On this page
Most styes go away on their own within a few days. This page is for people whose situation is different: a chalazion that has not gone away for weeks, or styes and chalazia that keep coming back, sometimes in the same eyelid. We explain what the eye doctor may do, why the lumps come back, how treating the eyelid margins may reduce recurrence, and when you need to get checked without waiting.
When to see a doctor straight away: swelling and redness that spread to the whole eyelid or to the skin around the eye, a fever, pain when moving the eye, reduced vision, double vision or any other change in vision, or an eye that bulges forward. These may be signs of an infection of the tissues around the eye, which needs urgent treatment. In addition, a lump that keeps coming back in exactly the same place, especially in adults, or that has loss of lashes next to it or a change in the appearance of the eyelid margin, should be examined by an eye doctor. The eye doctor will want to rule out other causes of the lump, and sometimes will send the tissue for testing.
Stye or chalazion, in brief
A stye is an acute, painful inflammation of a gland in the eyelid, and a chalazion is a lump that forms when a meibomian gland (an oil gland inside the eyelid) becomes blocked; it is usually less painful and grows slowly. Sometimes a stye that has not opened turns into a chalazion. You will find a full basic explanation of the differences in the guide to styes and chalazia on the Mitzmutz site.
In the first days: home care
The main step is a warm compress, pleasantly warm (not scalding), on the closed eyelid, for about ten minutes, several times a day, together with gentle cleaning of the eyelid margins and stopping eye make-up and contact lenses until the lump has gone. Do not squeeze or prick it. Research on home treatments is limited (a Cochrane review by Lindsley and colleagues), but this is a simple, safe treatment, and most styes improve with it. More details are in the guide on the Mitzmutz site.
A chalazion that will not go away: what the eye doctor may do
A chalazion can last for weeks or even months. But when the lump has not got smaller after several weeks of compresses, or it grows, interferes with vision, presses on the eye or simply bothers you, it is worth getting checked.
In most cases the diagnosis is made with an examination of the eyelid with a slit lamp (a microscope for examining the eye). Depending on the situation, the eye doctor may suggest:
- Continuing compresses and eyelid cleaning, when the lump is on its way to healing.
- An antibiotic ointment, or antibiotic tablets when there are signs of a spreading infection.
- For a stubborn chalazion: a local steroid injection or drainage in a minor procedure, done by an eye doctor when indicated.
Drainage of a chalazion is usually done under local anaesthetic, and in most cases through a small cut on the inner side of the eyelid, so there is no scar on the skin. A steroid injection is an even shorter procedure, and in some patients it shrinks the lump without a cut, but it may sometimes cause lightening of the skin at the injection site. Each option has advantages and risks, and the eye doctor will explain what suits your lump.
To make the examination as useful as possible, tell the doctor how long the lump has been there, whether there have been previous lumps and where, and whether you also have dry or burning eyes, red eyelids in the morning or redness of the skin of your face. These details help to understand whether this is a one-off event or part of an ongoing problem at the eyelid margins.
It is important to remember that treating the lump itself solves today's problem. To stop the next lump from appearing, you need to look at the cause.
A stye on the upper eyelid
A stye or chalazion on the upper eyelid is treated the same way as on the lower eyelid. The difference is mainly in appearance: swelling of the upper eyelid may look large, and sometimes make it hard to open the eye. A large chalazion on the upper eyelid may also press on the cornea (the clear window at the front of the eye) and cause blurring, which is a good reason to get checked. And if the swelling spreads or a fever appears, see a doctor straight away, as described above.
Why do styes and chalazia keep coming back?
For someone who gets a stye once every few years, it is usually a chance event. But when styes and chalazia keep coming back, there is often an ongoing problem at the eyelid margins in the background:
- MGD (meibomian gland dysfunction). The oil in the glands is too thick, the openings become blocked, and every blocked gland is a candidate for the next chalazion. This is also one of the most common causes of dry eye.
- Blepharitis (inflammation of the eyelid margins). Deposits, bacteria and chronic inflammation around the lashes increase the chance of infection of a follicle or gland.
- Demodex mites, which live in the lash follicles and the oil glands, and may contribute to blockages and inflammation.
- Rosacea, an inflammatory skin disease that often also affects the eyelids and the meibomian glands.
That is why people with recurring styes often also complain of dry, burning eyes or red eyelids. These are parts of the same picture.
