Stye

Overview of stye

Eye infections are common in people living in poor hygiene conditions. People of low and middle-income countries suffer most from these diseases. Eye infections caused by bacterial agents are very common in the tropical, temperate and humid regions. These climatic zones are ideal for bacterial growth. A very common infection of this category is “Stye”. It is mainly precipitated by poor eye hygiene. But bacterial infections can also account for a stye in many cases. The occurrence of stye is high among school-going children.

What is a stye?

Stye or hordeolum is defined as a painful lump formed under the eyelid or at the base of the eyelashes.

It is characterized by an acute inflammation of the eyelids, accompanied by gritty, itchy and watery eyes. A stye is formed due to clogging of the oil glands (sebaceous glands) present in the eye-lids. Styes can form on the upper or lower eyelid. Bacterial infections can also precipitate the formation of a stye.

Styes are usually filled with yellowish pus. In any case of stye, the vision is not impaired. But when styes are left untreated, they may worsen and can lead to chalazion. According to the degree of infection, multiple styes may develop at the same time. Normally styes are not communicable. But styes caused by bacterial infections are contagious in nature.

How will you differentiate between a stye and a chalazion?

It is important to understand the difference between a stye and a chalazion, since both of them look similar. A stye usually develops at the edge of the eyelid and is very painful. In the advanced stages, a stye can cause swelling and stiffening of the entire eyelid. A chalazion on the other hand, is caused only due to a blocked oil gland. It is usually formed at the back of the eyelid. It does not cause swelling of the whole eyelid.

What are the possible causes of stye?

Styes are caused both by bacterial infections and poor eyelid hygiene. The common causative factors are listed below-

• Infections caused by the bacteria Staphylococcus aureus, that affects the oil glands present at the base of the eyelashes
• Formation of abscess on the eyelids due to bacterial propagation
• Blockage of the sebaceous glands present in the eyes due to accumulation of dirt or waste matter from the eyes
• Past occurrence of Blepharitis (causes inflammation and redness of the eyelids)
• Existing eye infections
• Allergic response to eye-drops or using expired eye-drops or eye-medicines
• Diseases like Acne rosacea or Seborrheic Dermatitis that affect the eye-health
• Medical history of stye or chalazion
• Diseases like Diabetes mellitus
• Not cleaning eyes properly
• Habit of rubbing eyes frequently (especially with unclean hands)
• Exposure to hot and humid conditions on a regular basis
• Defective eye-wear such as lenses or allergic response to lens solutions
• Greasy eye make-up (applied on a regular basis)
• Direct contact with a person having stye or using items (such as towels) used by the infected person

What are the visible signs and symptoms?

Styes are easily identifiable. The common symptoms of styes are described below-

• Appearance of painful reddish bumps at the base of eyelashes or underneath the eyelids
• Presence of yellowish pus in the middle of the lump
• Irritation, grittiness, burning and inflammation of the eyes
• Reddish discolouration of eye-lids
• Gradual swelling of the entire eye-lid
• A tendency to scratch the eyes
• Constant watering from the eyes
• Extreme tenderness of the eyes
• Crusty appearance at the edges of the eye-lids due to the accumulation of discharged pus (observed mainly after long hours of sleeping)
• Heaviness of the eyelids especially in the morning
• Increased photosensitivity
• Difficulty blinking
• Appearance of small ulcers on the eyelids after the pus is discharged

Different types of styes

Based on the location, styes may be broadly classified into two categories. These are described below-

• External hordeolum: This is a type of stye that occurs at the root of the eyelashes. It initially erupts as a small reddish lesion and gradually grows into a bigger pus-filled abscess. It is caused by bacterial infections in the hair follicles due to poor eye hygiene. The Glands of Zeis or the Glands of Moll present inside the eyelids are infected in this case.  External hordeolum normally grows towards the skin surface of the eye-lids. Hence it can release the purulent discharge easily. This category of stye does not cause serious complications. It is normally self-limiting in nature. In a few cases, it may need minor medical intervention to heal completely. External styes are more common than the other types of styes.
• Internal hordeolum: It is a type of stye that develops inside the eyelids. It is caused by bacterial infections of the oil-glands present in the eyelids. It may also be caused by the clogging of the sebaceous glands (sweat glands) present in the eyes due to accumulated waste particles. The meibomian glands present inside the eyelids are severely affected in this case. It disrupts the lubrication of the tear film. Hence constant watering is observed in this type of stye infection. Internal hordeolum points and grow inwards towards the corner of the eyelids. Therefore the pus cannot be discharged outside the eyes. The sticky discharge thus gets accumulated in the eyes and causes severe pain and stickiness. Internal stye is no so common.

What are the possible complications?

Styes not only affect the eye-health, but also give rise to the following complications-

• It can progress to Orbital Celluitis or Preseptal Cellulitis
• It may lead to conjunctivitis
• An untreated stye can develop into a chalazion

Diagnosis, treatment, & prevention

A thorough eye examination by an ophthalmologist is necessary for the diagnosis of styes. Go to your general physician (GP) and get the ointment to fix the stye.

They can use a small, thin needle to burst the stye or remove the eyelash that contains the infection or you could refer you eye specialist.

Precautions that need to be taken are – make sure that your hands are clean at all times before touching your eyes, your eyes are clean and that there is no dirt of leftover makeup.

References