Chalazion and Stye

Chalazion and Stye are two very common inflammatory diseases of the glands of the eyelids. An immediate visit to the ophthalmologist and the appropriate treatment protect us from suffering and from surgery, which may be required if symptoms persist.

What is a chalazion?

Chalazion (meibomian gland cyst) is a chronic lipogranulomatous lesion formed due to the obstruction of the gland orifices and retaining of their sebaceous secretions. This results in the formation of a type of cyst usually found on the upper or lower eyelid. Patients suffering from rosascea or seborrheic dermatitis are more prone to multiple or relapsed chalazia.

What is a stye?

Styes can be internal or external. Internal stye is a small abscess caused by acute staphylococcal infection of the meibomian glands, while external stye is a small acute staphylococcal abscess of an eyelash pocket and of the respective Zeis and Moll glands.

What is the difference between chalazion and stye?

Chalazion is sometimes confused with stye as both appear as lumps on the eyelids. Stye is an acute infection in the eyelash follicle and forms a red, painful lump near the edge of the eyelid. Chalazion is usually a reaction to enclosed lipid secretions and is not caused by bacteria, even though its position can be secondarily infected. Chalazia tend to appear far from the edge of the eyelid, contrary to styes that tend to develop towards the inner part of the eyelid or the nasal part. In certain cases, a chalazion can cause a sudden edema that extends to the entire eyelid.

What is the clinical picture?

Both diseases appear as inflammatory enlargements of the eyelid. The eyelid is red, edematous and in pain when under pressure. These damages can appear on the upper or lower eyelid, in the inside or on the outside. If the inflammation is extended, the eyelid tends to close, while the weight of the cyst that is formed due to larger chalazia can cause blurry vision due to astigmatism caused by pressure on the cornea. In stye, a white spot may appear indicating the presence of pus.

How are styes treated?

• Internal: After the remission of acute infection, incision and drainage may be required if there are remnants.
• External: Usually, no special treatment is required, as the stye is absorbed or is drained externally towards the base of the eyelash.
  In more severe cases, warm compresses may prove useful.

Pus drainage can be accelerated through the removal of the eyelash that is connected to the afflicted pocket.

In severe eyelid cellulitis, systematic antibiotics may be administered.

How is chalazion treated?

Small, asymptomatic chalazia may go away without treatment. However, larger chalazia may cause blurred vision due to corneal deformation. The main treatment includes ophthalmic ointments and antibiotic eye drops or mixed with local cortisone. It is important to start treatment immediately, because if the inflammation becomes chronic, then it may form a full cyst, which could require surgical removal. Consequently, if the chalazion does not go away after 3-4 weeks, it can be surgical removed for cosmetic purposes.

Therefore, chalazia can be treated through one of the following methods, or through a combination of the following methods:

• Antibiotics: Or a combination with local steroid eye drops in the day and ointments at night for a few days.
• Warm compresses: They can be applied in various ways, e.g. by holding a clean, wet towel over closed eyelids for 5 to 10 minutes, 3-4 times a day. Sometimes the patient may need to wet the towel again to keep it warm. In the end, the patient needs to dry their eyelids by wiping them with a clean gauze to wipe away any sign of pus or other excretion.
• Massaging of the eyelashes: Mildly and periodically, in combination with medicine and warm compresses.
• Surgical Removal: If the chalazion does not go away with the above methods, it must be surgically removed. The operation does not require hospitalization. At first, anesthetic drops are instilled and an anesthetic injection is performed subcutaneously, creating a feeling like a dentist’s injection. Afterwards, the surgeon will turn the eyelid and through a small vertical incision on the inside of the eyelid will remove the contents of the cyst along with part of its walls. Finally, the eye is covered with an eye patch that applies pressure, which needs to stay on for at least six hours. Once the eye patch is removed, you can wash your eye with a clean towel or a cool, wet gauze, which you have previously boiled to clean the eye from remnants of blood or other secretions. You may notice some bruising on your eye, which, however, will disappear within the next few days. Your doctor will prescribe antibiotic eye drops or ointments, which you should use at least 4 times a day for at least a week.

Chalazia usually respond well to treatment, even though in some people relapses occur. In that case, a repeat treatment and a thorough examination may be required for the doctor to determine the cause of the relapse. If a chalazion appears on the same spot, the doctor will order a biopsy to exclude more serious conditions.

Finally, frequent relapses can be avoided with the use of corrective glasses for people who have hyperopia or advanced presbyopia and don’t wear glasses.

Prevention of the reappearance of chalazion

The reappearance of chalazia may be prevented through the thorough cleaning of the eyelids, especially in people who are prone to the condition. Regular cleaning of the area of the eyelids using children’s shampoo decreases the chance of gland obstruction. Furthermore, adopting certain dietary habits may help prevent the reappearance of chalazia and improve health.

• You should increase the consumption of foods rich in vitamin A, such as fish – mainly grilled fish, such as salmon and tuna (ideally you should consume them 2-3 times a week). Furthermore, consumption of B-carotene is required as it is converted to vitamin A in our bodies.
• Include in your diet foods rich in vitamin B6 – greens (beans and peas), tuna, salmon, chicken and vitamin B3 (sunflower seed).
• Consume 3 bowls of fresh salad a day, as they are especially nutritious.
• Drink large quantities of water (at least 6 glasses daily).

Finally, keep in mind: Your ophthalmologist is the best source for responsible information on issues that are related to the health of your eyes. Under no circumstances is the information available on our website intended to replace your doctor. Always contact your doctor for information.