Stye – Causes, Symptoms, Remedies, Treatment

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S
Stye is an inflammatory condition occurring in the eyelids. It is most often caused by an infection with Staphylococcus bacteria. It is also known as hordeolum. 
Read – Anatomy of Eye: Netra Rachana: Ayurveda Perspective

Introduction, causes, symptoms

It is an infection of one of the oil producing glands present inside the eyelid. Infection is usually caused by staphylococcus bacteria. Stye manifests in the form of an abscess or boil / lump / pimple. It is often red and painful. Most of the stye form on the outside of the eyelid, but some of them also develop inside the eye.

Styes rarely affect both eyes simultaneously. But stye occurring in both eyes cannot be ruled out. There may be one or more stye in a eyelid.
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Causes –
Stye / hordeolum is usually caused by staphylococcus aures bacteria. Affects all age group. Common in infants and children.
Read – Classification of Eye Diseases As Per Ayurveda

Types of Stye
1. External Hordeolum
External hordeolum are also called as external styes. They occur on outer edge of the eyelids. They often become big and painful when touched, get filled with pus when they get severely infected and become yellow.

They are caused following an infection in one of the below mentioned structures of the eyelid –

• Follicle of the eyelash
• Zeis (sebaceous) glands attached to the eyelash follicle and produces sebum, which in turn lubricates the eyelash
• Moll (apocrine) gland, sweat gland that opens into the eyelash follicle
  Read – Kaphaja Upanaha (Netra Roga) – Definition, Symptoms, Treatment

2. Internal hordeolum
Internal hordeolum is also called as internal stye. In this, the swelling develops inside the eyelid. Internal stye are a bacterial infection of meibomian glands inside the eyelids. These glands produce a type of secretion which make up the film that covers the eye. They are more severe in nature but are less frequent than their external counterparts. They are also painful than the external styes. It may appear either on the upper or lower eyelid.

Internal styes may also present with burning sensation of the eyes, crusting of the margins of the eyelids, tearing and stickiness of the eyelids, itching of the eye, discomfort while blinking and also sensitivity to the light.
Read – Chaturvidha Netra Srava – 4 types of eye discharges, symptoms, treatment

Signs and Symptoms of Stye –

• Presence of a swollen lump or boil on upper or lower eyelid
• Localized swelling of eyelid
• Mild to moderate pain in the lid
• Tenderness of eyelid
• Droopiness of eyelid
• Itching of the eye / eyelid
• Redness of the affected eyelid / eye
• Burning sensation in eye
• Irritation and light sensitivity
• Mucus or water discharges from the affected eye
• Sense of a foreign body in the eye
• Blurring vision
• Discomfort at blinking
• Crusting of eyelid margins
  Read – Watery Eyes: Causes, Ayurvedic Treatment, Remedies

Appearance, Risk factors, prevention

Appearance –
Internal stye tends to come to a point on the underside of the eyelid. It presents with general redness on the outer and visible part of the lid. (source)

Risk Factors –

• Poor eye care
• Poor nutrition
• Using out-dated and expired cosmetics, especially eye cosmetics
• Not removing makeup, especially eye makeup before retiring to the bed
• Changing contact lenses with dirty hands
• Putting on the contact lenses without disinfecting them
• Sharing face towels / napkins with those having stye
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Prevention –

• Stye can be prevented by improving hygiene around the eyelid and taking care of the eye, especially those who had stye previously.
• One should keep their hands and eyes clean.
• Women should not share cosmetics with others and remove eye makeup every night.
• Should not share clothes, face towels and napkins with person having stye. Also, one should not share pillow-cases, bed-sheets, wash-clothes or towels. This would increase the risk of cross infection.

Sometimes stye occurs as a complication of blepharitis, an inflammatory condition of the eyelids. Proper care of blepharitis can prevent occurrence of stye.
Read – Blepharitis: Inflamed Eyelids Ayurvedic Treatment, Remedies

Home remedies, treatment

Home Remedies for Stye
Give time – Stye usually go away on their own without the need of interventions or medicines. Symptoms subside and improvement can be seen once the stye breaks open.

Don’t touch or puncture – One should not try to forcibly open the stye.

Cleansing the eyes regularly – Eyelids should be cleansed. Dilute baby shampoo on a clean washcloth helps you do it. Following this rinse your eyes with clean warm water. Later pat your eyes and lids dry. Make sure to wash your hands before and after touching the stye. Pre-moistened eyelid cleansing pads can also be used. They are available in the drug stores.
Read – Ayurveda Eye Treatment Types, Methods – Ashtanga Hrudaya Sutrasthana 23

Stop makeup and contact lenses – Stop wearing make-ups, discard old makeup or applicators. They may be contaminated, if used they may worsen the condition. Until the stye heals, wear glasses, not contact lenses.

