelashes, a droopy eyelid and scarring. Of course, your doctor will talk to you about those risks before doing anything.

The alternative to an I&C is using the warm compresses, antibiotic and steroid drops, a steroid injection and observation (not doing anything). The majority of styes will go away even if you do nothing – but it will take time – sometimes up to a few months or a year.

For numbing, you will get Local Anesthesia – which means the surgeon will inject numbing medication around the stye. After the numbing medication is in, you shouldn’t feel anything sharp, maybe just some pressure. The procedure takes about 15 minutes. The incision is made either from the inside of the eyelid, or from the outside, depending on which way the stye points. Even if the incision is made from the outside, it usually heals very well, with minimal scarring. Everyone bruises after an Incision & Curettage. I tell patients that their eyelid will actually look worse for a few days after an I&C, because there is a lot of bruising. Expect to have a black and blue eye for up to 14 days after the procedure.

Afterwards, Tylenol (Acetaminophen) is all that is needed. Make sure to follow the directions on the label carefully and do not exceed the recommended dosage. All the other over-the-counter pain medications (Aspirin, Motrin, Aleve, Naprosyn, Ibuprofen, etc) will make your eyelid bruise more.

A biopsy is sometimes taken at the same time, if there is a concern that the bump is something more serious, like eyelid cancer.

StyeGuy is the Amazon of Doctor Appointments.

If you’re busy and have things to do – going to the doctor for a stye is probably not on the top of your list of things to do. 

StyeGuy is the Amazon of Doctor Appointments. 

The process is simple: Fill out our secure form with information about your stye and any questions or concerns you have. Also, you can send Dr. Landmann a photo of your stye. Our office will reach out to you and schedule a video consultation within the next business day. You’ll receive a diagnosis and treatment plan from a Board Certified Ophthalmologist, and if you need a prescription, we will even send it straight to your pharmacy. If Dr. Landmann thinks your stye warrants further follow up care, he’ll let you know, and our staff will be pleased to arrange an in-office visit. It’s really that simple.

Alternatively…

  • You can call and make an appointment with your primary care doctor or eye doctor – but do they specialize specifically in eyelids, like Dr. Landmann?
  • You can go to the ER and wait a few hours, or you can make an appointment and wait a few days, just to wait a half hour in the doctor’s office.
  • You can take a day off from work… or you can see the doctor while you are still at work.

Styes are very frustrating – we’re here to help!