All About Chalazion

A chalazion, also known as a meibomian gland lipogranuloma, is a cyst in the eyelid that is caused by inflammation of the meibomian gland, usually on the upper eyelid. Chalazions differ from styes (hordeolums) in that they are usually painless apart from the tenderness caused when they swell up. A chalazion may eventually disappear on its own after a few months, though more often than not, some treatment is necessary.

Signs and symptoms

* Swelling on the eyelid
* Eyelid tenderness
* Sensitivity to light
* Increased tearing

Treatment

The primary treatment is application of warm compresses for 10 - 20 minutes at least 4 times a day. This may soften the hardened oils blocking the duct and promote drainage and healing.

Topical antibiotic eye drops or ointment (eg chloramphenicol or fusidic acid) are sometimes used for the initial acute infection, but are otherwise of little value in treating a chalazion. Chalazia will often disappear without further treatment within a few months and virtually all will resorb within two years.[1]

If they continue to enlarge or fail to settle within a few months, then smaller lessions may be injected with a corticosteroid or larger one may be surgically removed using local anesthesia.[2][3] This is usually done from underneath the eyelid to avoid a scar on the skin. Rarely chalazia may reoccur and these will be biopsied to help rule out tumors.

Complications

A large chalazion can cause astigmatism due to pressure on the cornea. This will resolve with resolution of the chalazion.

Complications including, but not limited to hypopigmentation may occur with corticosteroid injection.

The presence of recurring chalazion in the same area should lead to a consideration of sebaceous cell carcinoma.

Prevention

Proper cleansing of the eyelid may prevent recurrences in people prone to chalazia. Cleaning the eyelash area with diluted baby shampoo will help reduce clogging of the ducts.[4]

References

* (1994) in J.B. Lippincott: The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Eye Disease.

Footnotes

1. ^ Chalazion GPnotebook 2080768019
2. ^ Khurana A, Ahluwalia B, Rajan C (1988). "Chalazion therapy. Intralesional steroids versus incision and curettage". Acta Ophthalmol (Copenh) 66 (3): 352-4. PMID 10994460.
3. ^ Jackson T, Beun L (2000). "A prospective study of cost, patient satisfaction, and outcome of treatment of chalazion by medical and nursing staff". Br J Ophthalmol 84 (7): 782-5. PMID 10873994. - in which of those cases attending a District General Hospital, approximately one third of selected chalazia resolved within 3 months with conservative treatment, and surgical treatment was successful for 72%.
4. ^ (UK) Moorfields Eye Hospital. Blepharitis - Lid Hygiene Advice For Patients (DOC). - Patient information leaflet