A chalazion is one of the most common inflammatory lesions affecting the eyelid, caused by a plugged gland. Its symptoms range from a small, painless lump, to painful eyelid-wide inflammation.
On the other hand, a stye is a bacterial infection at the base of an eyelash follicle. It usually looks like a localized red lump.
A chalazion begins as a small, painless subcutaneous nodule in the eyelid that can progress to cause a red, swollen, painful eyelid. While a chalazion can develop in the upper and lower eyelids, it’s more common on the upper eyelid.
Chalazia originate from obstructed meibomian glands, which are sebaceous glands in the eyelid rim. These glands secrete lipids that protect the eyes by preventing evaporation of the tear film. When the gland becomes blocked, its fluids leak into surrounding tissues, triggering an inflammatory response, which leads to the formation of the chalazion.
A stye, or external hordeolum, is an inflamed oil gland that presents as a small, red, painful bump. An external stye develops at the edge of the eyelid and presents as a small, red, painful bump. It’s usually caused by a bacterial infection in an eyelash follicle. An untreated stye may resolve on its own, but in some cases can progressively worsen in redness, swelling and pain. It sometimes requires antibiotics to resolve it.
A chalazion develops when the meibomian gland becomes blocked – it is not a bacterial infection. It’s usually painful for 24-36 hours, then often feels better. If it doesn’t resolve, however, a chalazion may require steroid injection or surgical excision to treat it.
Both are similar, and it can be difficult for a layperson to distinguish between the two. Both present with redness, usually some pain, and a swollen eyelid. If pain and redness continue after 36-48 hours, we recommend scheduling an appointment.
An untreated chalazion may resolve on its own within a few weeks. However, it can also develop an acute secondary infection or become enlarged. If it puts too much pressure on the cornea, it can lead to astigmatism or reduced vision in the superior peripheral visual field.
Gentle eyelid massage and warm compresses applied to the eyelid for 10-15 minutes several times a day help open the blocked gland, allowing oily secretions from the infected eyelash to drain.
Dr. Besser may inject steroid into the eyelid to decrease inflammation. More than one injection may be necessary.
Recurrent chalazia may also be treated prophylactically with systemic tetracyclines or topical macrolide antibiotics, such as erythromycin ointment.
When a chalazion doesn’t respond to medical care, is large and symptomatic, or interferes with vision, Dr. Besser may decide that a chalazion removal procedure is necessary. After injecting a local anesthetic, Dr. Besser makes a small incision and removes the chalazion’s fluids.
Styes don’t require much treatment, as they usually go away on their own within a few days. Warm compresses applied to the base of the infected eyelash are highly recommended – they help soften the fluids inside the stye, allowing it to drain.
In some cases, if the stye doesn’t recede, Dr. Besser would treat it with an oral antibiotic. The key takeaway here is to avoid squeezing or trying to pop the bump, as it can cause the infection to spread.