Styes

Summary

• A stye is an abscess in a gland of the eyelid
• It is caused by a bacterial infection
• Treatment consists of hot compresses or (occasionally) incision and drainage to remove the pus
• If the stye is particularly large or painful, or if the skin around the eye is red and swollen, you should see a doctor

What is a stye or external hordeolum?

A stye is an abscess in the eyelid. The abscess forms in the glands of the eyelid. It is usually associated with blepharitis, which is an infection of the eyelash.

What causes styes?

The usual cause is a bacterium called Staphylococcus areus. This bacterium is a natural skin organism , but may invade the glands.

Who gets styes and who is at risk?

Styes are common in children, but can occur in people of any age.

What are the symptoms and signs of a stye?

The margin of the eyelid becomes painful, tender and red. A small pimple forms, the eye may water a lot, and become light sensitive. 

Eventually the pimple comes to a head, the pus is released, the pain settles and the stye heals. If the stye becomes large or painful, or if the eyelid skin around the eye gets swollen and red, the patient should see a doctor urgently. Occasionally the infection may spread and affect the brain and related structures.

How is a stye treated?

Hold a wet cloth or other heat-retaining object (e.g. a boiled egg or baked potato wrapped in cloth) against the eyelid with the eye closed. The object must be as warm as possible, but not hot enough to cause burning. This will speed up the process of the pimple coming to a head and is called pointing. Once this has happened and the pus is expelled, the stye should get better on its own.

If the stye becomes very large and painful, see your doctor, since it may need to be opened up and an antibiotic ointment applied. If it is not treated at this stage, the infection may spread to the eyelid and the tissues around the eye, and oral antibiotics may be required.

When to see your doctor

If the stye is

• Large
• Painful
• Not settling
• Associated with red and swollen skin around the eye
• Associated with a fever or drowsiness.

Reviewed by Dr L.C. Boezaart

Reviewed by Dr Kgao Legodi, Ophthalmologist, (OSSA member), November 2010