Stye or chalazion? How to tell the difference

The stye: acute and painful

A stye is an infected gland at the edge of the eyelid — at a lash root on the outside, or in an oil gland just inside. It develops within a day or two: a red, warm, painful swelling, often with a yellow head of pus, sometimes with a puffy lid around it. Annoying, but almost always harmless: most styes come to a head, drain by themselves and heal within one to two weeks.

The chalazion: quiet and stubborn

A chalazion feels different: a painless or at most tender, firm lump somewhat deeper in the lid, about the size of a small pea. It is not an infection but an accumulated, walled-off oil gland — often the quiet remnant of an earlier stye or a feature of blepharitis. A chalazion has patience: it can sit for weeks to months. Most eventually disappear by themselves, helped along by warmth.

The treatment: warmth, warmth, warmth

The same recipe applies to both. Place a warm compress on the closed eye for ten minutes, three to four times a day — as warm as is comfortable, never hot. The warmth liquefies the blocked oil and helps the gland drain. After the compress, massage gently towards the lid margin. Keep this up for days to weeks; with a chalazion, persistence really is the key.

What not to do: squeeze or lance it. Squeezing pushes the inflammation deeper into the lid and can make things worse. Skip make-up and contact lenses until the swelling has gone, and wash your hands before touching your eyes.

When to seek help

With a stye: if the whole lid becomes swollen, red and painful, certainly with fever or redness spreading towards cheek or forehead — a broader tissue infection may be developing that needs treatment. A stye that has not improved after two weeks may also be looked at.

With a chalazion: if the lump has not shrunk after two to three months of faithful compresses, keeps returning in the same spot, presses on the eye or bothers you cosmetically. An ophthalmologist can then empty the chalazion via a small procedure on the inside of the lid, or inject an anti-inflammatory. One honest note: a 'chalazion' that looks different from usual, makes lashes fall out or recurs in exactly the same spot should be assessed by a doctor — very rarely something else hides behind it.

Prevention

Anyone who gets frequent styes or chalazia usually has lid margins that ask for a little extra maintenance: daily or weekly lid hygiene (see our blepharitis article), removing make-up faithfully and replacing mascaras and eye pencils every three months. Boring but effective.