If you have a painful and tender bump on your eyelid, you may be diagnosed with a stye or hordeolum. These are infections or inflammations in different tissues in the eyelid, sometimes with different treatments and disease courses. This article will explain the diagnosis and treatment of these conditions as well as some other types of bumps that they may be confused with or develop into.
Styes and External Hordeolums
This condition is what optometrists are often referring to when labelling a bump as a stye. This is an infection of a gland in the eyelash follicle that produces oil to lubricate the lash. The bump is located on the edge of the eyelid, near the eyelashes, and can cause swelling of the eyelid surrounding it when infection and resulting inflammation occurs.
Treatment for this condition might include frequent warm compresses with eyelid massage and a topical or oral antibiotic, possibly with an antiinflammatory medicine included in combination as well.
Our optometrist may remove the affected eyelash which will help drain the infection, and the lash will grow back in time. Eyelid hygiene with lid wipes is also helpful in acute treatment and preventing recurrence. With all of these treatment methods and some time, the infection will clear nicely.
Internal Hordeolum
Internal hordeola are often confused with styes because the pain feels similar and they are also located on the eyelid. As the difference in name suggests, however, these occur inside the eyelid surface rather than on the outside eyelash margin.
This is an infection of a Meibomian gland, which secretes oils on each blink that are used in your tears to help prevent evaporation. Meibomian glands line the entire upper and lower eyelid margins. If the consistency of these oils changes to be more thick, this can cause the glands to become clogged and stagnant, opening the way for infection.
Treatment is similar for this condition as for a stye, but as there is no lash to remove, other treatment methods are more important.
This condition is more likely to require oral antibiotics and frequent hot compresses with eyelid massage are vital to drain the abscess. Once resolved, omega-3 fatty acid supplementation may be recommended to decrease the chance of recurrence by making the oils less thick and less likely to clog the glands.
Sometimes, this infection can spread to become a preseptal cellulitis, where the entire eyelid is swollen, (requires oral antibiotics) or further to an orbital cellulitis, where the infection has spread to behind the eyelid and now requires hospitalization and intravenous antibiotics because it is much more dangerous.
Chalazion
Even if an internal hordeolum does not spread to the rest of the eye can become a much bigger problem, if it is not treated properly or quickly enough it can change into something that is annoying to deal with.
This is referred to as a chalazion, a condition that occurs when the body has dealt with the gland infection but has done so by sealing away all the abscess material in a rigid capsule. This means there is still a big, firm bump on the eyelid, although it is no longer painful or in any danger of spreading infection to the rest of the eye.
Again, frequent hot compresses with vigorous eyelid massage can sometimes clear chalazia, but they sometimes require surgical methods to be cleared as well. This may take the form of a corticosteroid injection at the site to knock out the inflamed tissue and let it drain, or the lesion may need to be cut open and all material scooped out.
Both procedures are quick and safe, and are commonly performed.