Stye (hordeolum): UK causes, treatment and when to see a doctor

A stye (hordeolum) is a painful, red lump on the eyelid caused by a blocked, infected oil gland. Most settle within a week with warm compresses and lid hygiene, but recurrent or persistent styes point to underlying blepharitis or meibomian gland dysfunction that benefits from proper assessment.

What a stye actually is

Styes come in two forms. An **external hordeolum** sits at the base of an eyelash and looks like a small yellow-headed spot. An **internal hordeolum** develops inside a meibomian gland deeper in the eyelid and often feels more tender because there is no route for the pus to drain.

Both are caused by staphylococcal bacteria colonising a gland that was already blocked. That is why lid margin disease — blepharitis, rosacea, dry eye — makes recurrent styes much more likely.

Symptoms

- A tender, red lump on the upper or lower eyelid

- Watering, mild swelling, a gritty feeling

- Sometimes a small yellow point of pus

- Rarely: swelling of the whole lid, blurred vision from pressure on the cornea

Home treatment that actually works

The evidence base for styes is simple: warmth and gentle expression, not antibiotics.

1. **Warm compress** — a clean flannel soaked in hand-hot water, held on the closed eye for 8–10 minutes, four times a day

2. **Gentle lid massage** afterwards to help the gland drain

3. **Lid hygiene** with a proprietary lid wipe or diluted baby shampoo along the lash line

4. **Do not squeeze** the stye and do not wear eye make-up or contact lenses while it is active

Most styes resolve in 5–7 days with this routine.

When to see a doctor

See your GP, optometrist or an eye specialist if:

- The stye is not improving after 7–10 days

- Swelling spreads to the whole eyelid, cheek or beyond the orbit (possible preseptal or orbital cellulitis — this is urgent)

- Vision is affected

- The lump becomes hard, painless and rubbery — that is a chalazion, not an acute stye, and often needs a small incision

- Styes keep coming back — underlying blepharitis needs treating properly

Antibiotics — usually not needed

Topical antibiotics do not shorten a stye and are only indicated when infection is spreading. Oral antibiotics are reserved for cellulitis. If you have been given repeated courses of chloramphenicol for styes without the underlying lid disease being addressed, ask for a lid margin assessment instead.

Preventing recurrent styes

Long-term prevention is about lid margin health. See our guide to blepharitis — daily warm compresses, lid hygiene and occasionally omega-3 supplementation reduce recurrence dramatically.

Book a consultant-led lid assessment

If styes keep coming back, or a lump has been present for more than three weeks, book a consultation with my private practice or call **020 3137 3237**. We treat chronic blepharitis, chalazia and recurrent styes across our UK clinics.