Eyelids

We often see eyelid lesions in the office that families will generally refer to as styes or eyelid bumps. Eyelid bumps are usually either styes (hordeolum) or chalazions.

Styes or hordeolum are swellings on the edge of the eyelid near an eyelash follicle, where a chalazion is found above or below the eyelid. Both are a combination of a blocked and possibly infected eyelash follicle or oil gland of the eyelid, sort of like an eyelid pimple. 

The treatment for both is the same and includes hot compresses for 15 minutes 3 times a day. Some kids (and adults) dislike doing hot compresses with hot water because of the wetness and the fact that it doesn’t stay hot for the full 15 minutes and must be continuously rewet. So, often I will recommend preparing the hot compress as follows:

• Use a thick, clean athletic sock so the grains will not poke through

• Fill it with one cup of uncooked rice (You can also add flax seed which takes longer to heat than rice but is also smoother and stays warmer longer.)

• Don’t pack it in tightly; leave some room for the grains to move around so that it will more easily conform to the area to be treated

• Use a rubber band to close the top or, if you are using a tube sock, you can knot it 

• Place it in the microwave for 30-60 seconds

• Check the temperature on the back of your hand before placing it on your eye (It should be warm, but not uncomfortably hot.)

Place it on your closed eye for 15 minutes 3 times a day. This will speed up drainage of the stye or chalazion. Sometimes if the chalazion is very irritated or painful, antibiotic eye drops can be prescribed. If we keep getting a chalazion in the same spot over and over again or if the bump is present for more than a month, the eye doctor can go in and remove the lesion.  But this course of treatment is rare, and most spontaneously resolve in a week or two.