Chalazion

Summary

A chalazion is a small, firm swelling usually near the edge of the eyelid. It is not usually painful (unless it swells suddenly) and often disappears on its own.

Causes

Chalazia are due to a blockage in an oil-producing Meibomian gland of the eyelid. The upper eyelid is more commonly affected.

It is a chronic inflammatory condition found frequently in patients with acne rosacea, and those with inflammation/infection of the eyelid rim. Chalazia occasionally become infected as well.

Symptoms

Symptoms include:

• Initial painful swelling - pain soon subsides or a painless swelling (no pain at any stage)
• Tender spot on the eyelid, usually the upper lid, and usually near the rim
• Increased tear production due to irritation
• In severe cases there may be increased sensitivity to light
• Large chalazia can press on the cornea, causing some astigmatism

Diagnosis

The diagnosis is purely clinical and no special tests are required.

Treatment

Most chalazia heal spontaneously, without special treatment.

Regular warm compresses to the eye are advised to soften any thickened oils, which may be blocking the duct.

A persistent or enlarging chalazion may need surgical drainage; this is a minor procedure often needing only anaesthetic drops to the eyelid to allow the doctor to scrape out the thickened oils. Because this is done from inside the lid, no scar is visible. After this minor surgery, antibiotic eye drops are used to prevent infection.

Recurrent chalazia should be biopsied to exclude possible basal cell or other carcinoma (cancer).

Prevention

Patients at increased risk of chalazia - those with previous chalazia, acne rosacea or recurrent blepharitis (eyelid inflammation/infection) are advised to regularly clean their eyelid rims with warm water, to which is added a few drops of no-tear baby shampoo. If this does not help, you should see an ophthalmologist who may prescribe ointment for the lids or oral antibiotics.

Reviewed by Dr Clive Novis, Ophthalmologist, November 2010