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Stye or chalazion: what is this lump on my eyelid?

Lumps on the eyelid are very common, in children and adults alike. Most are styes or chalazia, which are harmless and usually go away with simple care at home. A few need an eye doctor's help, and a very few need tests to make sure they are not something else. This guide explains the difference and what to do. For other eyelid and tear duct problems, see watering eye, blocked tear duct, styes and chalazia.

What is a stye?

A stye (hordeolum) is a small infection, usually by common skin bacteria, at the root of an eyelash or in a gland at the edge of the eyelid. It looks like a small red pimple on the lid margin, often with a yellow point. The lid is red, swollen and tender, and the eye may water or feel as if something is in it. A stye can also form on the inside of the lid. Most styes come to a head, drain by themselves and settle within about a week.

What is a chalazion?

A chalazion is a blocked oil gland in the eyelid. The eyelids contain a row of tiny glands that put oil into the tears to stop them drying out. When one gland's opening gets blocked, the oil builds up and forms a firm, round lump, a little further from the lid edge than a stye. It usually does not hurt once the first swelling settles, and it can stay for weeks or months. A chalazion sometimes follows a stye. A large one can press on the eye and blur vision.

How can I tell them apart?

• Pain: a stye is tender and sore; a chalazion is usually not painful after the first few days.
• Position: a stye sits at the lid edge, near the lashes; a chalazion is usually set a little back in the lid.
• Look: a stye is red and may have a yellow head; a chalazion is a smooth, firm, pea-like lump.
• How long: a stye usually settles within about a week; a chalazion can last for weeks or months.

The first-aid care is the same for both, so you do not need to be sure which one it is before you start.

What can I do at home?

• Warm compresses. Soak a clean cloth in warm water, not hot, squeeze it out and hold it on the closed eyelid for 5 to 10 minutes, three or four times a day. Test the warmth on the inside of your wrist first, especially for a child.
• Gentle massage of a chalazion after the warm compress, with a clean finger, towards the lid edge, if the eye doctor has shown you how.
• Keep the lids clean. Wash the lid margins gently with clean water, or with a cleaning method the eye doctor advises.
• Do not squeeze, prick or burst a stye or chalazion. It can push the infection deeper into the lid.
• Do not rub hot objects such as a warmed coin, ring or spoon on the eyelid, and do not put home remedies in the eye.
• Stop eye make-up and contact lenses until the lid has healed, and throw away eye make-up used just before the stye.
• Wash your hands before you touch your eyes and again afterwards, and do not share towels or pillows.

Do I need medicine?

Most styes and chalazia settle without medicines. Antibiotic drops or ointment are used only if the eye doctor advises them, and tablets only if an infection is spreading into the lid. Do not use drops bought over the counter, especially steroid drops, without an eye doctor's advice.

When should I see an eye doctor?

Book a visit if:

• a stye has not improved after about a week, or a chalazion after a few weeks
• the lump is large, blurs your vision or presses on the eye
• styes or chalazia keep coming back
• a child has a lump that is not going away, because a large chalazion can blur a child's vision while it is still developing
• you are not sure what the lump is

Come the same day if the whole eyelid becomes red and swollen, the redness spreads to the cheek or around the eye, you have a fever, the eye is pushed forward, hurts to move or will not open, or your vision drops. These can be signs of an infection spreading around the eye, which needs urgent treatment. Emergency eye care at ReNew Vision is available 24 hours; see eye emergency.

Have it examined if a lump keeps growing, bleeds, makes the lashes fall out, changes the shape of the lid edge, or comes back in exactly the same place, especially in an older adult. Most such lumps are still harmless, but a few are growths that need tests. Eyelid growths are not treated at ReNew Vision; if a lump may be a growth rather than a chalazion, the eye doctor refers you for further tests and treatment.

How is a chalazion that does not go away treated?

If a chalazion lasts for many weeks despite warm compresses, or is large enough to trouble you, the eye doctor may advise a small procedure to drain it. It is usually done under local anaesthetic through the inside of the eyelid, so there is usually no visible scar on the skin. The eye may be padded for a few hours, the lid can look bruised for some days, and ointment or drops are used afterwards as prescribed. The eye doctor explains whether this, or another option, suits your lump. Treatment of styes and chalazia is done at ReNew Vision.

Why do they keep coming back?

Repeated styes and chalazia are often linked with blepharitis, an ongoing inflammation of the lid margins that makes the oil glands thick and easily blocked. Oily skin and skin conditions such as rosacea play a part too. A daily routine of warm compresses and lid cleaning, kept up even when the lids look fine, helps prevent new lumps. If you have diabetes, keeping your sugar controlled helps the eyelids heal. Itchy, rubbing eyes from allergy can add to the problem; see itchy eyes: allergy or infection?

Styes and chalazia in children

Children get styes and chalazia often, partly because they rub their eyes with unwashed hands. Teach handwashing, and use warm compresses gently. A chalazion that stays for weeks, or a child who squints or tilts the head because of a lump, should be seen, because a lump pressing on the eye can change the spectacle power and affect how the eye develops. See children's eye care.

How do I book?

ReNew Vision Eye Hospital, 2nd floor, Pai Hospital building, Vaddem Merces Road, Vaddem, Vasco da Gama. Eye OPD Monday to Saturday, 4 pm to 7 pm. Call or WhatsApp 072489 88039.

Questions patients ask

Is a stye contagious?

Not in the usual sense, but the bacteria can spread on hands, towels and eye make-up. Wash your hands, use your own towel and stop eye make-up until it has healed.

How long does a chalazion last?

Many settle within a few weeks with warm compresses, but some last for months. If one has not improved after several weeks, or troubles your vision, see the eye doctor.

Can I pop a stye?

No. Squeezing or pricking a stye can push the infection deeper into the eyelid. Use warm compresses and let it drain on its own, or see the eye doctor.

Do styes and chalazia need surgery?

Rarely. Most settle with warm compresses and lid cleaning. A chalazion that lasts for many weeks, or is large, may be drained with a small procedure through the inside of the lid, as the eye doctor advises.

Can I wear contact lenses or eye make-up with a stye?

No. Stop both until the lid has healed, and throw away eye make-up you were using when the stye started, because it can carry the bacteria.

This page is general eye-health information, not personal medical advice. Your eye doctor advises you after examining your eyes.