Internal Stye: Symptoms, Causes, Treatment, and Prevention
A comprehensive guide to understanding, treating, and preventing internal styes for healthier eyes.
Internal styes (also known as internal hordeolum) are painful, inflamed bumps located inside the eyelid, often causing discomfort and vision disturbance. Although common and typically short-lived, recognizing their symptoms, causes, and treatment options is essential for maintaining optimal eye health and preventing detrimental complications.
What is an Internal Stye?
An internal stye is a bacterial infection affecting the oil (meibomian) glands situated inside the eyelid. These small, pimple-like bumps can appear on the inner surface of either the upper or lower eyelid and differ from external styes, which develop at the base of the eyelash or on the eyelid margin.
Understanding the Anatomy
The meibomian glands produce oils that help lubricate the eye. When bacteria enter these glands, inflammation and the formation of a pus-filled lump (stye) can occur. Internal styes are typically more painful and may persist longer than external styes due to their deeper location within the eyelid tissue.
Symptoms of Internal Stye
Symptoms may vary in intensity and presentation, but common features include:
- Pain and swelling inside the eyelid — The affected eyelid often appears red and swollen.
- Tenderness or sensitivity to touch
- Crusting or discharge near the affected eye
- Increased tear production (watering of the eye)
- Sensation of a foreign object in the eye
- Sensitivity to light
- Possible blurred vision if the swelling is significant
- In serious cases, flushed skin near the eyelids may appear
Symptoms can sometimes mimic other eye conditions, like a chalazion (a non-infectious cyst), so professional diagnosis is important if the stye does not resolve or worsens.
What Causes an Internal Stye?
Internal styes are typically caused by a bacterial infection, most often Staphylococcus aureus. Infection occurs when bacteria invade the oil glands (meibomian glands) within the eyelid. Causes and contributing factors include:
- Pre-existing skin bacteria — Normal bacteria living on your skin can enter a gland through tiny breaks or blocked gland openings.
- Spread from other infections — Bacterial infections in the nasal passages or sinuses can migrate to the eyelids.
- Poor eyelid hygiene — Failure to remove makeup or clean the eyelids regularly can contribute to bacterial growth.
- Contact lens or false eyelash use — Handling contact lenses or false lashes with unwashed hands can introduce bacteria.
- Shared cosmetics or eye-care items
- Chronic eyelid inflammation — Conditions such as blepharitis increase susceptibility.
Risk Factors for Developing an Internal Stye
Anyone can develop an internal stye, but certain factors increase your risk:
- Blepharitis — Chronic inflammation of the eyelid edge.
- Skin conditions, such as dandruff or oily skin.
- Dry eyes
- Diabetes — Poorly controlled blood sugar weakens immune defenses.
- Frequent use of contact lenses, especially if handled with unwashed hands.
- Poor eye makeup hygiene — Not removing makeup nightly or sharing eye cosmetics.
- Being a carrier of Staphylococcus bacteria in the nasal passages, which increases the risk of recurrent styes and other eye infections.
Potential Complications
Though usually harmless and self-limited, internal styes may result in complications, especially if improperly handled:
- Chronic or recurrent styes
- Chalazion formation — A stye may leave behind a hardened cyst inside the eyelid.
- Spread of infection — Popping or squeezing a stye can worsen or spread infection to surrounding tissues.
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Diagnosis of an Internal Stye
Diagnosis typically involves an examination by a healthcare professional. Your doctor will:
- Visually inspect the eyelid and affected area
- Check for localized swelling, redness, and pus
- Differentiate a stye from other eyelid lumps such as a chalazion or cyst
No additional tests are usually necessary, unless the infection persists or recurs.
Treatment for Internal Stye
Treatment depends on severity and duration. Many internal styes resolve on their own with conservative care, but medical intervention may be necessary for persistent or severe cases.
Home Remedies
- Warm compresses — Apply a clean warm compress to the affected eyelid for 10-15 minutes, 3-4 times daily to promote drainage.
- Eyelid hygiene — Gently clean the eyelid using a dilute, mild cleanser or saline solution. Specialized eyelid cleansers or diluted baby shampoo can be used to minimize irritation.
- Eyeball massage — Gently massage the eyelid with clean hands to promote drainage (take care not to apply excessive pressure).
- Avoid contact lenses, eye makeup, and creams during active infection.
