Chalazion vs. Stye: What Are the Differences Between the Two?

A chalazion and a stye are both lumps that appear on the eyelid. It can be difficult to tell the difference between the two since they often look similar. 

Both a chalazion and style are eyelid inflammations. A chalazion often develops after a stye.

The chalazion, also called a meibomian cyst, does not develop as fast as a stye, and it usually doesn’t hurt. It pops up after the sebaceous gland (an oil gland) has been inflamed for a while.

How Chalazia & Styes Develop

To understand why a chalazion or a stye develops, you have to understand the ocular glandular system. The eyelid has various glands that produce moisture, so the eyes do not become too dry. 

These glands are made up of small oil glands and sweat glands that appear at the edge of the eyelid. Some of the oil glands are on the inner part of the eyelid. 

The oil from the glands mixes with the tear fluid to keep the eye moist or from drying out. If the glands get blocked, the eyelid either becomes infected or inflamed, which leads to the development of a chalazion or stye.

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What Is a Chalazion?

While a chalazion looks like a stye or hordeolum, it usually develops further back on the eye than where styes generally develop. Although a chalazion may be red and tender, it is not typically painful. It may develop after the eyelid becomes irritated or inflamed.

Chalazion Symptoms

While a chalazion may be developing beforehand, you may not know you have the growth until your eyelid becomes quite swollen and red. Other symptoms of a chalazion include the following:

• A lump on the eyelid that is tender, but not usually painful
• Swelling and redness on the lump
• Swollen eyelid
• Blurred vision

Chalazion Causes

A chalazion develops after the meibomian glands (the eyes’ oil glands along the eyelid) become clogged. It may also emerge if the oil glands are obstructed at the eyelash follicle. Blepharitis is often noted as a cause.

Risk Factors 

Your chance for developing a chalazion increase if you have any of the following conditions:

• Rosacea
• Blepharitis
• Dandruff
• Demodex mites (an infestation)
• Low levels of vitamin A

Smoking also increases the risk of developing a chalazion.

Who Is More Prone to Developing a Chalazion?

People who have rosacea are more prone to developing a chalazion. Also, hormones during puberty can thicken oil secretions that clog the oil glands. 

In rare instances, a deficiency in the immune system can lead to dermatological abscesses and a chalazion. 

People who are 30 to 50 years old are more prone to developing these bumps.

How Are Chalazia Diagnosed?

An eye doctor will diagnose a chalazion with a visual examination of the eye and eyelid. The doctor will review a patient’s history to see if certain health problems may be contributing to the growth. 

The doctor will assess the lid structure, skin texture, and appearance of the eyelids. They will inspect the lid margins and oil gland openings using magnification and a bright light.

How Is a Chalazion Treated?

Typically, chalazia resolve on their own after several days or weeks. However, if you have a growth that will not go away, a doctor may recommend that you place a warm compress on the affected area. Doing so will promote drainage of the oil gland.

Anti-inflammatory eye drops may be recommended, or a steroid injection may be administered. 

In some cases, if the chalazion doesn’t resolve, surgery may be necessary. Surgery involves draining it.

If you experience recurrent chalazia, your doctor may biopsy the area to determine it’s not caused by a more serious issue.

What Is the Best Way to Prevent a Chalazion?

To prevent chalazia, follow these steps:

• Wash your hands before touching your eye area.
• Apply warm compresses daily for about 10 minutes.
• Gently scrub the eyelid area at the lash line, using a mild cleanser.
• Apply antibiotic ointment to the lash line.

If you have rosacea or dandruff, it’s important to treat these conditions and monitor them as they increase the likelihood of developing a chalazion. 

Doctors recommend that you wash your face before bedtime and use eyelid scrubs regularly to maintain the area.

What Is a Stye?

A stye, or hordeolum, represents a common bacterial infection or lump on the eyelid that is often painful. It generally develops due to a blocked oil gland, and bacteria can grow inside that blocked gland. The bump or swelling may be categorized as external or internal.  

If it is not treated properly, a stye can turn into a chalazion.

• External hordeolum: An external hordeolum starts at the base of an eyelash, and it is triggered by an infection of the hair follicle. Blepharitis is often the cause of an external stye, and the eyelid infection leads to redness and swelling.
• Internal hordeolum: An internal hordeolum sits inside the eyelid. It is caused when an infection affects an oil-producing gland in the eyelid.

Stye Symptoms

The following signs are indicators that you have a stye:

• A painful bump on the margin or just outside the eyelid or within the eyelid
• Swelling of the eyelid
• Pus that is visible at the center of the bump
• Sensitivity to light
• Increased tearing of the eye
• Eye irritation, such as the feeling of a foreign body inside the eye
• Eyelid crusting

Causes of Styes 

A meibomian gland infection will often cause a style to form. The bacterium is usually Staphylococcus aureus.

Risk Factors

You’re at an increased risk of developing a style if you are under stress or have an underlying immune system condition. Rosacea and blepharitis also cause styes, as does dry eye syndrome.

Who Is More Prone to Developing a Hordeolum or Stye?

While the oil glands of the eyes may get clogged periodically, people who develop styles may not practice good eye hygiene, or they may touch their eyes frequently. If you rub your eyes quite often or don’t clean your contacts properly, you’re more prone to developing a stye.

How Are Styes Diagnosed?

Your eye doctor can diagnose a style by visual examination. An optometrist or ophthalmologist often uses magnification and a bright light to take a closer look at the eyelid’s margins and glands.

How Is a Stye Treated?

A style will usually disappear on its own after one or two weeks. 

Because the growth is caused by an infection, your eye doctor may recommend an antibiotic cream that you apply topically or antibiotic eye drops. If your eyelid infection spreads beyond the eyelid, your doctor may prescribe an antibiotic in pill form.

What Is the Best Way to Prevent a Stye?

To prevent a style from returning, it is important to practice good hygiene and refrain from rubbing your eyes. Make sure to remove your makeup every evening, and wash your eye area daily. You can gently massage the area with a mild cleanser to prevent glands from getting blocked.

When to See a Doctor

If you have any bump or lump on your eyelid or eye area that doesn’t heal within a few days, it’s a good idea to see an eye doctor. The first treatment approach for both chalazia and styes is to simply watch and wait, but if the issue doesn’t resolve on its own, medical treatment may be needed.

References

1. Styes and Chalazia (Inflammation of the Eyelid): Overview. (December 2019). InformedHealth.org

2. What Are Chalazia and Styes? (September 2022). American Academy of Ophthalmology.

3. Blepharitis. American Optometric Association.

4. Chalazion. American Optometric Association.

5. Cellulitis. (January 2021). American Association for Pediatric Ophthalmology and Strabismus.

6. Hordeolum. August 2022. StatPearls.

7. Chalazion and Stye (Hordeolum). (May 2022). Merck Manual.

8. The Pathogenesis of Staphylococcus aureus Eye Infections. (March 2018). Pathogens.

9. What Are the Differences Between a Stye, a Chalazion, an Internal Hordeolum and an External Hordeolum? Moran Core.

10. What Is the Best Treatment for a Hordeolum (Stye)? (January 2020). Evidence-Based Practice.

11. Effects of Chalazion and Its Treatments on the Meibomian Glands: A Nonrandomized, Prospective Observation Clinical Study. (July 2020). BMC Ophthalmology.