Eye Health: Infections of the Eyelid

In our continuing series on Eye Health, Consultant Eye Surgeon Dr S.S. GILL talks to us about eyelid infections.

The eyelid has an important protective function over the eyeball, separating the eyeball from the external environment to keep out dust and other foreign materials. Additionally, with every blink it evenly spreads the lubricant tear film over the front of the eyeball (cornea and conjunctiva). Like any other area of the skin, it is not spared from various infections that may affect it. There are two main eyelid infections that commonly may occur. They are, stye and blepharitis.

In this issue, Dr Gill talks about about a condition called stye, which is an infection of the hair follicle of an eye lash. It is also known as hordeolum. It presents as a small painful bump on the outside (external hordeolum) or on the inside (internal hordeolum) of the eyelid. It basically looks like a pimple on the eyelid (called “ketumbit” in Bahasa Malaysia).

A stye is not harmful to vision but does cause a discomfort to the eye. It can occur at any age but most often affects infants and children. It is most often caused by bacteria called staphylococcus which is found in high concentrations within the nose and therefore is easily transferred to the eyelids by unwashed fingers!

When the eyelash follicles get infected with the bacteria, it swells up and becomes filled with pus. The eyelash follicle then looks like it has a pimple on the eyelid that becomes red and painful.


  • Painful swollen and red eyelid.
  • Droopiness of the affected eyelid
  • A more localised swelling with pus collection as time goes by
  • Tearing or watering of the eye, and increased sensitivity to light occasionally
  • Later, crusting on the eyelashes if the stye ruptures and pus is expelled out.


Pretty much everyone has the potential to develop a stye without any outside contamination since it is most often caused by bacteria from the nose. This bacteria is transferred easily to the eye especially when you rub first your nose, then your eye.

However, people with certain chronic conditions like diabetes mellitus, chronic skin conditions (seborrhoea) and chronic illnesses that reduce immunity are more prone to developing styes than the general population.


Most styes heal on their own within a few days. Warm compresses applied for 10 to 15 minutes, 3-4 times a day, help to relieve the pain and may help “ripen” the stye very much like a pimple. The stye eventually usually ruptures to drain the pus collection and finally heals. Remember never to “pop” a stye like a pimple; but always allow it to rupture on its own. The internal type of stye (that appears inside the eyelid) may sometimes not heal and therefore require drainage of the pus by an eye doctor. For such cases, an antibiotic eye ointment is commonly prescribed along with perhaps an oral antibiotic depending on the severity. If you suspect you have a stye that keeps on worsening, seek medical attention.

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