A chalazion is a blocked oil gland that appears on the inside of the eyelid, usually surfacing as a bump. An eye stye (or hordeolum) is a smaller pimple-like bump that appears on the upper or lower eyelid due to a blocked oil gland. It is typically near the eyelash and lives on the outside of the eyelid.
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.
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.
Before treatment can begin, our doctors will need to confirm that the lesion is truly a chalazion and not another type of skin lesion. In general, there are several treatments available. A common home remedy is to place warm compresses over the affected area multiple times a day. This method can help melt the thickened oil gland secretions and can free the affected area, allowing it to function normally again. Our doctors will sometimes prescribe an antibiotic to the patient in order to combat the main infection. Oftentimes, these conservative treatment methods alone will allow the eyelid to heal, and no further treatment will be required.
After a few weeks, if the bump does not recede or if it continues to grow, either a steroid injection or chalazion surgery may be an option. A steroid injection can be placed into the chalazion, thereby decreasing the inflammation and leading to likely regression of the chalazion. This can generally be performed in the office.
Depending on the size and location of the lesion, another option to treat a chalazion would be to perform an incision and drainage procedure. If the affected area of the eye consists mostly of fluid, the bump can be punctured and then removed with pressure on the surrounding area. If the affected area is more solid, an eyelid incision will be required and the sebaceous debris can be removed through the small incision. The surgery normally requires an incision from underneath the eyelid.
Recovery time from chalazion surgery is quick for most people. Some patients report minor discomfort or pain around the eyelid margin after the procedure, but this is typically remedied easily with medication. In most cases, an eye patch is worn over the eye for a few hours after the procedure in order to apply pressure to the surgical site to help prevent drainage from the affected area.
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.