Q: My son has a recurring stye in his right eye. How should we treat it and, better yet, prevent it?
A: A stye is a common condition and often appears as a red lump near the edge of the eyelid. It occurs when an oil gland in the eyelid becomes infected. It is usually slightly painful, especially when touched. A related condition is a chalazion. A chalazion occurs when this oil gland becomes clogged with oil. Chalazia are usually farther away from the margin of the eyelid, are not painful and are usually larger than styes. It is important to treat a stye, because if it doesn’t heal it may turn into a chalazion.
The most important treatment for a stye is warm compresses. A warm compress is best done by soaking a clean washcloth in hot water and applying the washcloth to the eyelid for 10 to 15 minutes, three to four times per day, until the stye is gone. Repeatedly soak the cloth in warm water to provide adequate heat. This allows the clogged gland to open and the infection and inflammation to resolve. One cause of a persistent stye is insufficient warm compresses — either too infrequent, not done for long enough or the compress not being warm enough. An antibiotic ointment may be prescribed if the stye does not improve after treatment with warm compresses.
If a chalazion forms, the treatment is similar: The patient should use frequent warm compresses and antibiotic ointment. If this is not sufficient, the child’s ophthalmologist may prescribe a combination antibiotic-and-steroid ointment.
Finally, if the chalazion does not resolve with warm compresses and the antibiotic-steroid ointment, the ophthalmologist may recommend surgical excision. For young children, this procedure would need to be done in the operating room under general anesthesia. Older teenagers may be able to tolerate having the procedure done in the ophthalmologist’s office with local anesthesia.
There are some children who, despite the use of frequent and adequate warm compresses and topical medication, have recurrent problems with stye and chalazion formation, in multiple sites and on more than one eyelid. In these circumstances, the ophthalmologist and/or primary care physician may prescribe oral antibiotics to be used on a daily basis over several months in order to prevent stye/chalazion formation.
Dr. Mary Louise Z. Collins
Director, Pediatric Ophthalmology and Strabismus, Greater Baltimore Medical Center Department of Ophthalmology