What is a stye/chalazion/ cyst of the eyelid?
If you have a lump which is red or swollen on your upper or lower lid this may be a stye , chalazion or mebomian cyst.
How do I know which one I have?
They are very similar but a stye has a head ( like a spot) which can be seen as tiny spot of pus on the lid surface. The chalazion ( also called a cyst or mebomian cyst ) also has a head but this on the eye lid margin just next to the lashes (If you get a magnifying mirror and look along the lash margin you will see the entrance to the cyst as a white/yellow head.)
Who get cysts or styes?
Children/ young adults.
If you are rundown with a cold or stressed. Working too long hours either at the computer or in a dusty/smoky dry environment or not sleeping well you will tend to get this condition. Mothers who are nursing babies get them because they are staying up late and probably stressed. Also students and night workers. . If you have been crying a lot you may also get them as you will have an imbalance in production of oil and tears.
Also if you have dry eyes or if your diet is bad you may be more prone.
Why do they occur?
Inside the lids are tiny oil glands which produce part of the tear film.
These oil glands discharge the oil into the eye but if oil becomes sticky and hard it forms a waxy plug at the entrance of the gland along the lid margin.( if you look carefully with a magnifying mirror you can see the head of the cyst along the lid margin) Then any bacteria that are naturally on the lid will start to enter the wax and start an infection as they multiply inside the gland. The gland becomes swollen and red and quite painful your body will start to fight the infection and given time if you are lucky the gland will form a pus filled sac and burst and the contents will be released and you will feel a lot better !
How do I treat the cyst?
The best way is with hot compresses , or steam baths of sauna . The reason for this is the heat will melt the waxy head of the stye allowing the contents to release.
Also the heat helps your body to fight the infection. Apply a warm as you can tolerate flannel to the lid and keep on applying or dangle your head over a basin of steaming water.
You can use topical antibiotics ( over the counter chloramphenicol) but in my opinion this is unlikely to be able to penetrate into the gland as the gland is blocked with wax.
The use of oral antibiotics is probably not a good idea as it tends to make the gland into a big unsightly abscess which will worry you !
Surgery for cysts
We only operate on cysts when they stop being inflamed. All cysts if left alone will calm down stop being red and and if you are lucky resolve but in some cases a painless lump is left on the lid. This can look quite unsightly so some people seek surgery. Most cysts however if left will disappear within 6-12 months so if you don’t fancy the idea of surgery and are not vain don’t worry.
Surgery is sometimes carried out in young children if the cysts is blocking the vision as otherwise if left for too long a lazy eye could develop , having said this in all my years as an Eye surgeon I have never come across this and my opinion is leave the cyst to resolve in a child if you can.
What does the surgery involve ?
It is a day case procedure and takes only a few minutes. A local anaesthetic like at the dentist is applied this is the most unpleasant part but if the doctor uses very fine needles its not that unpleasant. Then the lid is turned over with a clamp (You will not be able to see this and it won’t leave any visible scars ) A fine knife is used to cut into the cyst which sounds horrible but you wont be able to see or feel this. You may be left with a bruise on the lid which will take 10 days to go away . An eye pad is applied over the eye for 20 minutes to stop bleeding .
You can go to work and you can drive after about an hour. You will have to take antibiotic ointment 3-4 times a day for one week as well
How do I prevent cysts?
If you are prone to them then you should alter your environment ( dry and dusty) if you can. Improve your stress levels.
Use artificial tears ( available over the counter such as celluvisc . tears naturale. hypromellerose,viscotears ) Perform lid hygiene am and pm.
This means using either a cotton bud soaked in baby shampoo, or water with a teaspoon of bicarbonate of soda ( one spoon per pint) to scrub vigorously along the lid margin.
I think using a magnifying mirror with a light is useful as you can see the waxy heads of the glands and sweep these off.
If you find using a cotton bud difficult then optometrists and chemist also sell lid care wipes impregnated with a special solution to dissolve oil.
Some people advocate also making sure you diet is rich in flax and seeds and vitamin b6 .