What to Avoid:
- Touching or rubbing the affected area repeatedly
- Popping, squeezing, or attempting to drain the stye at home (risking further infection and complications)
- Wearing contact lenses until the stye heals
- Using shared towels, makeup, or face cloths
Medical Treatments
- Antibiotics — Prescription oral antibiotics or topical antibiotic ointments/drops may be recommended for persistent or severe infections.
- Steroid eye drops — Used in combination with antibiotics for significant swelling.
- Surgical drainage — An ophthalmologist may perform a minor in-office procedure, numbing the eyelid and draining the stye if it is especially large or unresponsive to other treatment.
Commonly prescribed medications may include:
| Drug | Type | Typical Use |
|---|---|---|
| Erythromycin ointment | Antibiotic ointment | Bacterial infection control |
| Dicloxacillin tablets | Oral antibiotic | More severe or spreading infection |
| Neomycin ointment | Antibiotic ointment | Topical use |
| Gramicidin-containing drops | Antibiotic drop | Topical infection control |
When to Contact a Doctor
Most internal styes resolve within a week with home care. However, consult an eye doctor if you experience:
- No improvement after several days
- Increasing pain, redness, swelling, or vision changes
- Stye recurs frequently or is associated with other infections
- Significant swelling of the entire eyelid or fever (which could signal spread of infection)
Prevention Tips
Practicing good eyelid hygiene and minimizing risk factors can help prevent internal styes:
- Wash hands thoroughly before touching eyes, lenses, or eye area
- Remove makeup before bedtime and avoid sharing eye care products
- Regularly clean eyelids and face to prevent oil and debris buildup
- Manage chronic conditions such as blepharitis, dandruff, or dry eyes
- Use clean contact lenses and follow lens hygiene instructions carefully
- Follow a balanced diet and manage underlying health conditions to support immune health
Internal vs. External Stye
| Feature | Internal Stye | External Stye |
|---|---|---|
| Location | Inside eyelid (meibomian gland) | Near eyelash follicle or lid margin |
| Pain | Often more painful | Usually less intense |
| Duration | May last longer | Typically resolves quickly |
| Complications | Chalazion formation, chronicity | Rarely chronic |
Frequently Asked Questions (FAQs)
Are internal styes contagious?
No, internal styes are not contagious. The infection is not spread from person to person, but the bacteria responsible for causing styes can spread to other areas of your own eye or face if good hygiene is not maintained.
What should I avoid when I have an internal stye?
Do not attempt to pop, squeeze, or drain the stye at home. Avoid wearing contact lenses or applying makeup/eye creams until the stye has healed, and refrain from touching or rubbing the area unnecessarily.
Why do internal styes keep coming back?
Chronic or recurrent styes may be related to underlying conditions such as blepharitis, oily skin, dry eyes, or nasal carriage of Staphylococcus bacteria. Proper management of these conditions and maintaining optimal eyelid hygiene can help reduce recurrence.
When should I seek medical help for an internal stye?
Consult a doctor if the stye does not resolve within a week, worsens, recurs frequently, affects vision, or if you develop swelling of the entire eyelid, fever, or severe pain.
Can styes cause permanent problems?
Most styes resolve without lasting problems. Rarely, untreated internal styes may form a chalazion (a firm, persistent cyst) that could need minor surgical removal. Persistent infection may rarely spread to nearby tissues, but this is uncommon with proper care.
Key Takeaways
- Internal styes are painful bacterial infections inside the eyelid, often caused by Staphylococcus bacteria entering the meibomian glands.
- Common symptoms include swelling, redness, pain, discharge, and sensitivity to light.
- Good eyelid hygiene, warm compresses, and avoidance of eye makeup and contacts are cornerstones of home care.
- Seek medical advice if your symptoms worsen, persist, or recur.
- Prevent future styes with rigorous eyelid and face hygiene, and by treating underlying risk factors.
References
- https://www.healthline.com/health/eye-health/internal-stye
- https://www.medicalnewstoday.com/articles/internal-stye
- https://www.spirehealthcare.com/health-hub/specialties/vision-and-eye-health/styes-causes-symptoms-and-treatment-explained/
- https://www.ncbi.nlm.nih.gov/books/NBK459349/
- https://my.clevelandclinic.org/health/diseases/17658-stye
- https://www.mayoclinic.org/diseases-conditions/sty/diagnosis-treatment/drc-20378022
- https://www.health.harvard.edu/diseases-and-conditions/stye-treatment
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