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Struck with a Stye

Swollen eyelid? Here’s why

iStock_000004716557_LargeOur eyelids are important structures in our body. Besides protecting our eyes from physical injury, they regulate the amount of light reaching the eyes, as well as distribute and drain tears. Eyelashes are found at the lid edges and protect the eyes from small particles such as dust, sand or debris.

Eyelids also contains several glands, which contribute to the tear film to prevent dryness and irritation of the eyes. When these glands become inflamed or infected, they form focal eyelid swellings known as styes and chalazia.

What are styes and chalazia?

Styes (singular: stye) are boils or pimples that occur most frequently near the margin of the eyelid, but occasionally may form in the inner part of the eyelid. They are often red, painful and filled with pus. They may cause eyelid pain, irritation and tearing and crusting around the eyelid. The eyeball itself is not affected and vision should remain intact.

Chalazia (singular: chalazion) are localised eyelid swellings caused by blockage and inflammation of the inner eyelid glands. They often present as a sudden swelling on the upper lid and cause discomfort. Usually, the overlying skin is unaffected and the swelling is easily seen when the eyelid is inverted. Like styes, chalazias do not affect the eyeball. In rare instances, chalazias may result in a serious eyelid infection known as preseptal cellulitis, where the entire eyelid is swollen, red and painful. Fever may also be present.

What causes them?

Styes and chalazia can be associated with the following:

  • Poor lid or eye hygiene, including contact lens handling
  • Eyelid margin inflammation (blepharitis)
  • Excessive oil gland production
  • Ocular rosacea, a skin condition that causes facial redness, swollen red bumps, eye problems and enlarged nose
  • Stress

Systemic illnesses such as tuberculosis, parasitic infections and HIV causing chalazia are uncommon. Cancer of the eyelid glands is also rare.

First aid kit isolatedSelf-help Measures

Most styes and chalazia start to get better on their own in a few days. Applying a warm compress, massaging the eyelid and cleaning are methods that one can use to aid recovery. These also help to reduce future occurrences.

Method What to do How it works
Warm compress Soak a cloth or cotton wool pad with warm water and apply to each eye (eyelid closed) for 15 – 20 minutes, four times a day. This softens crusting and debris which makes subsequent cleansing more comfortable, and helps to unclog glands.
Lid massage Close eyelid and run a finger either downwards (upper lid) or upwards (lower lid) in gentle strokes. You may need to use your finger from the other hand to pull the eyelid taut for effective strokes. Gradually work along the length of the eyelid. This loosens blocked glands and expresses them out of the lid margin.
Lid cleaning Mix soap with water and use this solution to wet a cotton wool or bud. Use this to gently clean off the crust and debris along the lid edge. This physically removes the crust, debris and expressed gland contents from the eyelid margins, and also helps to reduce inflammation.


When to Seek Medical Attention

You should seek medical attention if:

  • Symptoms are significant (pain, irritation, tearing, large obstructing swelling)5429556_xxl
  • The swelling does not improve despite observation and self-help
  • The swelling recurs frequently
  • There is extension of redness, pain and swelling to the entire lid and beyond (face, eye)
  • Atypical symptoms are present. Fever, general unwellness, acute loss of vision, limitation of eye movement, eye pain, swelling and redness may not be due to chalazia and should be evaluated quickly.

It is important to note that not all eyelid swellings are due to styes and chalazia.  Benign skin growths or cancers, specific skin conditions (such as eczema) and infections are less common but may need to be excluded.


Topical antibiotics in the form of eye drops or ointments are usually effective. Oral antibiotics may be required if there is spreading infection. Referral to an eye specialist for surgical removal may be required if the swelling does not respond after weeks of topical antibiotics or if the swelling is very large.


Here are some tips on preventing styes and chalazia.

washing hands12417187_xl13800144_xxl 9175346_xxl

  • Observing good hygiene is important. Ensure that you wash your hands regularly and avoid touching your eyes unnecessarily.
  • Contact lens wearers should clean and store the lenses properly.
  • Predisposing skin and eye conditions should be treated and controlled.
  • Lifestyle habits that promote good skin health such as adequate sleep, moderate sun exposure, exercise and stress reduction are also beneficial.
Dr James Cheong Siew Meng is a Family Physician at Unity Family Medicine Clinic, Serangoon Central, Singapore.
Posted by ezyhealth on Sep 1 2014. Filed under Eye Health. You can follow any responses to this entry through the RSS 2.0. Both comments and pings are currently closed.

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