Effective treatment of styes and chalazions is essential to maintain optimal eye health and avoid complications. These inflammations, whether chalazion or stye, can cause discomfort and affect the aesthetics of the eye. By exploring treatment methods for stye and distinguishing between chalazion and stye, this article offers valuable information on the cause, symptoms to watch out for, and treatment options available. Home methods and medical interventions will be discussed, highlighting modern approaches such as intense pulsed light and photobiomodulation for the treatment of chalazions. By addressing prevention, this guide aspires to be an invaluable resource for those seeking to understand and manage these common eye conditions.

What is a chalazion?

A chalazion is characterized by several distinct symptoms and causes, which require in-depth understanding for effective treatment. Here's a detailed analysis:

Initial symptoms and development:

• Early signs include diffuse eyelid swelling, redness and pain.
• Over time, a localized nodule forms in the eyelid, which is generally painless and oriented towards the inside of the eyelid ^[1].
• In some cases, a large or misplaced chalazion can lead to indentation of the cornea, affecting vision ^[1].

Causes and risks:

• A chalazion results from the blockage of a Meibomian gland. Conditions such as meibomian gland dysfunction or acne rosacea, which cause abnormal thickening of meibomian gland secretions, increase the risk of blockage. ^[2][4].
• Chalazions are usually painless, unlike styes, which are tender and superficial. ^[3].
• In elderly patients with recurrent chalazions, it is important to consider neoplasms such as sebaceous carcinoma, basal cell carcinoma and squamous cell carcinoma ^[3].

Nature and location:

• It is a benign cyst that develops on the eyelid due toinflammation of one or more sebaceous glands, known as the Meibomius glands ^[5][6].
• Chalazions can be internal (under the eyelid) or external, and develop slowly and painlessly. They often disappear on their own in a few days to two months. ^[5][6].
• Inflammation and obstruction of these glands do not constitute an infection, unlike a stye. ^[1].

Understanding the distinction between a chalazion and similar conditions, such as a stye, is crucial to choosing the right treatment. A chalazion is essentially a non-infectious obstruction of the Meibomian gland, leading to the extravasation of irritant lipids into the soft tissues of the eyelid and the formation of an inflammatory granuloma ^[1].

Recognizing a stye

Recognizing a stye requires close attention to the initial symptoms and their evolution. Here's a detailed overview to help identify this condition:

Initial symptoms:

• Eyelid redness, swelling and pain ^[1].
• Appearance of a localized nodule on the eyelid, usually painful and oriented toward the eyelid margin ^[1].

Further development:

• Suppuration: yellowish spot at the base of the lash, surrounded by hyperemia, induration and edema ^[1].
• Duration: 2 to 4 days for lesion to rupture and release pus, followed by resolution of pathology ^[1].

Identification and treatment:

A stye, or hordeolum, is caused by a bacterial infection, mainly by the bacterium Staphylococcus aureus ^[2][9].

• Risk factors include poor hygiene, contact lens wear and a weakened immune system. ^[9].
• Symptoms include redness, swelling, pain, itching, sensitivity to light and a visible white head on the eyelid ^[11].
• Styes can be diagnosed by an optometrist through a simple examination ^[13].
• Most styes heal on their own within a week or two, but applying warm compresses to the affected area several times a day can speed up the healing process ^[13].
• If the stye doesn't improve within 48 hours, is very painful, or if the redness and swelling spread to the rest of the face, it's important to consult an optometrist. The optometrist may prescribe antibiotics or perform in-clinic medical procedures.

This information provides a solid basis for recognizing a stye and taking the first steps towards home treatment, while emphasizing the importance of consulting a healthcare professional in the event of persistent or severe symptoms.

Causes Communes des Chalazions et Orgelets

Chalazions and styes result from inflammation and obstruction of the sebaceous glands of the eyelids. This condition can be influenced by several distinct risk factors, which vary according to the specific condition - chalazion or stye ^[3].

Risk factors for chalazion :

• Pre-existing medical conditions: The presence of blepharitis, dermatitis, or certain autoimmune, bacterial (such as tuberculosis) or parasitic (such as leishmaniasis) diseases may increase the risk of chalazion development ^[5].
• Environmental and behavioural: Exposure to air pollution, certain mites in the sebaceous glands, dry eyes, high blood lipid levels and exposure to UV radiation are also notable risk factors. ^[5].
• Gland-specific conditions: Disorders leading to abnormal thickening of Meibomian gland secretions, such as Meibomian gland dysfunction or acne rosacea, also increase the risk ^[1].

Risk factors for styes :

• Ocular hygiene: Poor eye hygiene, contact lens wear and the use of make-up can contribute to the development of styes. ^[12].
• Ocular conditions: Dry eyes are also a risk factor for styes, underlining the importance of good hygiene and proper eye health management ^[12].

