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by Milan Eye Center


What is a chalazion?

The eyelid glands, known as meibomian glands, normally produce an oily substance that contributes to the natural tears on our eyes. If one of these glands becomes blocked, it may develop into a chalazion or a stye (i.e. hordeolum).  A chalazion is a large, non-infectious cyst in the eyelid that often takes several weeks to develop.  A chalazion is not painful and usually occurs on the upper eyelid. This is likely because the upper eyelids anatomically have more glands (about 50 versus only 25 glands in the lower lid). Symptoms may include: eyelid drooping (ptosis), redness, and on rare occasion lid swelling. Interestingly enough, the term chalazion comes from the Greek word “khalazion” which means “small hailstone.”

What causes a chalazion?

A chalazion can be caused by either inflammation of the meibomian glands or it can start as a hordeolum. A hordeolum, also known as a stye, is often more acute and can be secondary to a bacterial infection of the eyelid glands. A hordeolum is smaller, more painful, and more tender to the touch than a chalazion. If a hordeolum is present for several weeks, it may develop into a chalazion.

Some individuals are more prone to developing a hordeolum or chalazion than others. Common risk factors include: acne rosacea, chronic inflammation of the eyelids, poor eyelid hygiene, and meibomian gland dysfunction.

How is it treated? 

The typical treatment regimen for a chalazion includes hot compresses with digital massage several times per day for approximately 2-4 weeks. This softens the oils and inflammatory cells, blocking the eyelid gland and helps the mass drain. Contrary to popular belief, topical antibiotics are not effective since a chalazion is not due to an infection. If a chalazion does not resolve within approximately one month with hot compresses, then other forms of intervention are usually necessary. Typically, either a steroid injection or surgical incision and curettage is used to remove the cyst. If surgical removal is deemed necessary, it is performed as an outpatient procedure with local/topical anesthetic.

If a patient has a recurrent chalazion or hordeolum, an extended course of low-dose antibiotic, typically a drug called doxycycline, may be prescribed to reduce chronic inflammation in the eyelids.

Why do I need to make an appointment if I notice a new growth on my eyelid?

Differential diagnoses for a chalazion include much more ominous conditions such as: sebaceous cell carcinoma, basal cell carcinoma, and squamous cell carcinoma. Sebaceous cell carcinoma is rare but highly malignant and can be lethal if left untreated. It is typically yellow in appearance but may also look eerily similar to a chalazion or hordeolum. Basal cell carcinoma (BCC) is the most common form of eyelid cancer which typically begins as a red bump on the lower lid. Squamous cell carcinoma (SCC) is uncommon but can be deadly. SCC can present as a red, patchy lesion that may even bleed intermittently. These lesions must be biopsied in a timely manner to rule out malignancy and be treated accordingly.

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