Eyelid margin care to reduce recurrence
The basis is a simple daily routine, even in quiet periods: a warm compress, gentle cleaning of the eyelid margins, removing make-up every evening and regularly replacing mascara and eyeliner. The American Academy of Ophthalmology guidelines on blepharitis stress that this is ongoing treatment, not something you do only when there is a flare-up.
When the home routine is not enough and the lumps keep coming back, it is worth having the glands and the eyelid margins checked closely. In dry eye testing, meibomian gland function is assessed, deposits and Demodex are looked for, and the tear film is checked. Depending on the findings, the Dry Eye Clinic in Haifa can combine:
- Meibomian gland expression, which empties the thick oil from the blocked glands.
- Eyelid margin cleaning with BlephEx, which removes deposits and a layer of bacteria from the base of the lashes, when there is blepharitis or Demodex.
- IPL treatment (broad-spectrum pulsed light, not a laser), when there is MGD or rosacea, usually together with gland expression.
When there is marked MGD or rosacea, the doctor may also consider a treatment by mouth from the tetracycline group, given here mainly for its anti-inflammatory effect. Research on preventing recurring styes is still limited, but treating the glands and the eyelid margins targets the cause that leads to them, and it may reduce recurrence in some patients and also improve the dryness.
Treatment like this is usually a process rather than a one-off procedure: it starts with an examination, home care is combined with treatment at the clinic as needed, and the follow-up visit checks whether the lumps are appearing less often. If a lump keeps coming back despite treatment, especially in the same place, that is a reason to be examined again by the eye doctor.
In summary
A single stye is usually a matter of a few days and a warm compress. A chalazion that has not gone away after several weeks is worth showing to an eye doctor, and lumps that keep coming back are a sign that the eyelids need attention. If you recognise yourself in this description, with recurring styes, red eyelids and eyes that dry out, it is worth having your eyelids and glands checked in a proper examination, and building a plan together that suits you, at home and at the clinic.
Want a basic explanation first?For basic information on styes and chalazia: the guide on the Mitzmutz site
Frequently asked questions
I have had a chalazion for several weeks and it is not going away. What should I do?
A chalazion can last a long time, but if it has not got smaller after several weeks of compresses, or it grows, interferes with vision or presses on the eye, it is worth being examined by an eye doctor. The doctor may suggest continuing home care, or consider a local steroid injection or drainage in a minor procedure, depending on the situation.
Is a stye on the upper eyelid more dangerous?
Usually not. A stye on the upper eyelid is treated the same way as one on the lower eyelid, but swelling of the upper eyelid may look large and make it hard to open the eye. If the swelling spreads to the whole eyelid or to the skin around the eye, or there is a fever, pain when moving the eye or a change in vision, see a doctor urgently.
How long does a stye take to go away?
An ordinary stye usually improves within about one to two weeks with warm compresses. A chalazion can last for weeks or even months. If there is no improvement, or the lump grows, it is worth being examined.
Can I squeeze a stye?
No. Squeezing or pricking a stye may make the inflammation worse and spread the infection to the surrounding tissues. Let it drain on its own with the help of heat, and if that does not happen, see a doctor.
Why does it keep coming back?
Recurring styes and chalazia are often linked to meibomian glands that are not working well or to blepharitis. Treating the eyelid margins and the glands, at home and at the clinic, may reduce how often they come back in some patients.
Home care not enough? We can look into it.
At the dry eye clinic in Haifa we find out what is causing the dryness and build a personal treatment plan.
Sources
- Lindsley K, Nichols JJ, Dickersin K. Non-surgical interventions for acute internal hordeolum. Cochrane Database Syst Rev. 2017;1:CD007742.
- Amescua G, Akpek EK, Farid M, et al. Blepharitis Preferred Practice Pattern®. Ophthalmology. 2019;126(1):P56-P93.
- Nichols KK, Foulks GN, Bron AJ, et al. The International Workshop on Meibomian Gland Dysfunction: executive summary. Invest Ophthalmol Vis Sci. 2011;52(4):1922-1929.
- Geerling G, Tauber J, Baudouin C, et al. The International Workshop on Meibomian Gland Dysfunction: report of the subcommittee on management and treatment of meibomian gland dysfunction. Invest Ophthalmol Vis Sci. 2011;52(4):2050-2064.
- Cronau H, Kankanala RR, Mauger T. Diagnosis and management of red eye in primary care. Am Fam Physician. 2010;81(2):137-144.
The information on this site is general only. It is not medical advice and does not replace an examination by an eye doctor.