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A cyst in the eyelid due to a blocked oil gland.
Typically occur in the middle of the eyelid, are red, and non painful.
They tend to come on gradually over a few weeks.
May occur following a stye or from hardened oils blocking the gland.
The blocked oil gland is usually the meibomian gland but can also be the gland of Zeis.
Styes are usually more sudden in onset, painful, and occur at the edge of the eyelid. and are typically painful.
Treatment is initially with warm compresses.
Of warm compresses are not effective injecting steroids into the lesion may be helpful.
Hypopigmentation complication may occur with corticosteroid injection.
With a large lesion, incision and drainage may be recommended.
As a last resort, surgery is performed as an incision is made on the inside of the eyelid, and the chalazion is drained.
Surgery is performed on as few as 5% of all chalazia patients.
Findings:
Painless swelling on the eyelid
Eyelid tenderness typically none to mild
Increased tearing
Heaviness of the eyelid
Redness of conjunctiva
A large lesion can cause astigmatism due to pressure on the cornea.
Laser eye surgery can predispose patients to deformation of the cornea from small chalazia.
Recurring chalazia in the same area may rarely indicate the presence of a sebaceous cell carcinoma.
It can sometimes be mistaken for a stye.
Differential diagnosis includes:
Sebaceous gland adenoma
Sebaceous gland carcinoma
Sarcoid granuloma
Foreign body granuloma
Treatment:
Topical antibiotic eye drops or ointment are sometimes used for the initial acute infection, but is of little value.
If left alone it will usually disappear without further treatment within a few months.
All lesions will reabsorb within two years.
Healing of a chalazion can be facilitated by applying warm compresses to the affected eye, promoting drainage and healing by softening the hardened oil that is occluding the duct.
If persistent smaller lesions may be injected with a corticosteroid, or larger ones may be surgically removed using local anesthesia.
Chalazion excision is an outpatient process taking about 15 minutes.
It is done in adults with local anesthesia.
If it recurs, biopsy should be done to rule out the possibility of a tumor.
Relatively small lesions are removed through a cut at the back of the eyelid.
Larger lesions are removed through an incision in front of the eyelid.
Chalazion surgery a safe procedure with few complications: infection, bleeding, or the recurrence of the chalazion.