Is an External Hordeolum (Stye) Contagious?
No, an external hordeolum (stye) is not contagious and does not spread from person to person through casual contact.
Understanding Contagion Risk
- External hordeola are acute, suppurative inflammations of the eyelid glands (glands of Zeis or Moll) most commonly caused by staphylococcal bacteria that are already present on the patient's own skin 1
- Unlike highly contagious eye conditions such as adenoviral conjunctivitis, which requires strict isolation measures for 10-14 days 2, styes do not require any special precautions or school/work exclusion
- The infection is localized to the individual's eyelid margin and does not transmit through direct contact, shared towels, or environmental surfaces 1
Basic Hygiene Measures
While not contagious, patients should practice standard hygiene:
- Avoid touching or rubbing the affected eye to prevent spreading bacteria to other areas of the same eye or the opposite eye
- Wash hands regularly, particularly after touching the affected eyelid
- Avoid sharing eye makeup or cosmetic applicators (general practice, not specific to contagion risk)
When to Seek Emergency Care for a Stye
Emergency department evaluation is NOT typically needed for an uncomplicated external hordeolum, as most resolve spontaneously within one week.
Warning Signs Requiring Urgent Medical Evaluation
Seek immediate medical attention if any of the following develop:
- Spreading cellulitis: Redness and swelling extending beyond the eyelid margin to involve the periorbital tissues or cheek 2
- Vision changes: Any blurring, double vision, or loss of vision
- Severe pain: Pain that is disproportionate to the visible swelling or that worsens despite treatment
- Fever: Development of systemic fever, particularly in patients with diabetes or immunocompromised states 2
- Inability to open the eye: Due to severe swelling
- Proptosis: Forward displacement of the eyeball, suggesting orbital involvement
High-Risk Patients Requiring Lower Threshold for Evaluation
Certain patients should seek medical evaluation more promptly, even with milder symptoms 2:
- Diabetic patients: Higher risk of severe complications and spreading infection 2
- Immunocompromised patients: Including those with HIV, on chemotherapy, or taking immunosuppressive medications 2
- Patients with recurrent hordeola: May indicate underlying conditions such as selective IgM deficiency or chronic blepharitis requiring investigation 1
When to See Your Regular Doctor (Non-Emergency)
Schedule an appointment with your primary care physician or ophthalmologist if:
- The hordeolum does not improve or resolve within 7 days
- Multiple recurrent hordeola develop 1
- The lesion becomes chronic or develops into a chalazion 3, 4
- You develop multiple simultaneous hordeola on the same eyelid