A stye or “hordeolum” is an infection within the eyelid. They can arise from an infection of an eyelash follicle, or more commonly, an oil gland inside of the eyelid. Our eyelids are more than just skin, they contain a complex network of oil glands that help to stabilize our tears. These oil glands are called meibomian glands, and they secrete meibum. Meibum is an oil layer that helps prevent the water layer of our tears from evaporating. Similar to a pimple, these oil glands can get backed up. This opens the door for skin bacteria to find their way into the gland, causing an infection. This infection results in the red, swollen, painful bump we call a stye.
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The primary reason styes originate is from a condition called “meibomian gland dysfunction” or MGD. MGD is extremely common, and affects nearly everyone at some point in their lives. The oil in our eyelids can vary in composition from an olive oil like consistency, to butter. MGD causes people to have more of a butter-like consistency to their meibum, leading to backed up and clogged glands. So how can we thin out that butter? Melt it! The easiest and safest way to treat a stye is with a warm compress. Warm compresses can be done at home using a washcloth, or purchased commercially.
For a quick DIY warm compress, I recommend running a clean washcloth under hot water, ringing it out, and placing it in the microwave for about 20 seconds. From here, fold it into a rectangle similar to the size of your eyes, and lay it gently over your closed eyes for 10 minutes. Be sure to test the temperature on the inside of your wrist to make sure it isn’t too hot. The point is to provide sustained heat, not burn your eyelids. Research indicates that in order to adequately melt the meibum, sustained heat of about 100 degrees Fahrenheit for 10 minutes is required. Warm compresses can be done several times throughout the day, I recommend at least 4 times daily during the acute stage.
A more effective option is to purchase a commercially available warm compress from the store or online. These are specially designed for the eyes, and will stay hotter longer than a washcloth. The best warm compress for the eyes is called the Bruder Mask. It is available from their website, or in some cases your local eye care provider. Commercially available compresses will come with instructions, but they are similar to those above.
When heat isn’t enough, or the infection is too deep for heat to resolve, topical or oral antibiotics may be necessary. For stubborn infections that are more toward the surface of the skin, an ointment like Erythromycin may be used to help clear the infection. If the infection is deeper, or the infection is more severe, antibiotics like Keflex or Augmentin may be prescribed by your doctor. These antibiotics work to eliminate the infection from the inside out, as your body heals the area.
Rarely, a simple infection of the eyelid can grow to infect the soft tissues surrounding the eye. This is known as cellulitis, and is much more serious than a stye. Cellulitis will differ from a stye as often both eyelids will be affected, as well as the skin around the eye, making the eye appear puffy or difficult to open. If at home treatments are not helping, or your vision is affected, it is strongly recommended to visit your eye care provider. Good eyelid hygiene and regular maintenance of the meibomian glands is usually enough to reduce the recurrence of, and even eliminate stye formation.