Styes (Chalazion and Hordeolum): Causes, Treatment, and Prevention

Lumps on the eyelid:
They fall into two broad types.

A stye (“monomorai”) is not contagious.
「conjunctivitis” is also something different.

Styes: Causes, Treatment, and Prevention

“Chalazion”: non-infectious

　The oil-producing glands at the edge of the eyelid (meibomian glands) become blocked
→ fat builds up and causes inflammation
→ swelling / a lump forms

○ Some appear on the inside of the eyelid and some on the outside.
　Depending on the clinical findings, eye drops, ointment, or oral medicine are used as appropriate.

○ In children, a chalazion often gets better over time.
It very often heals over a period of several months.
（It can heal without cutting, with eye drops alone(or by spontaneous healing).
It may also break open and discharge pus.

○ There is often little pain.

○ At first the whole eyelid swells, and within a few days a round lump forms.

○ If it does not heal with eye drops for some time, incision of the chalazion is considered.
(In adults, this is done as an outpatient procedure under local anesthesia.)

　Eye drops (antibiotic and anti-inflammatory) are continued until it is completely healed.

“Hordeolum”: infectious

Bacteria infect the oil glands (sebaceous glands) of the eyelid.
→ swelling / continued pain (suppuration progresses)
　In the early stage, a hordeolum can sometimes be itchy.

○ In 75–95% of cases, Staphylococcus aureus is the causative bacterium.
　Together with others such as Staphylococcus epidermidis, normal resident bacteria are the cause.
　These bacteria are found everywhere in our living environment, so it can happen to anyone.

○ Treatment centers on antibiotics (eye drops and oral).

○ Sometimes the lump is incised to drain the pus.

Telling a Chalazion From a Hordeolum

In both cases, the whole eyelid swells in the early stage, so it may be impossible to tell them apart.

If it does not hurt, a non-infectious chalazion is suspected; if it hurts, an infectious hordeolum is suspected.

A white “pus point” may be visible.

To help it heal faster,
after anesthetic eye drops, we may pierce it with a needle under the slit lamp microscope to drain some of the pus or contents (first aid).

Prevention and Points to Watch

○ Warm the eyelids
This is effective because it relieves the oil blockage in the meibomian glands.
Warm them with a bath towel,a hot eye mask, and so on

　✔ Warming is better than cooling.

○ Be careful with eye makeup
It can block the meibomian glands:

Using an eye shampooseems to be effective.
It keeps the edges of the eyelids clean.

○ Refrain from wearing contact lenses
They touch the edge of the eyelid directly and can worsen inflammation.

Addendum: different names for styes (dialects)

“Monomorai” is the common name for the two conditions above, “chalazion” and “hordeolum.”
The name seems to differ quite a lot by region.
Instead of “monomorai,” there are many dialect words such as “mebachiko.”

There was a stye map😳 (from Rohto).

In Fukuoka Prefecture,
meibo, mebachiko, mebo, memorai

I feel I have heard all of them.