Understanding these risk factors is essential to implementing effective preventive measures and selecting appropriate treatment options for chalazions and styes. Management of these conditions often involves a holistic approach, taking into account underlying environmental, behavioral and medical factors.

Symptoms to watch out for

Differentiating between a chalazion and a stye is essential for a correct diagnosis and to guide treatment options. Here's a comparison of the symptoms to look out for in each:

Chalazion:

• Presence of a bump on the eyelid, often painless and localized in the eyelid ^[1].
• Swollen eyelid, which may lead to blurred vision if the chalazion is significant ^[5].
• Watery eyes, especially if the chalazion is internal, and increased sensitivity to light ^[5].
• In some cases, a sensation of sand in the eye and mild conjunctivitis. ^[5].

Orgelet:

• Localized nodule on the eyelid, usually painful and located at the eyelid margin ^[1].
• Redness, swelling and discomfort of the eyelid, which may lead to ptosis (drooping eyelid) ^[6].
• Styes are typically more painful than chalazions and may present a yellowish spot at the base of the lash, indicating suppuration ^[1].

It is important to note that chalazions and styes may initially present similarly, but styes are typically more painful ^[1]. Differentiating symptoms not only helps to identify the condition, but also to adopt appropriate treatment measures. For example, chalazions, being generally painless, may not require immediate intervention and may resolve on their own, whereas styes, due to their painful nature and potential for infection, may require more prompt medical attention.

Home treatment options

For at-home treatment of chalazions and styes, several methods can be applied effectively to speed resolution and relieve symptoms. Here are the recommended approaches:

Warm Compresses

• Application: Apply warm compresses to the affected eye for 5-10 minutes, several times a day. ^[10][18].
• Purpose: Heat helps liquefy blocked glandular contents, facilitating drainage. ^[1][10].
• Additional technique: After applying warm compresses, gently massage the eyelid to help drain the Meibomian glands. ^[18].

Eyelid hygiene

1. Daily cleaning: Use a cleansing wipe or mild soap to clean the eyelids every day. ^[10].
2. Gentle massages: Gently massage the eyelids to release blocked glands, especially after applying warm compresses. ^[6][18].
3. Prevention: Maintaining good eyelid hygiene by washing regularly with lukewarm water and mild soap can help prevent chalazion formation. ^[6].

Additional Measures and Precautions

• Avoid squeezing or draining: Never attempt to squeeze or drain a chalazion or stye yourself to avoid the risk of infection. ^[18].
• Use of contact lenses and make-up: Avoid wearing contact lenses or make-up while treating a chalazion or stye to reduce irritation. ^[18][19].

These home treatment methods, when applied correctly and regularly, can greatly contribute to the resolution of chalazions and styes, while reducing the risk of recurrence. However, it is crucial to consult a health care professional if symptoms persist or worsen.

When to consult a professional

It's crucial to know when to switch from home treatments to a professional consultation for chalazions and styes. Here are clear indications for consulting a healthcare professional:

Persistence or worsening of symptoms:

• Chalazion that persists for several months despite treatment ^[10].
• Stye that does not improve after a few days or worsens ^[11].
• If the chalazion persists for more than 4-5 days, a consultation with an optometrist is recommended for treatment with antibiotic ointment and cortisone. ^[7].
• Consultation necessary if the stye does not improve after 48 hours of application of warm compresses or if it causes significant discomfort. ^[19].

Alarming symptoms requiring immediate attention:

• Vision problems, severe pain, or signs of infection such as redness, heat, or pus ^[20].
• Chalazion affecting the ability to perform daily tasks such as reading, driving, or working ^[20].
• Presence of other symptoms such as fever, chills, or swollen lymph nodes ^[20].

Special considerations:

• Biopsy may be considered for chronic chalazions that do not respond to standard treatments. ^[1].
• Surgical removal is considered if the chalazion does not respond to other treatments after two months ^[5].
• Repeated occurrences may indicate underlying health problems such as diabetes ^[12].

It is imperative to consult an optometrist before any surgical procedure ^[8].

Available medical treatments

For the medical treatment of styes and chalazions, several options are available depending on the severity and persistence of the condition:

Initial treatment for chalazions and styes:

• Antibiotic ointments: Use of an antibiotic ointment, which can be combined with a corticosteroid to reduce inflammation. ^[8].
• Specific creams: For styes, creams containing antibiotics and corticosteroids, such as Tobradex, can be prescribed.
• Corticosteroid injections: In some cases of chalazion, intra-lesional injections of corticosteroids may be necessary. ^[1].

