Stye and chalazion - Symptoms, Causes, Images, and Treatment Options

Diseases

Highlights & Basics

Key Highlights

Styes (hordeola) are typically tender to palpation, while chalazia are not.
Dacryoadenitis (infection or inflammation of the lacrimal gland) and dacryocystitis (infection of the lacrimal sac) can be confused with stye; their respective locations (lateral upper lid and inferior to the medial epicanthus) are key.
Most styes and chalazia resolve with warm compresses and topical antibiotics.
Recurrent lesions may require biopsy to exclude carcinomas. Recurrent chalazia may require excision.

Quick Reference

History & Exam
- Key Factors
- Other Factors
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Diagnostics Tests
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Treatment Options
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Definition

Epidemiology

Etiology

Pathophysiology

Images

Left upper lid internal hordeolum with limited cellulitis
Left lower lid external hordeolum
Lower lid chalazion of the left eye

Citations

Key Articles

The College of Optometrists. Clinical management guidelines: hordeolum. Feb 2023 [internet publication].[Full Text]
Carlisle RT, Digiovanni J. Differential diagnosis of the swollen red eyelid. Am Fam Physician. 2015 Jul 15;92(2):106-12.[Abstract][Full Text]
Gordon AA, Danek DJ, Phelps PO. Common inflammatory and infectious conditions of the eyelid. Dis Mon. 2020 Oct;66(10):101042.[Abstract]
The College of Optometrists. Clinical management guidelines: chalazion (meibomian cyst). Feb 2023 [internet publication].[Full Text]

