What are stye treatment options and medications? How long do styes last?
A noninfected sty will resolve on its own. Warm compresses will help soften the material in the gland, allowing the gland's contents to drain naturally. Squeezing, popping, or cutting the hordeolum should be avoided as this can result in scarring.
A noninfected chalazion similarly will resolve on its own with the aid of warm compresses, though over a much longer period of time. A small chalazion may resolve within weeks, while larger ones may resolve over the course of a year. As the chalazion decreases in size, patients feel gradual relief from their symptoms.
The most conservative treatment is application of frequent warm (not too hot) compresses alone. This can be accomplished with a warm wet washcloth, microwaveable eye masks (sold at drugstores), or a plug-in electric heating pad. The key is to dedicate as much time as possible to treatment with the warm compress. Several minutes at a time (for example, 15 minutes), several times a day (for example, four times per day) will improve the odds that the sty or chalazion will clear on its own. A child may need help applying the warm compress. Be sure to check the temperature of the compress against another part of your skin, such as the back of your hand, to ensure the compress does not burn your eye or face.
An ophthalmologist can inject a steroid into the lesion, often resulting in a speedier resolution. However, this carries a small risk of bleeding/bruising, depigmentation/thinning of the skin, scar, pain, and in very rare cases, loss of vision.
Finally, the chalazion can be incised and drained. This is the most invasive method and is reserved as a last resort by most eye doctors. The eyelid is anesthetized, and a clamp is placed around the chalazion. The eyelid is everted, and the meibomian gland is incised from the back surface of the eyelid, avoiding cutting the skin on the front surface. The waxy sebum is scooped out of the gland with a special curette. This debulking of the gland's contents may be sufficient to shrink the chalazion; however, there is risk that the chalazion may recur, particularly if the underlying cause is not addressed.
If a sty appears infected, oral antibiotics may be necessary. An abscess can form in the eyelid. A culture of the material in the chalazion is sometimes obtained to identify the bacterium. Antibiotic treatment is particularly important if the bacterial infection is spreading along the skin (cellulitis) or spreading into the orbit (orbital cellulitis). Orbital cellulitis is considered an emergency, as rapidly spreading infection can be vision or life-threatening. Orbital cellulitis treatment usually requires intravenous antibiotics.
In some situations, the infection spreads to the eye itself. If conjunctivitis (pinkeye) develops, topical ophthalmic antibiotics (antibiotic ointments or drops) might be necessary.
Treatment of the underlying cause of the sty is also important to prevent recurrence.
Some eye doctors will recommend not wearing contact lenses until the sty resolves. This is especially the case if there's concern about a concurrent infection.