chalazion vs stye melbourne

Chalazion vs Stye – What Is The Difference?

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The eyelid can be subject to various lumps and bumps, some of which are harmless and no more than a cosmetic concern, and others which need to be seen by an oculoplastic surgery specialist immediately for treatment. When it comes to common eyelid bumps, one of the most frequent confusions is what is the difference between a chalazion vs a stye. 

 

The Eyelid

The human eyelid is much more than a simple fold of skin lined with eyelashes. Understanding a little about our own eyelid anatomy can help before moving into distinguishing between a chalazion vs stye, as these two eyelid bumps arise from different locations in the eyelid. 

Within the eyelid beneath the visible skin are layers of smooth muscle, connective tissue, fibrous tissue, conjunctiva, and various secretory glands. An important set of glands are known as the meibomian glands, which line the eyelid margins on both the upper and lower lids. These glands produce an oily secretion commonly known as meibum, which functions to lubricate the surface of the eye and plays a crucial role in preventing dry eye. If you were to turn the eyelid inside out and examine the pink inner surface of conjunctiva with the appropriate imaging technology, healthy meibomian glands appear like little clusters of bulbs lining a central channel that leads to the eyelid margin and secretes onto the surface of the eye, just behind the rows of eyelashes. 

Each row of eyelashes is accompanied by two additional types of glands that function to support the health of the eyelashes. These are the known as the glands of Zeis, which are sebaceous glands, and the glands of Moll, which are modified sweat glands. Both of these are found at the base of each eyelash follicle and serve to keep the lashes from becoming brittle and unhealthy. 

 

Chalazion vs Stye 

Chalazia (plural of chalazion) and styes are among the most common eyelid bumps and lumps you’re likely to encounter in your lifetime. Fortunately, both are considered benign and non-cancerous, though can cause some distress if large or sore. It’s quite common for many people to use the umbrella term of “stye” to refer to all eyelid bumps, including chalazia, however these two lesions arise from different underlying causes. Both appear as a swollen lump on the eyelid, and both can feel red, warm, and tender. So, what is the difference between a chalazion vs a stye? 

difference chalazion vs stye melbourneA chalazion is a non-infectious blockage of a meibomian gland, while a stye, also known as a hordeolum, is an infection of either a gland of Zeis or Moll (in the case of an external hordeolum), or of a meibomian gland (an internal hordeolum). 

Chalazia may initially begin as an internal stye, which then resolves after a few days into an obstructed meibomian gland with no active infection. A chalazion may present as a general swelling of the eyelid, eventually reducing to a discrete hard bump on the eyelid. The composition of this bump under the skin consists of blocked meibum accumulating in the surrounding soft tissues due to the obstruction of its usual drainage channels. Usually this bump is not painful, even to the touch, and many people are bothered only by the appearance of it more than anything else. In some cases, the chalazion may be large enough to press on the cornea, the transparent front surface of the eye; this can cause some mild distortion of the cornea and temporarily blur the vision. Chalazia can take weeks, and occasionally months, to fully resolve as the body clears away the waste material from the eyelid. 

Conversely, a stye is often painful and red as it’s the product of an active infection. External styes are the most common type of hordeolum and appear as a yellowish or white pimple around the base of an eyelash, while an internal stye resembles more a chalazion and presents as a bump further into the eyelid. Styes most often involve a staphylococcal bacterial infection. In most cases, an external stye will rupture on its own within a few days, excreting a small amount of pus and self-resolving. 

 

Treatment

In the majority of cases, both chalazia and styes will self-resolve without any intervention from an oculoplastic surgery specialist. Your optometrist or GP may recommend applying a warm compress to the eyelid a few times a day to speed up the healing process, but you should never attempt to squeeze or pop either a chalazion or stye, as tempting as it may be! Topical antibiotic ointment may be used for an external stye, but are ineffective for chalazion as there is no active infection to treat. 

For severe chalazia or styes that are too slow to resolve with conservative therapy, you may be referred to an eye specialist experienced in oculoplastic surgery. For persistent chalazion, the ophthalmologist may perform a procedure known as an incision and curettage, or may administer a steroid injection into the eyelid. In the case of external styes, the ophthalmologist may pluck out the eyelash associated with the infected gland, or may use a surgical blade under local anaesthesia to assist drainage of infected material from the gland. 

Chalazion and styes can often recur, especially if you have underlying factors that make you more prone, such as acne rosacea or meibomian gland dysfunction. Frequently recurrent eyelid bumps, especially bumps that tend to occur in the same location on the eyelid, may require biopsy by an oculoplastic surgery specialist to rule out any other causes, such as an eyelid carcinoma. 

