Styes and Chalazia Health Article

Definition

Styes and chalazia are infections and inflammations of the tiny oil glands on the eyelids. A sty, or external hordeolum, is a common childhood infection of an oil gland on the surface of the upper or lower eyelids at the base of the eyelash. An internal hordeolum is an infection deeper inside the eyelid.

A chalazion is an inflammation or blockage of the deep oil glands within the eyelid that develops into a small hard mass.

Description

Styes and internal hordeola begin as a red, pimple-like bump on the eyelid. The eye may water and itch, and the eyelid may be swollen and painful. Styes come to a head in about three days when they open and drain. Healing is rapid. Internal hordeola are larger, last longer, and are more painful.

Chalazia develop within the Meibomian glands, or oil glands of the eyelid. There are approximately one hundred of these glands located underneath each row of eyelashes. Obstruction and infection, which often are the result of bacteria, cause the gland and the area around it to swell. Chalazia are slow growing, usually over two to three weeks, and can last several months.

A chalazion first appears as a firm lump under the skin but is usually not painful. If the oil gland is blocked and inflammation spreads beyond the eyelid, the condition can interfere with vision. Sometimes, a chalazion develops after a sty has healed.

Growths on the eyelid that are not red and painful are usually cysts and should be evaluated by a doctor. Sometimes, they are removed. In most cases, they are not.

Transmission

Staphylococcus aureus bacteria are thought to be responsible for most styes. Rubbing the eyes, especially when the sty is oozing pus, can spread the infection along the eyelid and cause other styes. There is also a chance that if transmitted to the face or other parts of the body the bacteria in the sty can cause impetigo, a contagious skin infection.

Demographics

Styes are more common in children than adults. Once a child has one sty, there is an increased chance of the child having another later on. They also seem to recur in children with lowered immune resistance such as children with diabetes. Acne also seems to trigger styes in some adolescents.

Chalazia occur more often in adults than children, and in men more than women. As is the case with styes, having acne seems to predispose some adolescents to having chalazia.

Causes and symptoms

Styes and internal hordeola in children are usually caused by Staphylococcus aureus bacterial infections that are transmitted from a child's eyes and nose. In most cases, the bacteria enter the eye through unwashed hands or contaminated contact lens. Bacteria may live on the eyelids or eyelash hair follicles themselves and begin to grow when the oil gland of a hair follicle becomes blocked.

Symptoms

Styes appear as red bumps on the eyelid and may cause itching or tearing. Sometimes children report feeling as if something is in the eye. Both styes and internal hordeola are usually painful. The eyelid may look red and be swollen. Vision is sometimes blurred, and the eyes may be sensitive to light.

Though chalazia may appear as large unsightly lumps deep within the eyelid, they are usually not painful. On rare occasions, if a chalazion becomes quite big, it can press on the cornea. If the chalazion is on the upper eye lid, it can produce various vision problems including astigmatism, a distortion of the lens that causes fuzzy vision.

When to call the doctor

It is important to call the doctor if the child has a fever, pain in the eye, swelling or redness over the entire eyelid, or a painful sty persists for one to two weeks. It may be necessary to call a doctor if the child experiences no improvement after three days of home care. In addition, if the child experiences vision problems, a doctor should be consulted.

Conjunctivitis, which appears as redness in the white of the eye, is a serious condition that must have a doctor's attention. In most cases, antibiotics or antibiotic ointments are prescribed.

Stubborn chalazia that do not go away within six weeks or continue to enlarge require medical attention. They may need to be removed surgically, using local anesthesia.

Diagnosis

The doctor determines whether a child has a sty by visually examining the appearance of the eyelid. If the bump is hard and is located deep within the eyelid, it probably is a chalazion. For a patient whose sty has not healed with home treatment, the doctor may test the fluid in the eye to determine the type of bacteria present and prescribe treatment accordingly.