Internal Stye

What is an internal stye?

An internal stye (hordeolum) is an inflamed oil gland on the inner edge of your eyelid. A bacterial infection is the usual cause.

When you have an internal stye, an oil gland swells up and forms an abscess (pocket of pus). This leads to pain and other symptoms. While the stye may go away on its own, some people need a minor procedure to drain the pus and clear the inflammation.

Primary care providers often see and diagnose styes. Your provider may refer you to an ophthalmologist or optometrist if your stye isn’t going away or is getting worse.

What is the difference between an external stye and an internal stye?

The main difference is where they’re located on your eyelid. An external stye forms on the outer edge of your eyelid. It faces outward and looks a bit like a small pimple. An internal stye develops on the inner side of your eyelid. It faces inward, toward your eyeball. An internal stye looks like a small bump, and it may be yellowish or white.

Internal styes are usually more painful and last longer than external styes.

Who does it affect?

Children and adults of all ages can develop internal styes. They’re especially common among school-age children and adults age 30 to 50.

How common are internal styes?

Overall, a stye is one of the most common eye conditions. However, internal styes aren’t as common as external styes.

What are the symptoms of an internal stye?

An internal stye is painful. You may experience:

• Pain, tenderness and swelling in one area of your eyelid.
• Red skin on your eyelid.
• Watery eyes.
• A feeling that there’s something in your eye.

Symptoms often appear suddenly, such as when you first wake up in the morning.

What causes an internal stye?

An internal stye forms when you have an infection in one of your meibomian glands. You have dozens of these glands along the edges of your eyelids. They produce oils that help protect and lubricate your eyes.

But like other glands in your eyes, your meibomian glands can become infected. Usually, a type of bacteria called Staphylococcus aureus is the culprit. This bacterial infection may happen if you:

• Touch your eyes without washing your hands first.
• Don’t properly clean your contact lenses (or put them in without washing your hands first).
• Use old or contaminated makeup.
• Have another eye condition that makes you more susceptible to infection.

What are the risk factors?

A main risk factor is whether you’ve had a stye in the past. In many people, styes keep coming back. So, if you’ve had a stye before, you’re more likely to have one again.

You also face a higher risk if you have any of the following conditions:

• Blepharitis (inflammation of your eyelid).
• Diabetes.
• Hyperlipidemia.
• Rosacea.
• Seborrheic dermatitis.

Is an internal stye contagious?

A stye usually isn’t contagious. However, the pus that drains from your stye contains a small amount of bacteria that could potentially spread to others. So, it’s a good idea to wash your hands after touching your eye area. Plus, wash your pillowcase and towel/washcloth daily.

Unless a provider tells you otherwise, it’s OK to go to work or school.

How is an internal stye diagnosed?

Healthcare providers diagnose an internal stye by examining your eye and talking with you about your symptoms. Usually, you don’t need any testing, and a provider can diagnose your stye through a simple exam.

Rarely, a provider will recommend a biopsy to rule out serious conditions like sebaceous carcinoma.

How do you treat an internal stye?

Usually, treatment starts with home remedies. Providers typically recommend the same home remedies that treat external styes. These include:

• Applying a warm compress to your eyelid for 10 to 15 minutes about three times a day. Use a clean, soft washcloth soaked in warm water. You may want to use boiled or distilled water, taking care that the compress (washcloth) isn’t too hot. Your eyelids are delicate and can be burned if the compress is too hot.
• Gently massaging your eyelid with your fingertips.

These remedies may relieve your symptoms. They may also help the stye soften and drain. Ask a provider before using any over-the-counter treatments (like drops, eyelid scrubs or ointments).

Be aware that home remedies typically help external styes but may not help internal styes. So, you may need other forms of treatment, including:

• A minor procedure to cut and drain the stye. An ophthalmologist performs this procedure.
• Oral antibiotics, if the infection spreads to the skin around your eye (periorbital cellulitis).

When you have a stye, you shouldn’t:

• Try to pop or squeeze the stye.
• Wear eye makeup.
• Wear contacts.

How can I prevent an internal stye?

Here are some tips for preventing a stye (internal or external):

• Keep your eye area clean. You can make a gentle soap by mixing baby shampoo with water. Use this soap to wash your eyelids (closed) and eyelashes.
• Avoid touching your eyes. If you must touch your eyes, wash your hands first.
• Wash your hands before putting in or removing your contact lenses.
• Disinfect your contacts with cleaning solution made for this purpose.
• Use a gentle makeup remover to take off mascara, eyeliner and other eye makeup at the end of each day.
• Once you begin using mascara or eyeliner, throw it out after two to three months.
• Never share eye makeup with other people.

Will internal styes go away?

Yes, your stye should go away with treatment, usually within a week or two. Most people have an excellent outlook.

How do I take care of myself?

Follow your provider’s guidance for home remedies. In general, you can care for your eye and potentially speed up the healing process by:

• Keeping your eye area clean.
• Using warm compresses.
• Avoiding irritants (like makeup and contacts).
• Not touching or trying to pop the stye.

When should I see a healthcare provider?

Seek medical care right away if:

• You have a fever or chills.
• There are changes to your vision.
• The eyelid swelling is getting worse or your eyelid is swollen shut.
• Home remedies are making the pain worse.
• Your eyelid feels hot to the touch.
• There’s thick pus or blood coming out of the stye.
• You have blisters on your eyelid.

A note from Cleveland Clinic

An internal stye is painful and bothersome, but it usually isn’t a cause for major concern. If you keep getting styes, you’re probably frustrated and wondering why. Talk to an eye care provider to learn what you can do to stop them from coming back. In some cases, simple changes like switching from contacts to glasses or keeping your eye area extra clean can help.