Chalazion/ Hordeolum (Stye)

What is a chalazion, hordeolum, and stye?

A small area of redness and pain on the margin of your eyelid may indicate that you have a stye, known in medical terms as a hordeolum. The hordeolum can either be near the edge of the lid, making it an external hordeolum, or it can be deeper in the lid, making it an internal hordeolum. The eyelid is generally red and painful, because this is an active bacterial infection. 

 

When the bump is not red and painful, it is referred to as a chalazion. This is a swelling of the eyelid caused by an inflammation of one of the small oil-producing glands (meibomian glands), located in the upper and lower eyelids. These tend to occur farther from the edge of the eyelid than hordeola and tend to "point toward the inside" of the eyelid. A hordeolum may become a chalazion if the active infection goes away, but material is still trapped in the eyelid. 
 

What are the symptoms? 

Although any bump on the eyelid can be uncomfortable, generally a hordeolum is more red and painful than a chalazion. The hordeolum may make the lid swell and cause some tightness. There may be some tenderness when touching it or when blinking. If large enough, these can cause some visual disturbances. 

What causes these? 

You have glands throughout your body. They make things that your cells, tissues, and organs need to work the way they should. A hordeolum occurs when one of the glands of the lid becomes infected by bacteria, usually Staphylococcus aureus.

When the meibomian glands in your upper and lower eyelids that make oil gets too thick or if the glands are blocked because of inflammation, you may get a chalazion.

Who develops these? 

You are more likely to get a hordeolum if you:

  • Have had one before

  • Wear contact lenses, especially if they are not kept clean, are overworn, or slept in. 

  • Are not keeping your eye area clean, including touching your eyes frequently with dirty hands

  • Use eye makeup that is old or contaminated

  • Have other eye conditions such as an inflamed or infected eyelid (blepharitis)

  • Have other conditions such as rosacea, seborrheic dermatitis, or diabetes

A chalazion happens more often in adults than children. They are more likely to occur in patients with

  • Chronic eyelid problems and inflammation, such as blepharitis

  • Skin conditions like seborrheic dermatitis or acne rosacea

  • Have other health conditions like diabetes

  • Have had chalazia before

To prevent these from happening, keep your eyelids and eyelashes clean. There are some good products that can be used for this, including Ocusoft lid scrubs and Optase lid scrubs. Never touch your eyes with dirty hands. Also, a few studies have found a possible correlation with the use of Omega 3 vitamins (Fish Oil) and less chance of hordeola and chalazia. 

How are they diagnosed? 

Hordeola and chalazia are only properly diagnosed by an eye specialist. During your medical examination at Visualeyes, our optometrists will take a comprehensive look at your eyelids and surrounding structures to determine the diagnosis and best treatment option for you. 

How are they treated? 

For both conditions, warm compresses should be applied to the area for 20 minutes two to three times a day. This 20 minutes should be performed with as much constant heat as possible, making warm washcloths not the best options. Either use a warm compress made specifically for the eyes that can be purchased at Visualeyes Optometry or local pharmacies, or a warm hard boiled egg that is wrapped in a cotton towel (which sounds strange, but it works very well!)

The compresses should be followed by lightly massaging the area with clean hands for about thirty seconds. Sometimes antibiotic ointments made specifically for the eye need to be applied after this. 

If the bumps do not get better after a period of time, our optometrist can refer you to the correct ophthalmologist to perform a either a steroid injection or a small surgical incision to remove the contents of the chalazion. 

What is the prognosis for them? 

Hordeola and chalazia generally respond well to treatment, although some patients are prone to recurrences. If a chalazion recurs, your optometrist may suggest a biopsy to rule out any other serious problems.