Referenced Articles

1. Mueller JB, McStay CM. Ocular infection and inflammation. Emerg Med Clin North Am. 2008 Feb;26(1):57-72;vi. [Abstract]
2. The College of Optometrists. Clinical management guidelines: hordeolum. Feb 2023 [internet publication].[Full Text]
3. Carlisle RT, Digiovanni J. Differential diagnosis of the swollen red eyelid. Am Fam Physician. 2015 Jul 15;92(2):106-12.[Abstract][Full Text]
4. Gordon AA, Danek DJ, Phelps PO. Common inflammatory and infectious conditions of the eyelid. Dis Mon. 2020 Oct;66(10):101042.[Abstract]
5. McAlinden C, González-Andrades M, Skiadaresi E. Hordeolum: acute abscess within an eyelid sebaceous gland. Cleve Clin J Med. 2016 May;83(5):332-4.[Abstract][Full Text]
6. The College of Optometrists. Clinical management guidelines: chalazion (meibomian cyst). Feb 2023 [internet publication].[Full Text]
7. Arbabi EM, Kelly RJ, Carrim ZI. Chalazion. BMJ. 2010 Aug 10;341:c4044.[Full Text]
8. Lin A, Ahmad S, Amescua G, et al. Blepharitis preferred practice pattern®. Ophthalmology. 2024 Apr;131(4):P50-86.[Full Text]
9. Wojtowicz JC, Butovich IA, McMahon A, et al. Time-dependent degenerative transformations in the lipidome of chalazia. Exp Eye Res. 2014 Oct;127:261-9.[Abstract]
10. Ansari AS, de Lusignan S, Hinton W, et al. The association between diabetes, level of glycaemic control and eye infection: cohort database study. Prim Care Diabetes. 2017 Oct;11(5):421-9.[Abstract]
11. Evans J, Vo KBH, Schmitt M. Chalazion: racial risk factors for formation, recurrence, and surgical intervention. Can J Ophthalmol. 2022 Aug;57(4):242-6.[Abstract]
12. Dalvin LA, Smith WM. Orbital and external ocular manifestations of mycobacterium tuberculosis: a review of the literature. J Clin Tuberc Other Mycobact Dis. 2016 Aug;4:50-7.[Abstract][Full Text]
13. Wald ER. Periorbital and orbital infections. Infect Dis Clin North Am. 2007 Jun;21(2):393-408;vi.[Abstract]
14. Shields JA, Demirci H, Marr BP, et al. Sebaceous carcinoma of the eyelids: personal experience with 60 cases. Ophthalmology. 2004 Dec;111(12):2151-7.[Abstract]
15. Lindsley K, Nichols JJ, Dickersin K. Non-surgical interventions for acute internal hordeolum. Cochrane Database Syst Rev. 2017 Jan 9;1(1):CD007742.[Abstract][Full Text]
16. Alsoudi AF, Ton L, Ashraf DC, et al. Efficacy of care and antibiotic use for chalazia and hordeola. Eye Contact Lens. 2022 Apr 1;48(4):162-8.[Abstract]
17. American Academy of Ophthalmology. Referral of persons with possible eye diseases or injury - 2014. Apr 2014 [internet publication].[Full Text]
18. Wu AY, Gervasio KA, Gergoudis KN, et al. Conservative therapy for chalazia: is it really effective? Acta Ophthalmol. 2018 Jun;96(4):e503-9.[Abstract][Full Text]
19. Goawalla A, Lee V. A prospective randomized treatment study comparing three treatment options for chalazia: triamcinolone acetonide injections, incision and curettage and treatment with hot compresses. Clin Exp Ophthalmol. 2007 Nov;35(8):706-12.[Abstract]
20. Chung CF, Lai JS, Li PS. Subcutaneous extralesional triamcinolone acetonide injection versus conservative management in the treatment of chalazion. Hong Kong Med J. 2006 Aug;12(4):278-81.[Abstract][Full Text]
21. Ben Simon GJ, Rosen N, Rosner M, et al. Intralesional triamcinolone acetonide injection versus incision and curettage for primary chalazia: a prospective, randomized study. Am J Ophthalmol. 2011 Apr;151(4):714-8.e1.[Abstract]
22. Aycinena AR, Achiron A, Paul M, et al. Incision and curettage versus steroid injection for the treatment of chalazia: a meta-analysis. Ophthalmic Plast Reconstr Surg. 2016 May-Jun;32(3):220-4.[Abstract]
23. Wong MY, Yau GS, Lee JW, et al. Intralesional triamcinolone acetonide injection for the treatment of primary chalazions. Int Ophthalmol. 2014 Oct;34(5):1049-53.[Abstract]
24. Cheng K, Law A, Guo M, et al. Acupuncture for acute hordeolum. Cochrane Database Syst Rev. 2017 Feb 9;(2):CD011075.[Abstract][Full Text]
25. Zhu D, Gupta RR, Stein RL, et al. Randomized prospective evaluation of microblepharoexfoliation BlephEx as adjunctive therapy in the treatment of chalazia. Cornea. 2023 Feb 1;42(2):172-5.[Abstract][Full Text]
26. Song X, Zhang C, Zhang S, et al. Therapeutic efficacy of optimal pulse technology in the treatment of chalazions. Front Med (Lausanne). 2023 Nov 21:10:1286159.[Abstract][Full Text]
27. Santa Cruz CS, Culotta T, Cohen EJ, et al. Chalazion-induced hyperopia as a cause of decreased vision. Ophthalmic Surg Lasers. 1997 Aug;28(8):683-4.[Abstract]
28. Jin KW, Shin YJ, Hyon JY. Effects of chalazia on corneal astigmatism : large-sized chalazia in middle upper eyelids compress the cornea and induce the corneal astigmatism. BMC Ophthalmol. 2017 Mar 31;17(1):36.[Abstract][Full Text]
29. Park YM, Lee JS. The effects of chalazion excision on corneal surface aberrations. Cont Lens Anterior Eye. 2014 Oct;37(5):342-5.[Abstract]
30. American Academy of Ophthalmology. What is the difference between a stye and a chalazion? causes, symptoms, treatment. Jun 2023 [internet publication].[Full Text]
31. American Optometric Association. Chalazion. [internet publication].[Full Text]
32. American Optometric Association. Hordeolum (stye). [internet publication].[Full Text]
33. Patient UK. Chalazion: eyelid cyst. Aug 2023 [internet publication].[Full Text]
34. Patient UK. Stye: eyelid infection. Jan 2024 [internet publication].[Full Text]