Chalazion

What is a chalazion?

A chalazion, or meibomian cyst, is a harmless cyst that can develop on the upper or lower eyelid. It is the most common cause of ‘eyelid lump’ and is the result of a blocked oil-producing gland in the eyelid, which is usually responsible for making up the oil layer of the tear film.

It is benign, meaning that it is not cancerous and may vary in size and even grow. It can be unsightly and uncomfortable, may press on the eye and exacerbate astigmatism. They can also occur in children for similar reasons and with similar symptoms.

What causes a chalazion?

The upper and lower eyelids each contain around 20-30 meibomian glands which secrete oils into the surface of the eye to create a stable tear film. When these glands become blocked due to certain conditions such as blepharitis, seborrheic dermatitis or rosacea, a chalazion may develop.

Are there any complications associated with having a chalazion?

Chalazion are unsightly but generally not dangerous. They can occasionally become infected and cause a preseptal cellulitis which is an infection of the skin around the chalazion. If they become large, they can press on the eye and cause astigmatism, which can worsen vision.

How does a chalazion present?

A chalazion is typically presents as a firm, red but painless swelling in the eyelid that develops over several weeks. Often, there may be more than one chalazion concentrated in the infected area.

Can you prevent a chalazion from developing?

Although a chalazion is not associated with poor hygiene, you should clean your hands before touching the eye or eyelids and it does help to wash your face daily with a cotton pad and baby shampoo or blepharitis cleaning solution such as Blephaclean or Blephasol. It is helpful to treat associated medical conditions such as rosacea or seborrhoeic dermatitis. There is some evidence that flax seed oil or omega 3 supplementation can help to prevent chalazion by reducing the viscosity of the oil secretions from the eyelid oil glands (meibomian glands).

What treatments are available for chalazion?

In most cases, a chalazion will resolve over time with the help of some home remedies, although this could take several weeks if not months. Treatment for chalazion include:

Warm Compress - You can start treating a chalazion during its initial phase with a warm compress, such as a clean washcloth soaked and wrung in hot water. Gently hold the warm compress over the chalazion for 5 to 10 minutes up to six times a day. This will help liquify the hardened oil, and stimulate the blocked oil gland to drain itself naturally. Remember to keep the washcloth for your own personal use, so as to avoid contaminating others. Heated eye masks which can be bought over the counter are also highly effective, as these tend to retain heat for longer periods of time.

Eye Massage – After your warm compress treatment, a gentle eye massage will further promote drainage of the meibomian glands. Make sure to wash your hands before applying pressure to the chalazion, and do not attempt to squeeze or pop it, as this will lead to tissue damage and further inflammation.

Chalazion Surgery - This is a simple procedure which is performed under local anaesthetic to numb the eyelid. A small incision is made on the inside of the eyelid to allow the contents of the eye cyst to drain. This is effective in approximately 70% of patients. In certain patients, the cyst no longer contains liquid contents but is formed of inflammatory granulation tissue which do not respond well to surgery.

Steroid Injection - Steroids may be injected into the cyst to treat the inflammatory granulation tissue. Your ophthalmologist will advise the best eyelid cyst treatment for you.

One-stop chalazion treatment

Chalazion treatment is performed under local anaesthetic in a minor op setting. It can be performed at the initial visit, where assessment and treatment can be performed on the same day. Please do ask and this will help resolve the issue promptly and get you back to your normal self with minimal delay.

What is the recovery like after chalazion treatment?

You will have an eye pad placed over your eye after treatment and be prescribed an antibiotic  ointment to use twice daily for a week. The pad ideally will be kept on until the following morning, and when removed, the eye will be puffy and possibly a little bruised. This settles over the next few days. The majority of chalazia settle with one treatment but occasionally a further procedure is required.