The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has demonstrated its ability to impact multiple body systems, leading many to question if common ailments might also be a consequence of infection. A specific inquiry has arisen: can a COVID-19 infection lead directly to the development of a stye? Examining the distinct biological causes of a stye and how the virus interacts with the eye provides the answer.
Understanding Styes and Their Typical Causes
A stye, medically known as a hordeolum, is a painful, localized infection appearing as a red bump on the eyelid margin. These lesions are acute bacterial infections of the eyelid’s oil glands or eyelash follicles, not viral. The infection occurs when small oil glands, such as the sebaceous glands of Zeis or the deeper Meibomian glands, become obstructed.
The primary culprit is the bacterium Staphylococcus aureus (S. aureus), commonly found on human skin and in the nose. When a gland is blocked, the trapped oil and cellular debris allow S. aureus to multiply, resulting in the pus-filled inflammation characteristic of a stye. Styes are fundamentally a problem of bacterial overgrowth following glandular blockage.
How COVID-19 Affects the Eyes
The SARS-CoV-2 virus enters human cells by binding to the angiotensin-converting enzyme 2 (ACE2) receptor. This receptor is found in various ocular tissues, including the conjunctiva, limbus, and cornea, establishing a pathway for the virus to interact with the eye. Ocular manifestations of a direct viral infection are generally inflammatory and distinct from a stye.
The most common eye issue reported with COVID-19 is viral conjunctivitis, or “pink eye,” which presents as redness, tearing, and irritation. Other complications include dry eye syndrome, photophobia, and in rare cases, vascular issues in the retina due to systemic inflammation. These conditions reflect the body’s inflammatory response or direct viral presence, but they do not involve the localized bacterial abscess seen in a hordeolum.
The Scientific Verdict Linking COVID-19 to Styes
There is no scientific evidence suggesting that SARS-CoV-2 directly causes the specific bacterial infection required to form a stye. The virus does not initiate the Staphylococcus aureus overgrowth that creates the hallmark pustule of a hordeolum. If a stye occurs during or shortly after a COVID-19 infection, it is considered a secondary event, likely triggered by indirect factors related to the illness and the pandemic environment.
Ophthalmologists observed a perceived increase in styes and chalazia—a related non-infectious lump—during the pandemic. One indirect link involves the disruption of the immune system and increased systemic inflammation caused by the viral illness. Stress on the immune system can affect the skin’s local microbiome and oil gland function, making the eyelid more vulnerable to opportunistic bacterial colonization by S. aureus.
Behavioral changes also contributed to the perceived increase in styes. Increased face-touching, often subconsciously to adjust masks or rub irritated eyes, can transfer bacteria from the hands or mask area directly to the eyelid. Mask-wearing itself can direct warm, humid air upward, potentially increasing the bacterial load and affecting the eyelid margin. While the virus does not directly cause the stye, the overall physiological and environmental stress can predispose an individual to this secondary bacterial infection.
Managing and Preventing Styes
Management of a stye focuses on encouraging drainage and reducing inflammation. The most effective at-home treatment involves applying a clean, warm compress to the affected eyelid for 5 to 10 minutes, multiple times a day. The consistent heat helps liquefy the hardened oil and debris within the blocked gland, promoting natural drainage of the bacterial abscess.
Prevention relies on maintaining good eyelid and hand hygiene to minimize bacterial transfer. This includes frequent hand washing, especially before touching the face or eyes, and avoiding eye rubbing. Cleaning the eyelid margins gently with specialized cleansers or diluted baby shampoo helps control the bacterial population and prevent gland blockage. If a stye does not resolve within a week, if swelling spreads rapidly, or if it affects vision, consult a healthcare provider for professional evaluation.