Chalazion vs. Hordeolum (Stye) – What is the Difference? 

Bumps or lumps on or around the eyelids can be an uncomfortable experience. If you’ve ever noticed one, you may have had a chalazion or a hordeolum (more commonly known as a stye). 

These bumps are incredibly common, making it important to know how to tell the difference. Understanding these bumps can help alleviate discomfort, preserving overall eye health and preventing potential complications. 

Summary: Chalazion vs. Hordeolum (Stye)

A chalazion is a usually painless, non-infectious swelling or bump on the eyelid, resulting from a blocked oil gland. It tends to develop gradually and is typically not accompanied by redness or tenderness.

On the other hand, a hordeolum, commonly known as a stye, is a painful, red lump caused by a bacterial infection of an oil gland or eyelash follicle. It often appears suddenly, is tender to the touch, and can be accompanied by swelling and redness.

Key Differences Between a Chalazion and Hordeolum 

Though a chalazion and a hordeolum are both forms of eyelid irritation, these two lesions are actually quite different. 

Initial Symptoms

Chalazia typically manifest as a painless, firm lump or nodule along the eyelid margin. Hordeola, or styes, present as a painful, red bump and often contains pus or a visible whitehead. 

Location

The location of the lesion can also aid in differentiating the two. Chalazia are commonly found along the upper or lower eyelid margin. Alternatively, external hordeola typically occur at the base of an eyelash and internal hordeolum occurs within the eyelid.

Chalazia and hordeola also differ in their onset and progression. Chalazia tend to develop gradually and often painlessly, whereas hordeola typically arise acutely and are accompanied by a rapid onset of pain, tenderness and inflammation. 

Causes

The underlying pathophysiological mechanisms driving the development of chalazion and hordeolum are quite distinct as well. Chalazia result from obstruction and inflammation of the meibomian glands, leading to the formation of a cyst-like lesion. 

On the other hand, hordeola are the result of bacterial infection of the eyelid glands or hair follicles, triggering acute inflammatory response and pus formation. 

Duration

Chalazia may persist for weeks to months if left untreated and have a higher tendency to recur, especially in individuals with underlying risk factors. Hordeola tend to be more acute with a self-limiting course.

Though there are a range of features that make chalazia and hordeola distinct, differentiating between the two is best left to a healthcare professional. Before pursuing any form of treatment, seek out a thorough clinical examination by a qualified ophthalmologist. Your provider will perform an inspection of the eyelid lesion and an assessment of symptoms while considering relevant medical history, to create an effective treatment plan.

What is a Chalazion?

A chalazion is a non-infectious, inflammatory bump on the eyelid resulting from a blockage in the meibomian gland duct. These glands produce an oily substance called meibum, which lubricates the eye. Excessive oil production, thickened secretions, inflammation of the eyelid margin, or poor eyelid hygiene can obstruct the meibomian gland ducts, leading to the formation of chalazia.

When the duct is blocked, the trapped meibum accumulates, causing the gland to enlarge. This accumulation triggers an inflammatory response in the surrounding tissue, leading to the formation of a cyst-like lesion within the eyelid.

Chalazion Symptoms

Typical symptoms associated with a chalazion include:

• Eyelid swelling
• Tenderness
• Redness
• Development of a painless lump or bump along the edge of the eyelid

Occasionally, individuals may also experience blurred vision or mild discomfort if the chalazion grows large enough to press against the eyeball. Unlike styes (which are quite painful and clearly visible), chalazia are typically painless and are not always visually noticeable.

What is a Hordeolum (Stye)? 

Commonly known as a stye, a hordeolum is a localized infection of the eyelid typically caused by the Staphylococcus aureus bacteria. Hordeola can be internal or external and tend to be more painful than chalazia.

External Hordeolum

An external hordeolum is a bacterial infection of the eyelash follicle or its associated glands. This type of hordeolum typically presents as a painful, red bump at the base of an eyelash. 

When the ducts of the eyelid glands become blocked, bacteria can accumulate. This triggers an inflammatory response and leads to the development of a stye or hordeolum. 

