By Dr. Charles J. Bock

Stye (Chalazion)

A chalazion (commonly called a stye), is an infection of the eyelid similar to a pimple of the skin. Each eyelid has many oil glands at the edge of the lid where the lid touches the eyeball. These glands normally secrete oil onto the tear film but can become plugged, causing infection. Children are often prone to chalazia because the oil glands around their eyelids are not fully developed, making them susceptible to plugging and infection.

Very early in the course of a developing chalazion, the entire eye may appear swollen due to the irritation caused by the infection. However, if the eyelids are very red and swollen, particularly if your child also has a fever, you should call your doctor right away-a deep infection of the tissues around the eye (called cellulitis) can look like this and may require oral or IV antibiotics.

During the next few days, the swelling usually decreases and a lump on either the upper or lower eyelid becomes noticeable. This lump is usually tender.

Treating a chalazion

Warm compresses are very helpful, and Dr. Bock will often prescribe a mild steroid-antibiotic drop or ointment to decrease the inflammation and treat the infection. To make a warm compress, Dr. Bock usually advises adults to soak a clean washcloth in very warm water and leave it over the eye for three to five minutes. Most children have difficulty holding still for this, however. You may want to try heating a small potato in the microwave and then placing it in a damp cotton sock. The potato will remain warm much longer than a washcloth, giving you time to chase after your child. Be careful to check the temperature of the compress before placing it on your child's skin.

If Dr. Bock has given your child an antibiotic or a steroid-antibiotic, you should use it three times a day. Dr. Bock will want to see your child back in a few weeks to be sure that the medication is working.

Sometimes, the chalazion becomes a hard, visible lump and the medications don't seem to penetrate it. When this happens, particularly if the skin overlying the chalazion is beginning to break down, surgical drainage may be needed. Although this drainage can be performed in the office in adults, it requires a trip to the operating room for children-so Dr. Bock will try to treat your child's problem medically before recommending surgery. Surgical drainage is a quick procedure, usually requiring the child go to sleep for a brief time (five to ten minutes). If surgical treatment is recommended, Dr. Bock will explain this to you in much greater detail.

Some children develop a lump on the inside surface of their eyelid that seems to be right on top of the deeper lump caused by the chalazion. This lump, called a pyogenic granuloma, is a raised area of mucous membrane tissue that forms in response to the inflammation. These usually improve on their own, and generally do not need to be removed.

Will the chalazion return?

A chalazion that is treated without needing surgery may return. Generally, those treated with surgery do not return, because the surgery destroys the affected oil gland. Some children, however, will continue to get new chalazia in different locations, and will require repeated treatment.

If you have questions

Please feel free to call our office at 503-656-4221 at any time with your questions. Our goal is that you understand completely your child's condition and treatment.