Stye Treatment

By Scott Burge, OD

Maryland Eye Associates

. http://marylandeyeassociates.com

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Stye Treatment

Eyelid hygiene is something one seldom thinks about until the dreaded stye makes its appearance one morning. It starts with a slightly swollen and tender lid. It doesn't look too bad. Apply the cosmetics; insert the contact lens. In another day or two at the most, it's worse, it hurts. You look in the mirror and realize now that this is a big problem.

The glands in the lids support the tear film with natural lubricants. If the ducts or pours for these glands become plugged, a back up occurs. Add bacteria and you have an infection. The infection is localized to one area of the lid. With the finger or Q-tip, the tender, painful “hot spot” is easily identified. Meanwhile the rest of the lid becomes swollen, often to the degree that the eye looks partially closed. You cannot insert a contact lens. Cosmetics will not cover up the problem. Applying them would only compound the worsening situation.

The first course of action to get rid of this is a combination of gentle lid scrubs, warm compresses and saline rinsing of the eye. Lid scrubs can be done with soap or shampoo. Johnson's Baby Shampoo is a great non-burning option. The goal is to have the lid and lashes completely clean. Over-the-counter (OTC) medicated lid scrub pads from OCuSOFT are an excellent product to accomplish this as well, with no irritation or burning. Pre-moistened pads are individually packaged for easy, no-mess use anytime during the day.

Warm to hot compresses are simple and highly effective. The best way to do them is at a sink with hot water running as warm as can be tolerated, soaking a clean folded washcloth continuously from the faucet as you are bent over the sink pressing the compress on the closed eyelids. The moist heat opens the lid ducts and pours to promote eventual drainage. Do this repeatedly for five minutes at least twice a day, or more often if possible.

Eye rinsing (irrigation) is also effective for flushing matter from under the lid.

Use saline for sensitive eyes, OTC, easily found in the contact lens solution section of supermarkets and pharmacies. Spread the eyelids apart so that the eye is as wide open as possible and rinse with a steady stream of saline.

Prescription medication may be necessary to speed up the process of getting rid of the stye. If the lid situation is improving with the above steps, continue doing them for a few more days (up to a week) until the problem has resolved.

However, if the situation is getting worse, a prescription anti-biotic steroid combination will get the job done within 48-72 hours. Besivance is a broad spectrum anti-bacterial drop, one drop applied three times a day. To apply, shake the bottle, lie down on your back, spread the lids apart and place one drop directly on the eye, roll the eye around to get some of it under the lids. Besivance is a milky suspension type drop; vision will be blurry for a few minutes until the drop dissipates.

At night before sleep, TobraDex ointment is applied on the eye with lids spread apart so that it also gets under the infected lid. It may also be applied externally on the lid surface. Because the ointment is thick, vision is blurred and the lids will feel quite gummy. Close the eyes and go to sleep. In the morning, clean the lids again as described above.