chalazion

Chalazion
Classification and external resources
Eyelid affected by Chalazion
ICD-10	H00.1
ICD-9	373.2
DiseasesDB	6009
MedlinePlus	001006
eMedicine	emerg/94 oph/243
MeSH	D017043

A chalazion pronounced /kəˈleɪziən/ (plural chalazia /kəˈleɪziə/), also known as a meibomian gland lipogranuloma, is a cyst in the eyelid that is caused by inflammation of a blocked meibomian gland, usually on the upper eyelid. Chalazions differ from styes (hordeolums) in that they are more painful than styes, as well as bigger in size. A chalazion or meibomian cyst could take months to fully heal with treatment and could take years to heal without any.

Signs and symptoms

• Swelling on the eyelid
• Eyelid tenderness
• Sensitivity to light
• Increased tearing
• Heaviness of the eyelid

A chalazion or meibomian cyst can sometimes be mistaken for a sty. If you have constant styes that are becoming more frequent and painful then it is possible that you have a chalazion and it is recommended that you visit your doctor. A cause for this is not removing eye makeup, the oil from the makeup gathers in the glands and causes a cyst.

Treatment

A large chalazion ca. 20 minutes upon excision. This bipartite chalazion was removed via two separate incisions. Further along the lower eyelid, signs of chronic inflammation (Blepharitis) are visible.

Topical antibiotic eye drops or ointment (e.g. 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 lesions may be injected with a corticosteroid or larger ones may be surgically removed using local anesthesia.^[2][3] This is usually done from underneath the eyelid to avoid a scar on the skin. If the chalazion is located directly under the eyelid's outer tissue, however, an excision from above may be more advisable so as not to inflict any unnecessary damage on the lid itself. Eyelid epidermis usually mends well, without leaving any visible traces of cicatrisation.^[4] Depending on the chalazion's texture, the excision procedure varies: while fluid matter can easily be removed under minimal invasivion, by merely puncturing the chalazion and exerting pressure upon the surrounding tissue, hardened matter usually necessitates a larger incision, through which it can be scraped out. Any residual matter should be metabolized in the course of the subsequent healing process, generally aided by regular appliance of dry heat. The excision of larger chalazia may result in visible hematoma around the lid, which will wear off within three or four days, whereas the swelling may persist for longer. Chalazion excision is an ambulant treatment and normally does not take longer than fifteen minutes. Nevertheless, owing to the risks of infection and severe damage to the eyelid, such procedures should only be performed by a doctor.

A home remedy is to have a hot, wet flannel, and rub gently, until the heat has reached the cyst. this helps to reduce the size, and eventually it will be rid of. It is rare that a chalazion will recur and they will usually be biopsied to rule out the possibility of a tumour.

Complications

A large chalazion can cause astigmatism due to pressure on the cornea.

As laser eye surgery involves shaping the cornea by burning parts of it away, weakening its structure, post operation patients can be left predisposed to deformation of the cornea from small chalazions.

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

Recurring chalazia in the same area may sometimes be a symptom of sebaceous cell carcinoma, albeit rarely. This is a type of cancer.

Sometimes, as a last resort, surgery is performed. The eyelid is injected with a local anesthetic, a clamp is put on the eyelid, then the eyelid is turned over, an incision is made on the inside of the eyelid, and the chalazion is drained and scraped out. A scar on the upper lid can cause discomfort as some patients feel the scar as they blink. Of course as surgeries are intrusive and damage healthy tissue (e.g. leaving behind scar tissue or possibly even causing blepharitis), given other options, less intrusive treatment is always preferable. Similarly, chalazions may recur once the eye is predisposed and surgical intervention each time is not possible. So surgery should be considered only as a last resort, performed on as few as 5% of all chalazia patients.

See also

• Blepharitis
• Stye

References

• J.B. Lippincott, ed (1994). The Wills Eye Manual: Office and Emergency Room Diagnosis and Treatment of Ocular Disease. 

1. ^ Chalazion 2080768019 at GPnotebook
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. doi:10.1136/bjo.84.7.782. 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. ^ Gerstenkorn/Hagelkorn

External links

• William Charles Caccamise Sr. "A cache of photographs of various stages of the chalazion". EyeRounds.org. http://webeye.ophth.uiowa.edu/eyeforum/atlassearch1.htm?appSession=53915620846591.