Patient information · Eyes
Stye and chalazion
the compress has to be hot enough, and long enough
A stye is an infection of an eyelash follicle; a chalazion is a blocked oil gland that has become a firm lump. Both are common and most settle without treatment. What speeds them up is heat applied properly — which is where almost everyone goes wrong.
Seek same-day assessment if there is
- swelling and redness spreading onto the cheek or forehead, or a fever
- pain on moving the eye, double vision, or a bulging eye
- reduced vision
- the eyelid swollen shut and the eye cannot be examined
- these signs in a child, or in anyone immunosuppressed or diabetic
Spreading eyelid infection can progress to orbital cellulitis, which threatens sight and needs intravenous antibiotics. Pain on eye movement or reduced vision distinguishes it from a simple lid infection. In an emergency call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
Telling them apart
- Stye — painful, red, tender lump at the lash line, often pointing with a small yellow head. Comes up over days, often bursts and settles within a week or two.
- Chalazion — a firm, usually painless lump further from the lid margin, sometimes appearing after a stye. Can take weeks to months to resolve and may not be tender at all.
- A chalazion is not an infection, which is why antibiotic drops do little for it.
Most people do the compress wrong
A flannel run under the hot tap cools below body temperature within about a minute, so it does nothing to melt the thickened oil. Use a microwaveable eye bag or gel mask, which holds heat for the required time, applied for 10 minutes, three or four times a day, for at least two weeks. Follow each application by massaging the lid firmly towards the lash line with a clean finger. Heat without the massage does half the job.
Alongside the compress
- Lid hygiene — clean the lid margins daily with a lid wipe or dilute baby shampoo on cotton wool.
- Do not squeeze, and do not attempt to lance it yourself — this spreads infection into the lid.
- Stop wearing contact lenses and eye make-up until it has settled; replace old mascara.
- Paracetamol or ibuprofen if it is painful.
- Antibiotic ointment has a limited role — useful for a discharging stye or where there is surrounding infection, not for a chalazion.
If it does not go
A chalazion that persists beyond four to six weeks despite proper heat and massage can be treated with incision and curettage — a small procedure under local anaesthetic through the inside of the lid, taking a few minutes, with no visible scar. A steroid injection into the lesion is an alternative in some cases.
A lump that keeps coming back in the same spot
Recurrent chalazia at exactly the same site, particularly in someone over 40, with loss of eyelashes, distortion of the lid margin or persistent redness, should be biopsied. A rare eyelid cancer — sebaceous carcinoma — can masquerade as a recurring chalazion, and it is diagnosed late for exactly that reason. This is uncommon, and it is the reason a persistently recurring lid lump is examined rather than simply treated again.
Preventing recurrence
- Treat underlying blepharitis — daily lid hygiene, long term. This is the main preventive measure.
- Warm compress once a day as maintenance if you are prone to them.
- Remove eye make-up thoroughly every night.
- Manage rosacea or seborrhoeic dermatitis, both of which drive lid gland dysfunction.
- Omega-3 in the diet may help gland secretions.
Why come to us. Most lid lumps need advice and the right kind of heat, which takes one appointment. We examine the eye and lid properly, distinguish a chalazion from the causes that need urgent referral, treat the underlying blepharitis, and where a chalazion persists our minor surgery team can perform incision and curettage in clinic under local anaesthetic — usually within the same week, with fees published in advance. Seven days a week, no referral needed.
Assessed, and treated in clinic if it persists
Minor surgery under local anaesthetic, published fees. Seven days a week.
Tower Bridge Hospital London
97–99 Whitechapel Road, London E1 1DT
WhatsApp 07903 284 189
info@mhwclinic.co.uk
Open Mon–Sat, 9am–7pm (closed Sundays until September)
In an emergency
Call 999, or go to the Royal London Hospital Emergency Department, Whitechapel Road, London E1 1FR.
When we are closed and it is not an emergency
Call NHS 111 or visit 111.nhs.uk.