Introduction
What is a chalazion?
A chalazion is a commonly localized swelling of the eyelid or eyelid margins. It is also called a meibomian gland cyst. A Chalazion is a sterile chronic granulomatous inflammation of the meibomian glands or gland of Zeiss. In this condition the ducts of meibomian glands are blocked by any foreign substance, leading to the accumulation of sebaceous gland secretions. The article will discuss the causes, symptoms, histopathology, diagnosis, treatment options how to get rid of a chalazion, and prevention of chalazion in detail.
Chalazion Causes
What are the causes of a chalazion?
The meibomian gland plays an important role in the production of lipids or oils. It makes up the outermost layer of the tear film called as lipid layer; it helps in preventing the evaporation of tear film and plays an important role in causing dry eyes. Any condition causing the blockage of ducts of the meibomian gland causes the accumulation of lipids and debris and the development of chalazion. The accumulated material may be invaded by organisms and leading to chalazion and formation of a bump. Certain other conditions associated with the development of chalazion include
- Poor eyelid hygiene
- Inflammatory conditions such as chronic blepharitis
- Seborrheic dermatitis (red and dry flaky lids)
- Tuberculosis
- Acne rosacea
- Hormonal changes
- Viral infection
Chalazion Symptoms
What are the symptoms of a chalazion?
The most common symptoms of a chalazion are the presence of a bump on the eyelid. Other symptoms include
- Gradually enlarging painless swelling on the lid surface
- Redness or swelling
- Blurred vision if the chalazion is large and pushing the eyelid downward
- Discharge from the affected eye
- Itching or burning sensation
- Symptoms of associated conditions for example watering, dry flaky lid margins
Histopathology
The histopathology of chalazion shows a lipo granulomatous chronic inflammation with extracellular fat deposition surrounded by lipid-laden epithelioid cells, multinucleated giant cells, and lymphocytes.
Diagnosis
How is chalazion diagnosed by a health professional
An opinion should be taken from an ophthalmologist when swelling is observed on the eyelid. The steps of eyelid swelling diagnosis include.
History taking: Detailed history is taken about the recurrence or associated conditions like acne rosace, and seborrheic dermatitis. Questions are asked about how the patient keeps his hygiene and uses his contact lenses.
Slit lamp examination: The doctor will also perform a detailed examination of the eyelid margins, tear film, and underlying conjunctiva. The ducts of meibomian glands will be observed under a slit lamp. The associated pain and location will be assessed to exclude any other cause.
Some health professionals may perform a biopsy of the lump in recurrent cases to exclude any underlying malignancy or bacterial infection.
Management and Treatment
Chalazion Treatment
- Conservative treatment: The majority of the cases of chalazion will disappear on their own and will need no treatment. However early treatment may be led to better patient satisfaction.
- Warm compresses: Applying a warm compress for 10 to 15 minutes at least four times a day to the affected eye can help reduce inflammation and increase blood flow to the area in the early stages. The compresses are applied in the directs of the opening of ducts.
- Oral antibiotics: Oral antibiotics are advised to resolve the associated bacterial infection, acne rosacea, seborrheic dermatitis, and inflammation.
- Steroid injection: A local injection of steroids is one of the non-invasive procedures for the treatment of chalazion. It is a favorable procedure for lesions near intricate structures such as the margin of the eyelid and lacrimal gland system. The success rate of steroid injection is comparable to surgery.
- Expression and Surgery: In rare cases, surgery may be necessary to remove the chalazion.
- Prophylaxis: Proper hygiene should be maintained to avoid recurrent cases. Other treatment option includes the use of oral tetracycline for a prolonged period.
How to get rid of a chalazion on your bottom eyelid?
The treatment of upper and lower lid margins same. The therapies applied for the upper lid can be applied for the lower lid which includes warm compresses and gentle massage.
How to get rid of a chalazion on your top eyelid?
The treatment options for upper and lower lids are the same.
Complications of Chalazion
- Although chalazion is a benign condition and goes away on its own, however, if the chalazion gets infected with bacteria, it can lead to localized painful conditions and cellulitis.
- It is also postulated that chalazion occurring repeatedly in a specific area may be the hallmark of underlying cancer.
- If the chalazion is located near the nasolacrimal duct system, it can cause a blockage of the duct, leading to excessive watering and eye irritation.
Prevention of Chalazion:
- Practice good eyelid hygiene: Wash your eyelids regularly with a gentle cleanser.
- Remove makeup before bedtime: Sleeping with makeup on can clog your oil glands. You should thoroughly wash your face and clean all the makeup material before going to bed.
- Avoid touching your eyes: repeatedly touching your eyes with dirty hands can lead to infection and inflammation.
