Stye or Chalazion? How to Tell and How to Treat a Bump on the Eyelid

A stye is a painful, red bump near the edge of the eyelid, usually at the base of an eyelash, caused by a small bacterial infection. A chalazion is a firmer, usually painless lump a little farther back in the eyelid, caused by a blocked oil gland. Both are common, both usually get better with warm compresses, and neither should ever be squeezed.

I see eyelid bumps nearly every week, and most people come in worried it's something serious. Usually it isn't. Here's how to tell what you have and what actually helps.

What is a stye?

A stye (doctors call it a hordeolum) is an infection of a small gland at the edge of the eyelid, most often at the root of an eyelash. It usually comes on over a day or two and looks like a small pimple on the lid margin.

Typical signs:

• a red, tender bump right at the lash line
• soreness when you blink or touch the lid
• a small yellow or white head that may form
• a watery eye or mild eyelid swelling

Some styes form on the inside of the eyelid instead. Those can make the whole lid swollen and sore without an obvious "head."

What is a chalazion?

A chalazion is a lump that forms when one of the oil glands inside the eyelid gets blocked. These glands, called meibomian glands, make the oil layer of your tears. When the oil can't get out, it builds up and the body walls it off into a firm, round bump.

Typical signs:

• a firm, rubbery lump, usually a bit back from the lash line
• little or no pain, especially after the first few days
• slow growth over days to weeks
• sometimes blurry vision, if a large one presses on the eye

A stye that doesn't fully drain can turn into a chalazion, so it's common to have one follow the other.

How can I tell which one I have?

A simple rule of thumb:

• Painful, red and at the edge of the lid? Probably a stye.
• Firm, mostly painless and a bit farther back in the lid? Probably a chalazion.

They can look alike, though, and a few other things can cause eyelid lumps. An exam is the only way to be sure, and it's quick.

What helps at home?

For both a stye and a chalazion, the first treatment is the same:

• Warm compresses. Hold a clean, warm (not hot) washcloth or a heated eye mask on the closed eyelid for 10 minutes, 3 to 4 times a day. The heat softens the trapped oil so the gland can drain.
• Gentle massage. After the compress, gently rub the eyelid in small circles, or toward the lashes, with a clean finger.
• Keep the lids clean. Wash your lids with a gentle lid cleanser or diluted baby shampoo once or twice a day.
• Take a break from eye makeup and contact lenses until it heals, and throw out mascara or liner you used while the stye was forming.

Don't squeeze or pop it. That can push the infection deeper into the eyelid and make it spread.

Many styes drain and heal within a week. A chalazion can take several weeks of steady warm compresses to shrink.

When does a stye or chalazion need a doctor?

Make an appointment if:

• the bump isn't getting better after a week or two of warm compresses
• it keeps coming back, especially in the same spot
• it's large enough to blur your vision or press on the eye
• you get styes again and again (often a sign of blepharitis or meibomian gland problems that we can treat)

Call us the same day if:

• the swelling spreads across the eyelid or to the cheek, or the skin turns red and hot
• you have a fever with eyelid swelling
• the eye itself hurts, your vision changes, or it's hard to move your eye

Those can be signs of cellulitis, an infection of the tissue around the eye, which needs prompt treatment. In children especially, a very swollen, red eyelid should be seen quickly.

What can an eye doctor do?

Depending on what we find, treatment may include:

• Prescription antibiotic ointment or drops, or oral antibiotics if the infection is spreading
• Treatment for the cause, such as blepharitis or meibomian gland dysfunction, so new bumps don't keep forming. This often overlaps with dry eye care.
• A steroid shot or minor procedure for a stubborn chalazion. Depending on the case, an eye doctor or eye surgeon does this.

A bump that keeps coming back in the same place, changes in appearance, or causes lashes to fall out should be looked at carefully. Rarely, an eyelid growth can be something other than a chalazion, and an exam tells the difference.

How we do it at Bolt Eye Group

At Bolt Eye Group, we look at the eyelid and the oil glands under the slit lamp microscope, so we can see whether it's a stye, a chalazion or something else, and why it formed. If you get them often, we look for the cause, like blocked oil glands, blepharitis or dry eye, and build a plan to keep your lids healthy.

On the days each office is open, we offer same-day visits for red, painful or swollen eyes at all five offices: Canton, East Cobb/Marietta, Lawrenceville, Riverdale and Johnson City, TN. Our post on red eye, pink eye and allergies covers other common reasons for a sore, red eye.

Frequently asked questions

Is a stye contagious?

Not really. A stye comes from bacteria that normally live on the skin, so it doesn't spread from person to person the way pink eye can. Still, wash your hands, don't share towels, and don't share eye makeup.

How long does a chalazion last?

Many go away within a few weeks with daily warm compresses. Some last longer, and a large or stubborn chalazion may need an injection or a minor procedure.

Can I wear contact lenses with a stye?

It's best to switch to glasses until it heals. Contacts can trap bacteria and irritate the eye, and you'll be touching the eye more than usual.

Why do I keep getting styes?

Repeat styes usually point to a problem with the eyelid oil glands, like blepharitis or meibomian gland dysfunction, which also cause dry eye. Treating the lids often stops the cycle.

Should I pop a stye like a pimple?

No. Squeezing can spread the infection deeper into the eyelid. Warm compresses let it drain on its own safely.

Book an exam at your nearest Bolt Eye Group office

Have a bump on your eyelid that won't go away? Book a visit at Bolt Eye Group in Canton, East Cobb/Marietta, Lawrenceville, Riverdale or Johnson City, TN. Same-day visits are available for red, painful or swollen eyes on the days each office is open. Find your office and book online.