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner. 

what is a ptosis melbourne

What is a Ptosis and How This Condition Can Be Treated?

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Our eyelids can droop for a number of reasons. In your experience, you’ve most likely experienced this simply when tired or sleepy. However, in other cases, there can be other underlying reasons for what is known in the medical world as an eyelid ptosis. Some of these causes are simply due to age-related changes to the body while other cases of eyelid ptosis may herald a more serious disease. 

 

What is a Ptosis?

 Eyelid ptosis refers to an involuntarily drooping upper eyelid. The eyelid may be only slightly lowered such that it’s barely noticeable, or in some cases can be so lowered that it can block vision from that eye and requires ptosis surgery by an eye specialist experienced in oculoplastic surgery procedures.  

While the most obvious sign of ptosis is a drooping upper eyelid, there may be other more subtle signs that point to an issue with a person’s ability to keep their eye open. These signs include adjustments to head posture, such as tilting your head backward or lifting up your chin in order to see through the narrowed opening between your eyelids. A person with a ptosis may also unconsciously raise their eyebrows in an effort to use the forehead muscles to pull their upper eyelids up further.  

 

What is Ptosis Caused By? 

An eyelid ptosis can occur in any age group. Children can be born with a ptosis, either on one or both eyes – this is known as a congenital ptosis. Typically, the underlying reason for this is damage or underdevelopment of the muscles responsible for lifting the upper eyelid, or to the nerves that supply these muscles. If the ptosis is severe enough to limit the sight in that eye, your child’s eye specialist will most likely recommend that he or she undergo ptosis surgery reasonably soon so that the normal development of their vision is not unduly impacted. Unnatural head and neck positions from an attempt to see around a ptosis can also cause problems with neck muscle development if not addressed. 

causes what is a ptosis melbourneIn adults, the most common underlying cause of a ptosis is age-related weakening of the levator palpebrae muscle that lifts the top eyelid, or a loosening or detachment of the tendon that helps to anchor this muscle. Ptosis surgery, or a ptosis repair, is able to either reattach the tendon or even shorten the levator muscle so that the upper eyelid can be properly lifted. 

There are some cases of ptosis that are due to a more sinister underlying reason. Myasthenia gravis, an autoimmune disease characterised by increasing muscle fatigue and weakness, will often present with gradual worsening of drooping eyelids as the day progresses. This ptosis improves with rest and worsens when the eyelid muscles are exerted, such as when looking upwards for a sustained period of time.

An eyelid ptosis may also be a sign of damage to the nerve that supplies the eyelid levator muscle, such as in the case of Horner’s Syndrome or a 3rd cranial nerve palsy. These conditions are considered serious and may in fact be medical emergencies as they can be associated with the presence of an aneurysm or tumour. Such diseases will typically present with other symptoms in addition to the ptosis, such as unequal pupil size and restricted eye movements causing double vision, and must be managed as per the underlying cause rather than with ptosis surgery. 

There have been reports that certain eye operations can induce a ptosis, particularly those that require the use of a tool called a speculum, which is used to keep the eyelids open during the procedure. The theory is that the stretching of the eyelid by the speculum causes damage to the muscle or tendon, resulting in a post-operative ptosis. Post-operative ptosis has been reported after anterior eye operations such as cataract surgery and refractive procedures including LASIK. 

 

Oculoplastic Surgery

If you have been diagnosed with a ptosis, your doctor will first establish that there are no other serious underlying diseases as mentioned above. An ophthalmologist experienced in oculoplastic surgery can do a thorough assessment to determine what is your ptosis caused by and whether it’s suitable for management through ptosis surgery. 

A ptosis repair is typically a day procedure performed under local anaesthetic, though your surgeon may also offer you a sedative to ensure the procedure is comfortable for you. There are a couple of techniques the eye specialist may employ during the surgery, depending on the degree of ptosis and the condition of the eyelid muscle or nerve function. Ultimately, the aim of surgery is to raise the eyelid to ensure that it does not block your vision, and to improve the cosmetic appearance, ideally for the height of the eyelids to appear symmetrical. 

Immediately after surgery you’ll be given post-operative instructions, such as keeping the operated eye clean and protected from eye rubbing and dirt or dust and avoiding any strenuous activity or contact with unsterile water sources such as swimming pools.  

As the operation involves incisions and stitches into the skin and tissues around the eyelids, the final outcome of the surgery may not be apparent for up to a few months after the surgery as the eyelid heals. If required, the eye surgeon can perform a corrective procedure to ensure you’re fully satisfied with the results.  

 

 

Note: Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.