Our eyelids are delicate structures but are also a lot more intricate and functional than we give them credit for. Most of us will experience a little lump or bump on an eyelid at some point in our lives – some of these eyelid bumps are harmless while others need the attention of a specialist in oculoplastic surgery. Out of all the garden variety eyelid bumps, the most commonly confused are a chalazion vs stye.
Understanding a little of the anatomy of the human eyelid will help us to have a better grasp of the difference between a chalazion vs stye.
Our eyelids serve several purposes, including physically protecting the sensitive surface of the eye as well as providing lubrication via several different glands. The eyelid is made up of layers of smooth muscle, connective tissue, fibrous tissue, a mucous membrane known as conjunctiva, and various secretory glands. Lining the upper and lower eyelid margins are a particularly important set of glands known as the meibomian glands, which open their orifices just behind the eyelash line. The oily secretion produced by these glands is called meibum, which has the purpose of lubricating the surface of the eye, keeping these tissues healthy and contributing to clear vision.
Each eyelash follicle is paired with two additional types of glands known as the glands of Zeis and Moll. The glands of Zeis are sebaceous glands while the glands of Moll are modified sweat glands. Both of these glands support the health of our eyelashes, with their secretions keeping the lashes from becoming brittle.
While the glands of our eyelids are certainly useful, they can also be subject to infection and blockages, much like other glands throughout our bodies. It’s then that you may experience one of those inconvenient little eyelid bumps.
Chalazion vs Stye
Chalazia and styes are among the most common lumps and bumps found on the eyelid. Although both are considered benign, both types of eyelid bumps can be a cause of concern for many people, particularly if the lump is large, sore, or red, leading them to enquire about oculoplastic surgery. The underlying cause is what differentiates a chalazion vs stye, although many people will use the term “stye” to cover both types of bumps.
A chalazion (plural, chalazia), is a blockage of a meibomian gland in the eyelid without an active infection. Initially a chalazion may begin as a stye but then eventually the infection resolves, leaving behind a painless bump that we then call a chalazion. A chalazion is made up of blocked meibum accumulating in the surrounding soft tissues of the eyelid as its usual drainage route through the duct is obstructed. The main concern for someone with a chalazion is not pain or redness, even when the chalazion is touched, but more of a cosmetic issue. A chalazion can vary in size, with some being large enough to put some pressure on the cornea and causing temporarily blurred vision. Unfortunately, chalazia are known to take some time to clear, from weeks to months.
On the other hand, a stye, also known as a hordeolum, involves an active infection. An external stye is due to an infection of one the glands of Zeis or Moll, and typically appears as a yellowish-whitish pimple around the base of the affected eyelash follicle. Conversely, an internal stye or hordeolum involves an infection of a meibomian gland inside the eyelid. It’s an internal stye that is most likely to be confused with a chalazion as they both appear as bumps under the skin of the eyelid. Because there is an active infection, styes are typically sore and associated with redness and inflammation.
Most styes and chalazia will self-resolve without needing intervention from an oculoplastic surgery doctor. To hasten the healing process, you may consider using a gentle warm compress over the affected eyelid in order to encourage blood flow to the area, or your optometrist and GP may pluck the eyelash associated with an external stye to help drainage of the blocked glands. As tempting as it may be, however, you should never try to pop a chalazion or stye as this will potentially exacerbate the lesion. Some eyecare practitioners may prescribe a topical antibiotic ointment for an external stye but these should be avoided in the case of chalazia as there is no infection.
Large chalazia and styes that are taking a long time to self-resolve with home remedies such as a warm compress can be referred to an ophthalmologist experienced in oculoplastic surgery. For very stubborn chalazia, the eye specialist can perform a surgical procedure to remove the contents of the chalazion, known as an incision and curettage. There is also the option of steroid injections into the eyelid to help the chalazion to resolve more quickly.
Styes and chalazia are known to recur, whether in the same area of the eyelid or elsewhere. Several risk factors have been identified in the likelihood of developing recurrent styes and chalazia, such as having acne rosacea or meibomian gland dysfunction. A chalazion that frequently pops up in the same area may require examination by an ophthalmologist to rule out any other conditions that may mimic a chalazion, such as an eyelid carcinoma.
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Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.