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It is very common that out of nowhere a red and even painful “little bump” could appear on the margin or on the eyelid itself. It is not unusual that people would tell you: “you have a stye.” Some will even tell you that you have a “chalazion.” It’s so confusing!!! Is it stye or is it chalazion? And what is a stye? And what is a chalazion? Let’s start by defining each one.

Stye (or hordeolum) is a lesion at the level of the eyelid that is frequently associated with a bacterial infection. As it is an infection, it is usually red, this might be tender and slightly warm on palpation. There is a high probability that the infection will spread to the entire involved eyelid. This can originate from the base of the eyelashes or on the eyelid itself. That is why it is common to hear the term internal stye, or external stye.

• External stye refers to an infection in the eyelash follicle, it looks like an infected pimple on the edge of the eyelid.

• Internal stye refers to an infection of one of the oil producing glands on the edge of the eyelid, this is often related to blepharitis (infection of the eyelashes).

As noted, the differentiation between a stye and a chalazion is very technical, and definitely requires an assessment by a specialist in the field. An ophthalmologist could be very helpful, and perhaps even better; the expertise of an oculoplastic surgeon.

Chalazion is a lesion in a deeper location of the eyelid, and usually occurs due to the occlusion of some of the oil-producing glands that are located on the margin of the eyelid, behind the eyelashes. This occlusion may or may not be infected. Most of the time, the chalazion can start as an internal stye. It is usually not painful, and it may look a little red and grows over time. This growth can produce a mass effect against the eyeball, leading to blurred vision.

The initial treatment of a stye is the cleaning of the eyelids and eyelashes. The application of warm means or compresses could make the pores of the eyelashes and those of the oil-producing glands in the margin of the eyelids (glands of meibomian) open and drain the remains of inflammation. When the style does not resolve in 3 days with external measures, it is best to consult the eyelid specialist. Depending on the degree of infection, it is likely that the treatment could range from topical to even oral antibiotics. In the case of chalazions, the therapeutic options could be from a simple steroid shot to the affected gland to surgery (curettage). The eyelid specialist can recommend the best option.

In Costa Rica, Dr. Lin Yang is an eyelid specialist with extensive experience in conditions in this area. Contact us to schedule your appointment. Tels:+506 6084-3238 / +506 22898137

In the last blog, we talked about ectropion, a condition of eyelid malposition. Entropion is another position condition that the eyelid may suffer. We know that the eyelids are essential structures for the protection of our eyeball. Any problem that the eyelid suffers will directly affect the capacity and quality of vision. Entropion is a condition, less common than ectropion, in which the margin of the eyelid is inverted into the eye (the eyelid “rolls-in” against the eyeball), placing the eyelashes in direct contact with the eye causing severe discomfort.

Most patients with entropion experience a great amount of tearing, foreign body sensation, irritation and redness of the eye. If entropion is not treated promptly, aside from the irritation symptoms, the eye can suffer from a mild corneal abrasion to a severe ulcer. If not treated properly, both the symptoms and consequences caused by entropion can affect life quality and become disabling, due to the fact that it might cause blindness.

In the lower eyelid there is a muscle called the eyelid retractor that keeps the lower eyelid upright or its vertical position. When this muscle loses its site of adhesion in the tarsus (hard part of the eyelid), the eyelid cannot stay in the upright position. The counter balance effect of lower eyelid retractor toward the orbicularis muscle (the superficial set of muscle, responsible in blinking) is lost. Consequently, the eyelid along with its lashes “rolls-in” towards the eyeball with every blink, causing the annoying symptoms of tearing, rubbish sensation, eye irritation and redness among others. The most common cause of disinsertion of the eyelid retractor is aging. Over time, tissues stretch tend to lose their support sites. Although other causes of entropion could be trauma, eyelid tumor, eyelid and/or previous eye surgery, frequent eyelid spasms and frequent rubbing of the eyes.

Regardless of the cause, the definitive treatment for entropion is surgery. There may be circumstances in which a patient cannot undergo surgery or simply does not want surgery as a treatment. For this group of patients, there are temporary measures such as the use of artificial tears frequently during the day and the use of these tears in presentation of gel at night before bedtime. If abrasion or ulcer forms in the cornea, therapeutic contact lens can be placed and topical antibiotic initiated. Fillers can be used transiently to keep the eyelids in their anatomical position while waiting for surgery. Remember that depending on the type of filling used, the duration of the effect can last from 6 to 12 months. In summary, the important thing regarding entropion is an accurate and timely diagnosis for the correct treatment. And this can be achieved by consulting with an oculoplastic surgeon.

Corrective ectropion surgery in Costa Rica
To definitively eliminate the annoying symptoms of entropion (tearing, redness of the eyes, foreign body sensation), surgical intervention is the only solution. The eyelid specialist (oculoplastic surgeon) performs the corrective operation by means of an almost imperceptible incision under the eyelashes in the lower eyelid to re-insert the eyelid retractor muscle to its usual site in the tarsus, returning the anatomical eyelid verticality without altering its contour with the desired cosmetic result.

Corrective entropion surgery is an out-patient procedure, without the need for hospitalization. It is carried out under local anesthesia with a light touch of sedation. This procedure has a prompt recovery. Under normal conditions, the patient can expect mild to almost unnoticeable inflammation and bruising around the eyelids that resolves in a week. Usually, corrective surgery takes 30 to 45 minutes. The stitches are removed one week after surgery. And most importantly, entropion surgery is NOT painful.

In Costa Rica, Dr. Lin Yang is an oculoplastic surgeon with extensive experience who can offer you the definitive treatment to correct the entropion, returning the functionality to your eyelid with the best cosmetic appearance. He uses minimally invasive and safe techniques, with rapid recovery. Solve the entropion once and for all. You can call us at 2208-8322 / 2289-8137 or write to info@doctorparpados.com to schedule your appointment. It will be a pleasure to assist you.