Compresses – Hot / warm compresses will often take care of styes most of the time and may not need treatment. The compresses need to be applied for 3-4 times a day, with each session comprising of 10-15 minutes. This allows opening the blocked pores of oil glands of the lids and allows proper drainage. It will also enable drainage of pus. This eventually enables the eyes to heal all by itself.

Once the discharges are let out, the symptoms including pain and discomfort will reduce. If the warm compress is given using cloth dipped in hot / warm water, care should be taken to see that the water is not too hot. The heat of the compress should be felt on ones hand before applying. The warmth should be tolerable. We need to remember that the eye is a sensitive organ and an important one too. Special cares should be taken especially when applying compresses to a child.
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Warm tea bag – Warm tea bag may be used in place of warm compresses. Black tea works best. It reduces swelling. It also has antibacterial action. Drop the tea bag intended to use for your eye in hot water mug, just like you do it while preparing tea. Let the tea steep for about a minute. Wait until the tea bag cools enough and is not too hot so that you can place it on your eyelid.

Feel the temperature of the bag before you keep it on your eyelid. Once you feel that the temperature is good enough and your eye can tolerate, keep the bag for 5-10 minutes on the eye / eyelid. For each eye, use separate tea bag. Every time use new tea bag and discard the used ones.
Read – Tarpana Putapaka – Ayurveda Eye Care – Ashtanga Hrudaya Sutrasthana 24

Give a Triphala wash – Triphala is a known remedy for eye disorders. It is a powder prepared from fruits of Terminalia chebula, Terminalia bellirica and Emblica officinalis.

Take coarse powder of Triphala. Boil it in water on moderate steam. Strain the powder. Allow the Triphala liquid to cool down. Wash the eyes having stye with this Triphala water. Along with this, the Triphala preparations including Triphala Churna, Triphala Ghrita and Triphala Guggulu can be used as advised by your Ayurvedic physician. Tablet Saptamrita Loha is another best remedy for the eye disorders including stye.
Read – Triphala Home Remedy For Eye Care

Apply ghee or honey – pure ghee or honey may be applied with clean hands / fingers over the stye. This will help making the stye soft and enables easy draining. They also have healing effect on the eye.
Read – Honey Qualities, Usage, Remedies, Ayurvedic Benefits

Treatment of Stye
Note – When the stye doesn’t respond to home remedies in 3-4 days or if it persists for more than 1 week, then one should see a doctor. (case study)

The below mentioned conditions should alarm one to go to the doctor without trying home remedies –

• Stye existing for more than one week, not responding to any softer remedies and hot compresses
• Stye interfering with vision
• Severe pain in the lump
• Bleeding from the lump
• Swelling spreading to other parts of the face
• Excessive redness of the eyelid or eye
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If the stye persists, the doctor may prescribe a topical antibiotic cream or antibiotic drops to hasten healing. Oral antibiotics may also be needed if the infection is beyond the eyelid. Topical eye medicines have less use since they cannot penetrate deep into the glands.

Eyelashes on the lump / boil may be removed gently to help drainage of pus and infected content of the stye. This shall be done by a professional doctor and especially when it is a case of extremely painful external stye. The doctor shall drain the pus by lancing it with a thin sterile needle, after removing the eyelashes nearest to the stye swelling. Eyelid scrubs shall be used to clean the eyelid margin on the advice of the doctor.

He may refer to a specialist example, ophthalmologist for expert intervention if conventional treatments don’t help or if complications appear to be seen.
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prognosis, complications

Prognosis –
In most cases styes go away within 1 week without any medical interventions or with softer measures like hot compresses applied at home. Stye usually heals in maximum 10-14 days. They are usually harmless and complications are rare. But they often recur. This point has been emphasized by master Sushruta in the description of kumbhika Pidika.

External styes may turn yellow and release pus in long course. At the same time, the internal styes which occur inside of the eyelid are more painful.
Read – How To Make Prognosis Of Disease According To Ayurveda?

Complications –
Complications of stye are rare because it is often attended promptly and comprehensively. But we cannot rule out the complications of this condition as they may occur sometimes.
Below mentioned may be some of the common complications of stye –

Meibomian cyst – If stye is not treated comprehensively, they may become Meibomian cyst / chalazion. This is a cyst which occurs in the small glands located in the eyelids. A persistent stye on the inside of the eyelid can develop into Meibomian cyst especially if the gland gets obstructed.

Preseptal / peri-orbital cellulitis – This occurs if the infection of stye spreads to the other tissues around the eye. This consequentially leads to the inflammation of the skin layers around the eye. The eyelids become swollen and red.
Read – Classification of Eye Diseases As Per Ayurveda

Stye in Ayurveda

Stye in Ayurveda
In Ayurveda, in the context of Vartmagata Rogas, (diseases occurring in the eyelids) two conditions named Kumbhika and Anjananamika are explained. Their explanation resembles that of stye / hordeolum.

Kumbhika Pidika are often compared to the internal type of stye.
Anjananamika is compared to the external stye.

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