What Is Stye?

Stye refers to swelling and inflammation of the eyelid glands due to inflammation caused by a bacterial infection, usually Staphylococcus aureus. Stye is sometimes referred to as a hordeolum and may be confused with a chalazion, another condition that causes eyelid swelling. The main difference between these two conditions is that a stye is painful and a chalazion is painless.

Overview

Stye is a very common cause of eye discomfort. It often appears as a  painful, red bump at the eyelid margin. These swellings are often self-limiting and will resolve on their own in most cases. In this article, we will discuss this common eye condition, its causes, symptoms, and available treatments.

Types of stye

There are two ways a stye can develop

External hordeolum which is inflammation of the eyelash follicle. This type of stye appears on the eyelid margin. It affects the Zeis and Moll glands which are ciliary glands that are located toward the outside of the eyelids. They produce the lipid component of tears. The appearance of this type of stye is more noticeable as these glands are located more superficially at the base of the eyelids

Internal hordeolum is an infection of the meibomian glands of the eyelids. They produce an oily substance that helps in eye lubrication. Because they are located deeper within the eyelid, they have a less obvious appearance than an external hordeolum.

Causes of stye

The primary cause of stye is an infection of the meibomian glands, typically by the bacteria Staphylococcus aureus. Staphylococcus aureus is a bacteria that lives on our skin surface naturally without causing us harm but can be harmful when they get into parts of the body like mucosal surfaces or blood. Some contributors to the development of stye are poor eye hygiene like touching eyes with contaminated hands, improper care of contact lenses, and sharing make-up with other people. 

Signs and symptoms of stye

The most noticeable symptom of a stye is the appearance of a warm, tender, red, swollen bump on the eyelid. Other symptoms include:

1. Swelling of the affected eyelid: The affected eyelid may swell and become puffy as a result of inflammation
2. Pain: Pain is the feature that differentiates stye from the similar condition chalazion. Pain may increase when the eyelid is touched or when blinking
3. Crust formation: The swollen bump that appears on the eyelid may sometimes be filled with pus as a result of the infection, which sometimes forms a yellowish crust around the swelling
4. Tearing: Stye often gives a “watery eye” appearance to the affected eye which is caused by excessive tearing,  a natural reaction of the eye to irritation caused by the  stye
5. Light sensitivity: Some individuals may experience some increased sensitivity to light, this is known as photophobia

Management and treatment for stye

Most cases of stye resolve spontaneously within a week or two without any medical intervention. There are a few home remedies and over-the-counter treatments that could help alleviate your symptoms while your body takes care of the infection.

• Warm compresses: Soaking a clean cloth in warm water and applying it over the affected eye for 5-10 minutes, several times a day, helps decrease the swelling and encourages drainage of the stye
• Avoid unnecessary manipulation: It is important to avoid frequently touching or attempting to squeeze a styeThis will not only increase inflammation and pain but might lead to the spread of the bacteria to other parts of the eye
• Over-the-counter pain medication: Over-the-counter pain medications like non-steroidal anti-inflammatory drugs (NSAIDs) can help minimise inflammation and reduce pain
• Antibiotics: In complicated cases that do not resolve, an eye specialist may prescribe oral antibiotics,antibiotic ointments, or eye drops to accelerate healing and prevent the infection from spreading to other areas of the eye

Diagnosis of stye

The diagnosis of stye is mostly clinical, involving a medical professional taking a history of your symptoms and examining your eye with no tests needed. However, a bacterial culture test could be indicated for complicated infections. Approximately 90% to 95%  of the cultures done on stye exudates are positive for Staphylococcus aureus¹. 

Risk factors

• Poor eyelid hygiene:

Poor eyelid hygiene practices like failure to completely take off eye makeup can lead to the accumulation of debris and bacteria, increasing infection risk.

• Use of contaminated eye makeup: 

Sharing eye makeup such as mascara or eyeliner and makeup applicators encourages the spread of bacteria from person to person. Old or expired eye makeup often harbours bacteria that increase the risk of infection.

• Touching or rubbing the eyes: 

Frequent eye touching especially with hands that are not clean promotes the transfer of bacteria from the hands to the eyelids, increasing the chances of developing a stye. 

• Meibomian gland dysfunction: 

The meibomian glands in the eyelids help keep the eyes lubricated by producing oils that prevent the evaporation of tears. Dysfunction of these glands can lead to the accumulation of oils, causing inflammation and increasing the risk of styes.

• Other skin conditions: 

Individuals with skin conditions, such as acne or seborrheic dermatitis, may be more likely to develop styes since these conditions also affect oil-producing glands. 

• Weakened immune system: 

A weakened immune system due to factors such as chronic illnesses, stress, or certain medications can compromise the body's ability to fight off infections, including those that cause styes.

FAQs

How can I prevent stye?

You can  minimise your risk of developing stye by maintaining good eyelid hygiene. Here are some helpful tips to follow:

• Frequent hand washing, especially before touching the eyes or applying eye-related products.
•  Avoid unnecessarily rubbing or touching the eyes .
•  Regular eyelid cleaning with a gentle cleanser or soap.
•  Regular replacement of  cosmetics and avoid makeup sharing.
•  Proper removal of  makeup before going to bed.
•  Practice proper contact lens hygiene, including regular cleaning and disinfection.

How common is stye?

While stye is a very common condition, the exact incidence is not known. The condition can be observed in different ages and demographics. People with skin conditions such as seborrhoeic dermatitis may be at increased risk, but there is little evidence on the reason.

When should I see a doctor?

Most cases of stye will resolve on their own within a week or two.However, you should consult a medical professional if:

1. The stye does not resolve for more than two weeks
2. The pain intensifies or becomes severe
3. You have difficulty opening your eyes or have problems with your vision
4. You have multiple styes on one eye, or styes in both eyes at the same time
5. The swelling or redness spreads beyond the eyelid

Summary

Styes are painful swellings of the eyelid caused by infection and inflammation of glands in the eyelid. While they can be painful and uncomfortable but usually follow a mild course and resolve on their own within days to a couple of weeks. You can decrease your chances of developing a stye by practicing good eyelid hygiene, frequent hand washing and implementing self-care measures. 

Home-based and over the counter remedies like warm compresses and painkillers often help in accelerating recovery, however some complicated cases may warrant a visit to a healthcare professional who may prescribe oral antibiotics or antibiotic eye creams. It is essential to seek medical treatment if symptoms do not resolve within two weeks.