What is a Chalazion?
A chalazion is a lump in the eyelid caused by blockage of Meibomian glands (the oil glands within the eyelid). It is usually caused by underlying blepharitis – a condition in which the eyelids, including the oil glands within the lids, are chronically inflamed.
A chalazion is a small, firm bulge in the eyelid, caused by a blockage or infection in the duct responsible for lubricating the eye. The initial symptoms of a chalazion are eyelid tenderness, swelling and increased tearing.
Usually a chalazion will shrink within a few weeks. When the area fails to heal on its own the primary treatment is a warm compress on the eyelid. This treatment gradually clears the ducts and promotes drainage. In rare cases a chalazion may grow large enough to apply pressure on the eye causing droopiness of the eyelid and blurred vision. If the affected area stays the same or grows worse a doctor’s exam maybe required.
Once a doctor has examined the area several treatment options are available. Steroid injections may be used to shrink the chalazion or the area may be drained. Draining the chalazion is done using local anesthesia and is generally quick and painless.
An incision is usually made on the inside of the eyelid, so no visible scar remains. The area is drained of excess fluid which greatly reduces the appearance of the bulge and provides the patient with immediate relief. For patients with a recurrent chalazion cleaning the area with non-abrasive shampoo can help reduce blockage or infection.
In the first instance, treatment comprises of hot compresses (to try to soften and melt the retained oily substance within the cyst) followed by massage to try to express the retained oil. Short courses of antibiotic and steroid ointments are sometimes prescribed.
It is important in the longer term to perform regular lid hygiene for the blepharitis in order to prevent future recurrences. Patients with severe blepharitis or frequent recurrent chalazia are sometimes prescribed an antibiotic for six to twelve weeks, which is thought to modify the oil gland secretions in the lids and reduce the growth of bacteria in the lids.
Most chalazia resolve with these simple measures within six months; however in cases of persistent, large or troublesome chalazia, surgery is recommended.
The surgery is usually performed under local anaesthetic, except in young children. The cyst is drained via a small incision on the underside of the lid thereby avoiding a scar. Stitches are not required. Antibiotic ointment is instilled and a firm eye pad is placed over the eye. The pad can be removed after a couple of hours or left overnight. The lid is normally bruised and swollen after the procedure and this usually settles within two weeks. Antibiotic drops and/or ointment are usually prescribed for the first week to prevent infection.
Bleeding, bruising and swelling are common yet temporary after surgery. Infections are very rare as is any recurrence or incomplete drainage. More commonly, patients who have developed one chalazion are prone to developing other chalazia, particularly if the underlying blepharitis is not controlled.
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