Internal Hordeolum

An internal hordeolum is a bacterial infection of the meibomian glands located within the eyelid. This type of hordeolum is characterized by a painful, swollen bump beneath the eyelid’s surface. Internal hordeola is less visibly apparent. Unlike a chalazion, internal hordeola have a more acute onset and are much more painful.  

Common causes of both internal and external hordeolum formation include poor eyelid hygiene, ocular irritation from substances like dust or allergens and the spread of bacteria from nearby areas. Chronic eye inflammation, contact lens use and compromised immune function can also put individuals at a higher risk for stye development. When a hordeolum forms, typical symptoms include localized pain, tenderness, redness and the development of a red, inflamed lesion that resembles a pimple or abscess. 

Treatment: Chalazion vs Hordeolum

When it comes to managing chalazia and hordeola, understanding the nuances of treatment options is crucial for effective resolution. There are several different types of treatments for each depending on the severity and response to other treatments.

Chalazion Treatment Options

Once diagnosed, treating chalazia is often quite simple. Warm compresses can be used to reduce swelling, as they aid in promoting glandular drainage and reducing inflammation. Gentle eyelid massage and eyelid hygiene with baby shampoo are also helpful in preventing recurrence. 

In cases of persistent or large chalazia, your healthcare provider may recommend corticosteroid injections or topical steroids. These medications are powerful anti-inflammatory treatments that can expedite resolution and minimize scarring. Corticosteroid injections and topical steroids are both generally safe but can potentially cause irritation at the injection or application site.

Chalazia that proves resistant to conservative treatment or is associated with significant cosmetic concerns may require surgical removal of the chalazion. Two common procedures used are incision and curettage or excisional biopsy.

H3: Hordeolum Treatment Options

On the other hand, a number of strategies can aid in treating a hordeolum and reducing the associated discomfort. Cleansing the affected eyelid helps to remove bacteria and applying a warm compress multiple times a day can facilitate glandular drainage and reduce inflammation.  

Over-the-counter pain relievers may also help to alleviate some discomfort. In cases of bacterial hordeolum, particularly those that are recurrent or severe, topical or oral antibiotics may be prescribed.

Large, painful hordeola that doesn’t respond to more conservative treatment tactics may require incision and drainage. This procedure expedites the healing process and provides almost immediate pain relief.

Prevention and Management Strategies

To prevent the recurrence of chalazia and styes, a few strategies are key. Be sure to maintain proper eyelid hygiene, avoid eye makeup contamination and regularly replace contact lenses. Managing underlying conditions like blepharitis, rosacea and acne can also help to reduce the risk of developing eye bumps.

Maintaining Eyelid Hygiene

Maintaining good eyelid hygiene is an important step in preventing the development of eye diseases and bumps. Once daily, gently cleanse the eyelids with a mild, non-irritating cleanser, such as baby shampoo diluted in warm water. This practice helps to keep the eyes free of debris, oil and bacteria, all of which increase the risk of both chalazia and hordeola.

Avoiding Contamination

Using contaminated eye makeup or sharing personal items like towels, washcloths or cosmetics applicators can spread harmful bacteria that can contribute to stye development. You can reduce the risk of bacterial contamination by replacing eye makeup regularly, avoiding expired products and refraining from sharing makeup with others.

Proper Contact Lens Care

Proper contact lens hygiene is also paramount to minimize the risk of microbial contamination and infection. Be sure to follow recommended cleaning and disinfection protocols, avoid sleeping or swimming with contact lenses and adhere to prescribed wearing schedules to maintain optimal eye health.

Final Thoughts

While chalazia and hordeola may seem similar at first, these eye bumps differ in everything from their presentation to their duration. With that in mind, understanding their differences is critical for effective management and prevention.

Before a chalazion or a stye even arises, it is important to prioritize eye health. If you find an eye bump, consult a healthcare professional for personalized advice and treatment. The team at UCF Health is here for you, schedule an appointment today.