Hordeolum (Stye): Internal Vs. External

In most cases, a hordeolum (also called a stye) is a swollen, painful eyelid bump located on the outer part of your lash line. This is an external hordeolum or stye.

However, it’s possible for a stye to develop inside your eyelid (further away from the base of your eyelashes). When this happens, it’s called an internal hordeolum.

So, what’s the difference between an internal stye and an external stye? To put it simply, they are infections of different types of eyelid glands.

Internal hordeolum

An internal hordeolum is an infection of a meibomian (“my-BOW-me-an”) gland in the eyelid.

Meibomian glands open at the base of the eyelashes, but extend relatively deep into the tissue of the eyelid. They secrete oil into the tear film that coats the front of the eye and keeps tears — which are made mostly of water — from evaporating.

Internal hordeolums develop when bacteria gets into the meibomian gland, causing an infection.

An internal hordeolum is typically present in only one eye at a time, though it’s possible for it to affect both eyes.

While an internal stye is not nearly as common as its external counterpart, it can be more painful, last longer, become chronic, or harden into a cyst or chalazion.

SEE RELATED: How long does a stye last?

Internal stye causes

Internal styes are typically caused by bacteria called Staphylococcus aureus (commonly called “staph” bacteria).

Staph bacteria are commonly found on our skin and in our noses and usually don’t cause a problem. But if they increase in number and infiltrate a Meibomian gland, this results in infection, inflammation and swelling.

Staphylococcus aureus is also one of the types of bacteria that cause conjunctivitis.

LEARN MORE: What causes a stye?

Internal stye symptoms

If any of the following symptoms persists for more than a week, it’s important to make an appointment with your eye doctor:

• Bump on or near your lash line

• Itching of the eyelid

• Eyelid swelling or redness

• Intense eye or eyelid pain

• Oozing or crusting along the lash line

• Eye redness

• Eyelash loss

Avoid scratching, squeezing or touching the stye while you’re experiencing symptoms. It’s also important to increase your hand washing during this time.

LEARN MORE: How to relieve a sore eyelid

Internal stye treatment

While medical attention should be sought if symptoms persist or become severe, an internal hordeolum can usually be treated using stye home remedies. At-home treatment options include:

• Applying a clean, warm compress on the affected eyelid.

• Keeping the eyes clean by flushing them with sterile eye drops.

• Gently massaging the eyelid with two fingers .