Surgical approaches:

• Incision and drainage: If medical treatment proves ineffective after 2 months, surgery may be considered. This procedure involves making a small incision near the encysted chalazion gland ^[5].
• Surgical technique: The incision is usually made on the inner side of the eyelid, leaving no visible scarring ^[5].
• Procedure: Surgery is performed under local anaesthetic and takes less than 30 minutes. After surgery, a bandage is applied to the eye for four hours, and a cream is used to prevent infection and inflammation. It is recommended to avoid rubbing the eye, wearing contact lenses, exposing the eye to water and using make-up for at least two weeks. ^[5].

Complementary treatment for infections:

• Antibiotics and anti-inflammatories: If an infection is present, antibiotics may be prescribed. Anti-inflammatory ointments can also be used to treat chalazions. ^[5].
• Eye drops: If pus remains, antibiotic and corticosteroid eye drops or ointment may be required. If pus persists, a minor incision may be required by a healthcare professional in a surgical setting ^[12].

It is important to note that over-the-counter topical antibiotics are generally not useful in treating styes ^[19].

Intense Pulsed Light and Photobiomodulation for Chalazion Treatment

Intense Pulsed Light Therapy (IPL ) and Photobiomodulation (PBM) represent significant advances in the treatment of chalazions, offering non-invasive and effective alternatives to traditional approaches. Here is a summary of these methods, illustrating their mechanism of action, application and efficacy:

Intense Pulsed Light Therapy (IPL)

• Mechanism of action: IPL uses a high-intensity, polychromatic, incoherent light source applied to the periocular area to stimulate the Meibomius glands, promote regeneration and increase meibum secretion. Mechanisms include thrombosis of abnormal blood vessels, eradication of Demodex, heating of meibum and modulation of lipid profiles in the tear film ^[23].
• Application and Safety: Includes three sessions at specific intervals, with additional sessions for maintenance if required. This therapy is non-invasive, painless and safe for the eyes, although there are contraindications such as pregnancy, recent sunburn, epilepsy, and other specific medical conditions ^[23].
• Efficacy: After a single 15-minute session followed by a standard pharmaceutical regimen, 46% of treated eyes showed resolution of chalazions. This rate rises to 92% after two treatments, significantly reducing the likelihood of needing surgery ^[25].

Photobiomodulation (PBM)

• Mechanism of action: PBM uses low-energy light to stimulate biological processes in the skin, promoting cell growth, reducing inflammation and increasing blood flow. This method can be applied using a variety of light sources, such as lasers, light-emitting diodes (LEDs) and broadband light ^[23].
• Application: Treatment sessions typically last between 10 and 20 minutes, and may require several sessions to achieve optimal results. PBM has shown potential in the treatment of dry eye, with positive effects observed on Meibomian gland function ^[23].

These modern approaches offer promising alternatives to conventional methods, incorporating advanced technologies for more targeted, less invasive treatment of chalazions.

Prevention of Chalazions and Styes

To effectively prevent chalazions and styes, it's crucial to adopt rigorous eye hygiene practices and take specific preventive measures. Here are some key recommendations:

Daily eyelid hygiene:

• Regularly clean the eyelids with antibacterial wipes.
• For those with pre-existing conditions such as blepharitis or rosacea, special attention to eyelid hygiene is recommended ^[13].

Use and care of cosmetics:

• Avoid using old cosmetics because of the risk of bacterial contamination, and replace make-up regularly. ^[27].
• Never share make-up with others to prevent the transmission of bacteria and infections ^[28].
• Remove eye makeup before going to sleep, using gentle makeup removers, and discard old or expired products. ^[13].

Additional measures:

• Apply warm compresses to closed eyelids for 5 to 15 minutes, 2 times a day, to help unblock sebaceous glands and prevent chalazions ^[27][18].
• Gently massage eyelids after applying warm compresses to encourage expression of blocked glands ^[18].
• Avoid touching eyes with unwashed hands, and wash hands regularly, especially before handling contact lenses or applying eye care products. ^[28].

These practices, when applied consistently, can significantly reduce the risk of chalazion and stye formation, helping to maintain optimal eye health.

Conclusion

Understanding and treating chalazions and styes is crucial to eye health, underlining the importance of differentiating between these two conditions in order to adopt the right treatment. This article explored the symptoms, causes, and proposed effective treatment methods ranging from home remedies to medical interventions, including technological advances such as intense pulsed light and photobiomodulation. By taking prevention into account and applying rigorous eye hygiene practices, it is possible to significantly reduce the risk of developing these conditions.

If symptoms persist or worsen despite measures taken at home, it's crucial to consult a healthcare professional for a complete evaluation and personalized treatment. Scheduling a consultation for your chalazion or stye can be the first step toward healing and restoring your visual comfort. Eye health is a fundamental aspect of our overall well-being and deserves proper attention and care. Whether through preventive measures or targeted treatments, it's essential to remain vigilant and proactive in managing eye health.

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