Internal Stye: Symptoms, Causes, Treatment

What are the symptoms of an internal stye?

An internal stye, also known as an internal hordeolum, is an infection of the meibomian glands located inside the eyelid. The symptoms of an internal stye include:

1. Pain and Tenderness: The affected area of the eyelid is usually painful and tender to the touch.
2. Swelling: Swelling of the eyelid is common and may cause the eye to feel puffy.
3. Redness: The inside of the eyelid often becomes red and inflamed.
4. Bump or Lump: A visible bump or lump may form on the inside of the eyelid.
5. Discomfort: General discomfort in the eye, which can feel irritated or sore.
6. Tearing: Increased tearing or watering of the eye.
7. Crusting: Crusting may form along the eyelid margin.
8. Blurred Vision: If the stye is large enough, it can press against the eyeball, causing blurred vision.
9. Sensitivity to Light: Increased sensitivity to light (photophobia) can occur.

Internal styes typically develop over a few days and may resolve on their own within a week or so. However, if the symptoms are severe, persistent, or if the stye does not improve, it is important to seek medical attention. Treatment may include warm compresses, good eyelid hygiene, and in some cases, antibiotic ointments or drops. In more severe cases, a doctor may need to drain the stye.

What are the causes of an internal stye?

An internal stye, or internal hordeolum, is caused by an infection of the meibomian glands located within the eyelid. The primary causes and contributing factors for developing an internal stye include:

1. Bacterial Infection: The most common cause is a bacterial infection, usually by Staphylococcus aureus. These bacteria can enter the gland through tiny openings at the base of the eyelashes.
2. Blocked Glands: Meibomian glands can become blocked by oils, dead skin cells, or other debris, leading to an infection.
3. Poor Hygiene: Touching the eyes with unwashed hands, not removing makeup properly, or using contaminated eye cosmetics can introduce bacteria and increase the risk of infection.
4. Preexisting Conditions: Certain skin conditions, such as blepharitis (inflammation of the eyelids) and rosacea, can increase the risk of developing styes.
5. Contact Lenses: Improper use of contact lenses, such as not cleaning them properly or wearing them for extended periods, can introduce bacteria to the eye area.
6. Eye Makeup: Using old or contaminated eye makeup can contribute to the development of styes.
7. Hormonal Changes: Hormonal fluctuations can affect the oil production in the meibomian glands, leading to blockages and infections.
8. Stress and Fatigue: These factors can weaken the immune system, making the body more susceptible to infections, including those affecting the eyes.
9. Chronic Conditions: Individuals with diabetes or other conditions that affect the immune system may be more prone to developing styes.

Practicing good eyelid hygiene, avoiding touching the eyes with dirty hands, properly cleaning contact lenses, and using clean eye makeup can help reduce the risk of developing an internal stye.

How is the diagnosis of an internal stye made?

The diagnosis of an internal stye (internal hordeolum) is typically made through a clinical evaluation by a healthcare provider, usually an ophthalmologist or optometrist. The steps involved in diagnosing an internal stye include:

1. Medical History: The healthcare provider will ask about your symptoms, their duration, and any factors that may have contributed to the development of the stye, such as recent eye infections, contact lens use, or eyelid hygiene practices.
2. Visual Examination: The provider will examine the affected eyelid and eye using a magnifying instrument, such as a slit lamp, to get a close and detailed view of the eyelid’s inner surface and the meibomian glands.
3. Palpation: The provider may gently press on the eyelid to assess the tenderness, the presence of a lump or bump, and any discharge.
4. Assessment of the Eye and Surrounding Areas: The provider will check for signs of infection, inflammation, or other abnormalities in the eye and surrounding tissues.
5. Differential Diagnosis: The healthcare provider will differentiate the internal stye from other possible conditions with similar symptoms, such as chalazion (a non-infectious blockage of the meibomian gland), blepharitis, or other eyelid cysts or tumors.
6. Additional Tests (if needed): In most cases, the visual examination and medical history are sufficient for diagnosis. However, if the stye does not improve with treatment or if there is suspicion of a more serious condition, the provider may order additional tests, such as bacterial cultures or imaging studies, to rule out other issues.

If you suspect you have an internal stye, it is important to see a healthcare provider for an accurate diagnosis and appropriate treatment.

What is the treatment for an internal stye?

The treatment for an internal stye (internal hordeolum) aims to relieve symptoms, promote healing, and prevent complications. Here are common approaches to treating an internal stye:

1. Warm Compresses: Applying a warm compress to the affected eyelid several times a day can help reduce pain, promote drainage of the stye, and relieve inflammation. Use a clean cloth soaked in warm water (not too hot) and apply gently to the closed eyelid for 10-15 minutes at a time.
2. Eyelid Hygiene: Keeping the eyelids clean is important to prevent further irritation and infection. You can gently clean the eyelid with mild soap and water or with commercial eyelid cleansers as recommended by your healthcare provider.
3. Avoid Squeezing: It’s important not to squeeze or attempt to pop the stye, as this can spread the infection and lead to complications.
4. Topical Antibiotics: In some cases, your healthcare provider may prescribe antibiotic ointments or drops to apply to the affected eyelid to help clear the infection. Follow the instructions provided by your healthcare provider carefully.
5. Oral Antibiotics: If the infection is severe or does not respond to topical treatments, oral antibiotics may be prescribed.
6. Steroid Injections (rarely): In certain cases where there is significant inflammation and swelling, a steroid injection into the stye may be considered to reduce inflammation.
7. Pain Relief: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate discomfort and reduce inflammation.
8. Avoid Contact Lenses and Eye Makeup: To prevent further irritation and infection, avoid wearing contact lenses and using eye makeup until the stye has healed completely.
9. Follow-Up: It’s important to follow up with your healthcare provider if the stye does not improve with treatment or if symptoms worsen. They may need to reassess the condition and adjust the treatment plan if necessary.

Most internal styes improve within a few days to a week with appropriate treatment. If you have recurring styes or if the stye persists despite treatment, your healthcare provider may investigate underlying causes or recommend further management.