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Hordeolum (Stye) / Chalazion

What is a Hordeolum (Stye)?

A hordeolum or “stye” is a small, red, painful bump that grows at the base of the eyelash or under the eyelid. Most styes are caused by a bacterial infection.

Two Types of Styes:

External Hordeolum: Begins at the base of the eyelash. Most are caused by an infection in the hair follicle.

Internal Hordeolum: A stye inside the eyelid. Most are caused by an infection in an oil-producing gland in the lid.

Signs and Symptoms of a Stye:

  • Redness

  • Tender to touch

  • Eye may feel sore & scratchy

  • Swelling, sometimes affecting the entire eyelid

  • Usually appears at edge of eye lid

  • Sensitivity to light

  • Crustiness along lid margin

  • Tearing

What is a Chalazion?

A chalazion is a benign, painless bump inside the eyelid. It usually results from an internal hordeolum that is no longer infectious. These cyst-like nodules form around an oil-gland within the eyelid, resulting in a red, swollen bump on the lid. The contents of a chalazion include pus and fatty secretions that usually help lubricate the eye but are now blocked from doing so. Many chalazion will drain and resolve on their own, however some may persist for more than several weeks and grow large enough to become cosmetically unappealing.

Signs and Symptoms of a Chalazion:

  • Bump on lid, sometimes red and swollen

  • Occasionally tender

  • Blurry vision, if the chalazion is large enough to press on the eyeball

Risk Factors:

Often there is no obvious cause of a hordeolum or chalazion. However, they are more common in those with certain predisposing conditions:

  • Blepharitis, inflammation of eyelid margins

  • Previous stye or chalazion

  • Skin conditions, such as Rosacea or Seborrheic Dermatitis

  • Diabetes


Small chalazia may require no treatment at all. However, some blockages causing chalazia do not clear up on their own and persist, or may grow larger.

Warm Compresses:

The number one, most important treatment for styes or chalazia, are warm compresses. This is done by soaking a clean washcloth in hot water and holding it over the eyelid for 10-15 minutes at a time, at least 3-5 times a day. For a chalazion, this warm compress will help soften the clogged oil gland to help it open and drain. After applying heat, it is also important to massage the area with your finger to help the gland drain.


Antibiotics are prescribed for active infections as in the case of an internal or external hordeolum. An ointment may be applied directly to the lid, or an oral antibiotic may be prescribed. Doxycycline is the most commonly prescribed antibiotic for these conditions as it targets the oil glands. It is sometimes used in the treatment of chalazia as well as it has underlying anti-inflammatory properties which may help speed the healing process.

Steroid injections:

If a chalazion is very swollen, a cortisone injection may be used to reduce the inflammation. This will allow better drainage. A potential side effect of this is lightening of the surrounding skin, which can be more problematic in darker skinned people.

Surgical excision:

A local anesthetic is used to numb the area. A small incision is made, typically from underneath the eyelid to clear the contents of the lesion without visible scarring. In cases where a stye or chalazion keeps returning to the same location or has a suspicious appearance, the tissue removed may be sent to a laboratory to rule out a more serious eye problem.

Fortunately, most chalazia are harmless.

DO NOT squeeze or try to pop a stye or chalazion. Doing so may spread the infection into your eyelid.


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