How to Treat a Stye: Incision and Drainage of a Chalazion
A common condition I see and treat in my practice is a bothersome red and swollen bump on the eyelid, commonly referred to as a stye. To be medically accurate, there are two types of such bumps: a chalazion and a hordeolum.
A chalazion is an inflamed bump in the eyelid that occurs when hardened oils block an oil-producing gland (meibomian gland). It can be associated with blepharitis (inflammation of the eyelids) and rosacea, and can often lead to symptoms of dry eyes.
A hordeolum (stye) is an acute infection of oil-producing glands, most commonly caused by Staphylococcus aureus bactreria. An external hordeolum involves the glands of Zeis and appear to center around an eyelash follicle, while an internal hordeolum involves the meibomian glands. Rarely, hordeola may spread to the surrounding soft tissue (cellulitis) and can even form an abscess of the eyelid.
Treatment of chalazia and hordeola is initiated with frequent warm compresses and/or topical medications. Depending on the severity, oral antibiotics may be prescribed. Non-resolving or large chalazia can be treated with steroid injections or surgically in the office by incising and draining the inflamed lesion. This is usually performed through an incision on the inside of the eyelid, which leaves no visible scar.
This video demonstrates how I incise and drain a chalazion:
After injecting an anesthetic agent (numbing medication), I place a special clamp* along the eyelid to isolate the chalazion. I then evert the eyelid and make an incision on the inside of the eyelid. Then, using an instrument called a curette, I scoop out the contents . At the end of the procedure, I remove the clamp and place an ophthalmic ointment on the eye.
Keep in mind, that while chalazia are generally benign, recurring or atypical chalazia warrant evaluation (and often biopsy) by an ophthalmologist or oculoplastic surgeon to rule out other causes.
* The chalazion clamp is a surgical instrument that is used to aid in the incision and drainage of chalazia/styes. It was originally designed in the 19th century by French ophthalmologist, Louis-Auguste Desmarres (1810–1882).
The clamp helps with isolating the chalazion, minimizing bleeding by applying pressure, and stabilizing the eyelid during the procedure. Its ingenious design was introduced by Desmarres in his book, Traité théorique et pratique des maladies des yeux, published in 1847.
The chalazion clamp has also found use beyond ophthalmology. It is commonly used in dermatology, intraoral surgery (oral mucosal biopsies), scrotal surgery, earlobe reconstruction, and much more.
For more information about chalazia or styes, or to schedule a consultation, call us at 858.356.2647
These are images of actual patients of Dr. Jean-Paul Abboud. They are shown for informational purposes only and are provided with patient consent for use on this website. Please do not copy or distribute images/videos. Each individual’s treatment and/or results will vary, and no guarantee is stated or implied by any photo or statement used on this website.