This Lesion Looked Like a Stye - But It Was a Hidden Infection

 Surprise Diagnosis: When a Stubborn ‘Stye’ Turned Out to Be Something Rare

This patient was referred to me for what was assumed to be a stye. She already tried the usual options from her doctor: warm compresses, antibiotic drops, ointments, and even oral antibiotics — with no improvement. She also had another symptom that didn’t quite fit: persistent tearing and thick mucus buildup in the eye.

 

At first glance, I too thought it was a classic stye. But when I examined more closely, a few red flags stood out:

• Excessive tearing and discharge — more than I typically see with styes.
• Location — the bump was very close to the nose, over the tear duct area, not along the lash line.
• Color of the inner eyelid — pulling the lid down, I noticed a white-yellow hue, unlike the usual pink inflammation seen with styes. 

That’s when I realized this wasn’t a stye at all — it was something much rarer: canaliculitis.

 

What Is Canaliculitis?

Canaliculitis is an infection of the tear drainage system, often caused by a very clever type of bacteria called Actinomyces. This organism doesn’t just infect the area — it builds itself a protective home, in the form of a stone, much like a kidney stone, inside the tear duct.

• These “sulfur stones” harbor bacteria deep inside, making them resistant to antibiotics.
• Drops, ointments, and oral meds won’t work — the only cure is surgical removal of the stones.

 

The Surgery: One of the Largest Stone Extractions I’ve Ever Done

After injecting local anesthesia, I made a tiny incision on the inside of the lower eyelid. What happened next is unforgettable:

I removed four large stones — perhaps most I’ve ever taken out of one patient in 25 years and hundreds of similar cases. This was nearly a world record.

The entire procedure took under two minutes. The patient experienced no pain, mild bruising, and started steroid-antibiotic drops afterward. Her symptoms were nearly gone within two days — and she was thrilled.

 

Why This Matters

Most styes are not difficult to diagnose. But if a bump:

• Doesn’t respond to treatment
• Causes mucus discharge
• Sits very close to the nose
• Or reveals a yellow-white hue inside the eyelid

…it could be something more — like canaliculitis.

 

Don’t Guess. Get it Checked.

If you’ve had a stye for more than a few weeks, or one that just doesn’t behave like the others — see an eye care specialist.

And if you’re dealing with recurring styes or inflammation, try our StyeRx Drops and Eyelid Cleanser — made by a doctor who’s treated more styes than anyone in the U.S.