Treatment of a Stye

Most styes can be treated without medical intervention by applying hot compresses for 10-15 minutes at a time for four times per day.  There is some controversy that a warm compress may worsen the swelling and shouldn’t be used for several days.  However, the purpose of the warm compress is not to decrease swelling, but rather to open the pores of the tiny oil glands to allow proper drainage so the eye can heal itself.  Therefore, we only recommend warm/hot compresses.

Removing an eyelash or two in the center of the bump may help to stimulate drainage of the infection.

Clean the eyelid margin and the entire eyelid with an over the counter eyelid scrub (e.g. SteriLid Eyelid Cleanser or Ocusoft eyelid  scrubs) that can be purchased at any pharmacy.

Most styes will heal within  10-14 days.   

If the stye does not get better within 3-5 days treatment by an eye doctor is recommended.  The doctor may prescribe oral antibiotics such as:

Keflex (cephalexin) 500mg twice per day for seven days for patients who are not allergic to penicillin or cephalosporins.

Option (also if no penicillin allergy)  Augmentin (Amoxicillin + Clavulanic acid):

     Dose if mild infection -generic Augmentin 500 mg. twice a day for one week

     Dose if more severe –generic 875mg Augmentin twice a day for one week

    Most severe - 1000mg Augmentin twice a day for one week (not generic)

When the patient has a penicillin or cephalosporin allergy:

Zithromax (azithromycin) in a Z-pak (500mg on day one, followed by 250mg for the next four days) is a good alternative.

OR, if the patient also has allergies to macrolides, we recommend:

Oral fluoroquinolone Levaquin (levofloxacin) at 500mg once daily for 7 days.

Or Cipro (ciprofloxacin) 500-1000 mg once daily for 7 days

Topical eye medicines in most cases offer very little healing since they do not penetrate into the glands.  There is some evidence that topical Azithromycin (Azasite) has some penetrating ability.  However, it is an expensive medicine and most patients are not happy if it doesn’t heal the hordeolum.  The tested and proven treatment would be to use an oral antibiotic, many of which are available generically at a greatly reduced cost.

Complications of a Stye

Use of the above medicines on a timely basis will also prevent an eyelid cellulitis or preseptal cellulitis which is a serious complication of a hordeolum.

If the above medicines are not effective at treating the hordeolum it has probably become a chalazion.  Chalazion may resolve without treatment but many require a minor surgery to remove.