The definition of a chalazion is a lump in the upper or lower eyelid that is caused by obstruction of the drainage duct of an oil gland within the eyelid.
Each of the meibomian oil glands produces oil that flows out of the gland onto the eye's surface. There are about 40-50 meibomian glands within the upper lid and about 25 within the lower lid. They are actually located within the tarsal plate, which is a firm tissue located under the skin of the lids. The oil exits from each gland through a tiny circular opening just behind the eyelashes of the upper and lower lids of both eyes. A chalazion is caused by the oil in the gland becoming too thick to flow out of the gland or the opening of the gland being obstructed. Without anywhere to go, the oil builds up inside of the eyelid gland and forms a type of meibomian cyst. The trapped oily material can have the texture of solid butter or even hardened wax. The gland wall may leak, releasing the oil into the tissue of the eyelid, causing inflammation and sometimes scar tissue. Alternative names for a chalazion include conjunctival granuloma, internal hordeolum, conjunctival lipogranuloma, or meibomian gland lipogranuloma.
A stye is also a lump or cyst in the eyelid caused by obstruction of an eyelid gland. A stye, or hordeolum, is a plugged oil or sweat gland in the skin of the eyelid and usually resolves much more quickly than a chalazion. Like a chalazion, a stye may start out as an inflammation but can become infected as well.
Risk factors for a chalazion include
Call a primary care doctor or an ophthalmologist (a medical doctor who specializes in the diagnosis and medical and surgical treatment of eye disease) for an appointment if eyelid redness or swelling does not improve with warm compresses. Medicine will be needed if there are signs of infection.
Contact an eye doctor immediately if experiencing any of the following signs of serious infection:
In very rare cases, a longstanding chalazion may show additional signs (such as irregular skin, loss of lashes, abnormal blood vessels) that could indicate a form of cancer in the eyelid. Be sure to notify your doctor if you have these uncommon but serious signs.
A health care provider will take a detailed patient health history and perform a physical examination. The medical examination includes vision testing of each eye and an inspection of the face, eyelids, and the eye itself. If you have frequent chalazion infections, your health care provider might perform a more thorough examination and order blood tests (to check for chronic illnesses such as diabetes).
The initial treatment is warm compresses and treatment of any chronic inflammation from meibomian gland dysfunction or blepharitis. You'll be instructed to apply warm compresses as mentioned above (see Home Remedies). This is the safest way to treat the chalazion without forming scar tissue, which could make the gland vulnerable to future clogging.
A health care provider will prescribe antibiotic eyedrops or ointments if a bacterial eye infection is present. If there is no improvement after several days or weeks of warm compresses, more aggressive treatment may be offered.
Injection of a steroid into the chalazion may help decrease the inflammation and speed its resolution. You'll still need to continue frequent warm compresses following the steroid injection. There are some risks with steroid injection, such as bruising or permanent discoloration of the skin overlying the injection site. The chalazion can also be debulked surgically by incision and drainage. This is usually reserved as a last resort. The ophthalmologist will inject a numbing medication and secure a small clamp on the lid. The eyelid is then everted, and an incision in made on the back side of the lid. The oily contents of the gland are then removed with a curette instrument. Surgery recovery is usually quick but warm compresses should be continued for a few more days to soften any residual trapped oil.
Patients who develop multiple chalazia or recurrent chalazia may have an underlying abnormality in the oil glands, such as meibomian gland dysfunction (MGD) or blepharitis. Your eye doctor can make that diagnosis with a slit lamp examination. . MGD is often associated with acne rosacea of the face. Treatment involves daily warm compresses, baby shampoo lid scrubs, and possible use of long-term low-dose oral antibiotics in the tetracycline family like doxycycline or minocycline to alter the consistency of the oils produced by the glands. Children and women who are pregnant or breastfeeding cannot safely use oral tetracyclines.
If your doctor finds signs of preseptal cellulitis (infection spreading from the chalazion to the surrounding skin), an oral antibiotic will be prescribed. If the infection spreads posteriorly into the orbit, urgent treatment with intravenous antibiotics and possible hospitalization will be necessary.
Typically, a chalazion heals within a few weeks, but in some cases, it resolves slowly over months. If no infection or scarring develop, there are no long-term health consequences and it is unlikely to recur. However, in patients with untreated meibomian gland dysfunction or chronic blepharitis, another chalazion may develop later in any of the eyelids.
Preventive measures against the development of a chalazion include ensuring that the lid margins are clean and that oil gland flow remains unobstructed. Treatment of underlying MGD and blepharitis are the best defenses against recurrence.
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A sty or a chalazion causes eye pain because of local irritation. Either of these conditions cause a lump you can see or feel within the eyelid. The lump is a result of a blocked oil gland within the eyelid. This lump causes irritation to the eye, can be very painful to the touch, and can occur in both children and adults.
