Chalazion or stye? Lumps on the eyelid and when they need removing

How to tell them apart

The NHS describes a stye as a painful lump and notes that a hard lump that is not very painful is more likely to be a chalazion.

• Stye: tender, red, at the lash line, often with a yellow point like a small boil. Comes up over a day or two
• Chalazion: firm, round, smooth, set back from the lash line, often painless once the early swelling settles. Grows slowly
• A chalazion can become red and sore if it gets inflamed or infected, so the two can look alike for a while

Home care that helps both

Hold a clean flannel soaked in warm, not hot, water against the closed eye for five to ten minutes, three or four times a day. For a chalazion, gently massage the lump towards the lashes afterwards. Keep the lids clean, and wash your hands before touching your eyes.

• Do not squeeze or prick it with a pin or needle
• Do not put breast milk, urine, herbs or leftover drops in the eye
• Stop eye make-up and contact lenses until it settles
• Antibiotic tablets are not usually needed for a stye or chalazion unless the infection spreads

When a chalazion should be removed

Most chalazia go on their own with time and warm compresses. Removal is a reasonable choice when:

• It has not gone after a few months of proper home care
• It is large enough to press on the eye and blur vision
• It keeps coming back in the same place
• It bothers you or your child enough to want it gone

What removal involves

In adults it is a short procedure under local anaesthetic. The lid is turned over, a tiny cut is made on the inside, and the contents are scraped out, so there is usually no visible scar. A pad is worn for a few hours, and the lid may be bruised for a few days. Antibiotic ointment is often given. Children usually need a short general anaesthetic, because they cannot keep still.

A lump that keeps returning in the same spot in an adult, or that looks unusual, should be sent for testing after removal. A few uncommon eyelid cancers can look like a stubborn chalazion.

Warning signs: get help the same day

See a doctor urgently, or go to an eye emergency service, if:

• The redness and swelling spread over the whole lid or around the eye
• You have a fever or feel unwell
• Your eyesight changes, or the pain is in the eye itself rather than the lid
• It hurts to move the eye, or the eye bulges
• A baby under one month old has a red, sticky eye

Common questions