- Systemic tetracycline: It should be used for a long duration in a person with recurrent chalazion or associated acne rosacea.
chalazion surgery
What are the steps of chalazion surgery?
- Local anesthesia is given on the eyelid skin surrounding the chalazion.
- After adequate anesthesia, a specialized clamp for chalazion is applied and the eyelid is everted.
- A vertical scion is made in the center of the clamp, and curettage of the lesion is made.
- The clamp is removed and topical antibiotics and ointments are applied.
- A suture is not applied in chalazion surgery.
- Topical antibiotics are used for around 1 week.
chalazion treatment without surgery
Home Remedies for Chalazion:
In addition to medical treatment, there are several home remedies that can help alleviate the symptoms of chalazion. Warm compresses can be applied to the affected eye several times a day for 5-10 minutes at a time. This can help to reduce inflammation and softening of the material inside that encourages the chalazion to drain. Pain relievers such as ibuprofen or acetaminophen can also be used to alleviate pain and swelling. It is important to avoid squeezing or popping the chalazion as this can lead to infection.
Prognosis
The prognosis of chalazion is good. Once removed successfully there are lesser chances of recurrence. The majority of the chalazion will disappear on its own without causing any complications. However immediate health care opinion should be taken if the chalazion is associated with pain or takes longer duration to resolve.
Children, less than 8 years with mechanical elements / causing the dropping of the eyelid should be assessed and treated well on time to avoid amblyopia.
How long will I have a chalazion?
The duration of a chalazion can vary from person to person, and it may take a few weeks or several months for the lump to fully resolve. In most cases, a chalazion will go away on its own without treatment, although there are some cases where medical intervention may be necessary.
Size: The size of the chalazion can be a factor in how long it takes to heal. A smaller chalazion may resolve more quickly, while larger ones may take longer to heal.
Location: The location of the chalazion on the eyelid can affect healing time. Chalazion on the lower eyelid may take longer to heal compared to those on the upper eyelid.
It is important to note that some chalazion may not fully go away on their own and can cause recurring episodes. In these cases, medical treatment may be necessary to prevent future chalazion formation.
Conclusion:
A chalazion is a common condition that can be easily treated with warm compresses, medication, or surgery. It is important to practice good eyelid hygiene and avoid touching your eyes to prevent chalazion. Any lump observed on the lids should be immediately brought to the notice of the health professional.
FAQ’s
Is a chalazion a stye?
chalazion is a painless condition however it can be confused with stye when associated with pain. Stye or external hordeolum is the inflammation of the hair follicle or gland of Zeiss. It is a painful condition and treated with oral and topical antibiotics.
How long does it take for a chalazion to go away?
The duration of chalazion depends on person to person. However early treatment may lead to early satisfaction of the patient.
Why is my chalazion not going away?
Some patients may be resistant to local therapies and oral antibiotics. The larger the size the longer duration it will take to resolve.
Will my chalazion ever go away?
Yes, the prognosis of chalazion is good. Once removed successfully, there are very less chances of recurrence.
Does massaging a chalazion help?
Massage or warm compresses is one of the early conservative treatment options of chalazion. The pressure causes hydrostatic pressure and expression of the lipid and debris via the ducts.
How serious is a chalazion?
Chalazion is a benign condition and associated other diseases e.g., dermatitis, blepharitis and poor hygiene. However, it can have a serious complication if the chalazion once removed is occurring again and again. The health care provider will perform biopsy to exclude underlying malignancy.
Will I get more chalazion?
If proper hygiene is followed and the cause of chalazion like blepharitis, dermatitis and other conditions are well controlled, then there are rare chances of recurrence.
What is the easiest way to get rid of a chalazion?
The home remedies or the conservative treatments includes warm compresses and gentle massage in the direction of ducts. However, those lesions resistant to these therapies should be treated by the health professional.
References:
- American Academy of Ophthalmology. (2021). Chalazion and Stye Treatment. https://www.aao.org/eye-health/diseases/chalazion-treatment
- Cleveland Clinic. (2020). Chalazion. https://my.clevelandclinic.org/health/diseases/12276-chalazion
- Mayo Clinic. (2021). Chalazion. https://www.mayoclinic.org/diseases-conditions/chalazion/symptoms-causes/syc-20354487
- National Eye Institute. (2021). Facts About the Cornea and Corneal Disease. https://www.nei.nih.gov/learn-about-eye-health/eye-conditions-and-diseases/corneal-disease
- The British Association of Dermatologists. (2021). Rosacea. https://www.bad.org.uk/shared/get-file.ashx?id=157&itemtype=document
