Bumps on eyelids (chalazion vs stye)

Understanding and Managing Common Eyelid Bumps: Styes and Chalazia

We often receive calls from patients concerned about a bump on their eyelid or something resembling a pimple. Most of these cases turn out to be either a stye or a chalazion. Let's explore what each of these conditions involves, their causes, treatments, and when to see an optometrist.

What is a Stye?

There are two main species of Demodex mites that affect humans: Demodex folliculorum and Demodex brevis. Demodex folliculorum primarily resides in the hair follicles, including those of the eyelashes and eyebrows, while Demodex brevis prefers the sebaceous glands. These mites feed on dead skin cells, oils, and hormones, and their life cycle lasts about two weeks.

How Do Styes Form?

Styes occur when bacteria become trapped in oil glands that are blocked or plugged. Medications or hormonal changes can sometimes alter the oil's composition, increasing the likelihood of gland blockage. Styes can affect either the external or internal surface of the eyelid but almost always involve the glands at the eyelid margin.

Symptoms of a Stye

• Swelling and inflammation of the eyelid
• Redness and tenderness to the touch
• Pain in the affected area
• Increased mucous production, causing blurred vision and crusting in the corners of the eyes or at the eyelid margins

In rare cases, the infection can spread to surrounding tissues, leading to cellulitis, characterized by severe swelling, fever, and potential vision obstruction due to swollen eyelids.

Treatment for Styes

• Mild Styes: Warm compresses and eyelid hygiene two or three times a day help the oil flow more freely and remove bacteria and debris.
• Moderate Styes: Topical antibiotic or combination antibiotic/steroid ointments in addition to warm compresses and lid hygiene.
• Severe Styes and Cellulitis: Oral antibiotics may be required, and some styes with abscess formation might need surgical drainage.

What is a Chalazion?

A chalazion is an accumulation of firm nodular tissue called a granuloma inside the eyelids where the oil glands have been inflamed. This inflammation is a reaction to oil seeping out of the glands into the surrounding tissue of the eyelid, causing the glands to become plugged. Chalazia can occur independently or following stye formation and treatment. They are usually painless or only mildly irritating, though some may be more symptomatic.

Treatment for Chalazia

• Mild Chalazia: Warm compresses and eyelid hygiene.
• Moderate to Severe Chalazia: A combination of warm compresses, lid hygiene, and topical or injected steroids.
• Chronic Chalazia: May require surgical treatment through a small incision, usually on the inside surface of the eyelid to avoid external scarring. This minor procedure is generally covered by insurance and performed in-office. Post-procedure, antibiotic ointment is used in the eye for about a week.

An alternative successful treatment is IPL (Intense Pulsed Light) therapy, which can resolve acute chalazia in 3-5 days. Chronic chalazia may require multiple IPL treatments (typically 2-3) to achieve complete resolution. This medication-free, injection-free, and incision-free approach has been very well received by our patients.

Treatment for Chalazia

If you experience any of the following, contact your eye doctor immediately:

• Redness and swelling extending beyond the eyelid to the cheek or other parts of the face
• Severe swelling and fever, indicating cellulitis
• Persistent bumps that do not respond to basic treatment measures

Prevention Tips

• Maintain Eyelid Hygiene: Keep your eyelids clean and remove makeup before bedtime.
• Replace Eye Makeup Regularly: Change eye makeup every three months.
• Hand Hygiene: Wash your hands before touching the area around your eyes.
• Avoid Sharing Eye Makeup
• Contact Lens Care: Ensure contact lenses are clean and avoid over-wearing them.

By following these steps, you can help prevent the occurrence of styes and chalazia. For further advice and treatment, contact our suburban optometry practice. Your eye health is our priority.