How to treat a stye if it is still swollen after using antibiotic eyedrops, and when does it need to be drained?

Doctor's Answers 4

Photo of Dr Desmond Quek
Dr Desmond Quek

Ophthalmologist

I'm sorry to hear that you have had a stye for so long! I used to have styes as a teenager and can understand the discomfort and frustration it is causing you.

Our eye lid margin contain numerous oil glands, which secrete oil to lubricate our eyes (as part of the tear film). The opening of these oil glands can frequently get blocked, resulting in the secretions accumulating and forming a lump. When bacteria gains entry into this mass, it may cause an infection, resulting in a large, red, painful lump of pus, that may be either on the underside or outside of your eyelids.

In addition to antibiotic ointment/ cream, it is important to perform eye lid hygiene. I usually use a clean cotton square soaked in baby shampoo diluted with warm water to clean the eye lid margins. This will remove debris and bacteria from the eyelid margin and also unblock any clogged pores. You can then apply gentle warm compress (with a clean towel soaked in warm water -- careful not to burn your skin!) to the lump to encourage the secretions and pus to discharge. Do this at least twice a day, or more often if you can spare the time.

After a few days the swelling will usually get smaller and less red. It is common for a firm hard lump to remain. This residual lump may sometimes take weeks to resolve completely. It is important to continue lid hygiene practices to prevent further infection, or further styes from forming.

Some styes may require a small procedure to drain the contents of the stye, in order to accelerate healing. This is particularly so for large styes filled with pus. However, do remember that the stye may recur after the procedure, or new styes may form, if the oil gland openings remain clogged!

I do hope your stye has resolved by now, and if so, do continue to practice lid hygiene to prevent further occurrences -- it has worked quite well for me so far!

Regards,

DQ

Stye usually occurs as a result of inflammation and poor oil flow in the oil glands around the eyelid margin.

There are 2 main approaches to treating styes.

Performing warm compress twice a day for 10 to 15 minutes often helps soften the contents in the stye, resulting in gradual resolution of the style. In addition, maintaining lid hygiene by cleaning it with mild soapy solutions or lid wipes helps reduce risks of infection.

You may however want to consider incision and drainage of the stye when there is little relief after 2 to 3 weeks of the above mentioned approaches. A visit to an ophthalmologist is strongly recommended if there is pain as it may indicate the presence of an infection. Recurrence is common; a visit to an ophthalmologist to exclude other serious causes such as eyelid tumour is recommended for peace of mind.

One could continue to maintain regular lid hygiene and warm compress even after the stye has resolved as a form of preventative measure.

Hi H

Styes/chalazions or lumps in the eyelids due to blocked glands can be drained when they persist despite conservative treatment like hot compresses and antibiotic eyedrops/ointments, and if they are large enough to be bothersome.

Large styes may cause not only cosmetic issues, if they are in the centre of the upper eyelid they may even press on the cornea and cause temporary visual blurring.

Although they may go away by themselves eventually, sometimes this could take months.

So if you have already had the stye for 3 weeks, and it is bothering you and not getting smaller, you can consider going to see an eye doctor to have it drained. Otherwise, you could continue with conservative measures first also.

Photo of Dr Natasha Lim
Dr Natasha Lim

Ophthalmologist

It should be drained if it has failed to respond to 1-2 weeks of antibiotic eye drops.

The Incision and curettage procedure is a simple minor operation and can be done on the same day as your consultation. There is no visual downtime and you will be ready to return to work the next day.

Thank you.

Kind Regards,

Amelie

NOVENA Bladeless Cataract Surgery & Eye Specialist Centre

in association with

Dr. Natasha Lim Eye Centre

Tel: +65 6570 2220

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